Staff Report

As the state of Texas faces a huge budget crisis and the people of Texas face a huge health crisis, the Texas Public Health Coalition (TPHC) this week offered solutions for both.

The public health advocates encouraged state senators and representatives to support public health initiatives now for the future health of Texans and the state budget. Solid science has shown that cutting budgets for tobacco-control and obesity-reduction programs has a negative impact on both the physical and the fiscal health of the state.

The Public Health Coalition is a collection of more than 26 Texas health care organizations committed to advancing core public health principles in the state and local communities.

“We hope our legislators will make healthy choices now that can both help them balance the budget and help Texans live longer, healthier, more productive lives,” said Texas Medical Association (TMA) President Susan Rudd Bailey, MD. “For starters, Texas can no longer afford to indulge the smoking and eating habits of some at a huge cost to all Texas taxpayers.”

Tobacco prevention and control: Tobacco is the leading cause of preventable death in Texas, Dr. Bailey pointed out. Nearly 25,000 deaths each year in Texas are linked to tobacco, she said. The direct and indirect cost of smoking in Texas is $20 billion per year.

Dr. Bailey and her TPHC colleagues said the draft state budgets in the House and Senate cut about $23 million in state and federal funds from tobacco-control programs. “This cut amounts to four-fifths of our meager tobacco-control budget. We oppose this cut as it’s penny-wise but very pound-foolish,” she said.

Recent national research shows smoking cessation programs return up to $2.61 for every dollar spent.

TPHC endorsed statewide smoking ban legislation:

* House Bill 670 by Rep. Myra Crownover (R-Denton) and Senate Bill 355 by Sen. Rodney Ellis (D-Houston), which would prohibit smoking in public places and workplaces; and
* Senate Bill 268 by Sen. Carlos Uresti (D-San Antonio), which raises the legal age to buy tobacco products from 18 to 19.

“The cost to the state of Texas for this indoor smoking ban is zero. But the savings are immense,” said Texas Nurses Association (TNA) President Susan Sportsman, RN, PhD, dean of the College of Health Sciences & Human Services at Midwestern State University in Wichita Falls.

Dean Sportsman noted that a report released last week found that passing this legislation would save Texas — Texas businesses, Texas government, and individual Texans — more than $400 million a year.

Savings to Texas Medicaid: Prohibiting indoor smoking would reduce chronic disease and help the ailing state budget — saving $31 million for Medicaid over the next two years. And that includes about $13 million in state dollars invested in the program.

Dean Sportsman named one group of people many might not consider as vulnerable to secondhand smoke. “Nowhere can you see more tragic evidence of the cost of smoking than in our neonatal intensive care units, where infants born prematurely due to exposure to secondhand smoke are struggling to live.” She said many newborns begin life in neonatal intensive care units hooked up to IVs and breathing machines instead of being able to rest in their mother’s arms.

The cost of caring for a low birth-weight baby born prematurely is about $50,000. “Since Medicaid pays for about half of all births in Texas, we estimated that every premature birth we can avoid because of the indoor smoking ban will save Texas Medicaid $25,000,” Dean Sportsman added.

Obesity prevention: TPHC members also are hopeful that legislators will continue to help Texas fight its obesity epidemic. Obesity causes suffering, poor health, and poor schooling, and it costs Texas businesses almost $10 billion a year. Obesity is responsible for a 27-percent growth in health care spending. More than 5 million Texans are obese; this is expected to double over the next 20 years.

Despite these facts, the draft state budgets would cut ALL funding for state obesity-prevention programs — $4.8 million. They also would cut public school health programs by more than two-thirds, or $65 million. TPHC strongly opposes those proposed cuts because they will cost Texas so much more in the not-too-distant future.

“It’s important to remember that obese kids have an 80-percent chance of staying obese their entire lives,” said Kimberly Avila Edwards, MD, of Dell Children’s Medical Center and medical director of Healthy Living Happy Living/Vida Sana Vida Feliz in Austin. “Our public schools, when given the chance and the funding, are making great strides in early intervention.” She urged legislators to continue that momentum.

TPHC members endorsed several fat-fighting bills. They include:

* Senate Bill 186 by Sen. Jane Nelson (R-Lewisville) and House bills 280 and 281 by Rep. Carol Alvarado (D-Houston), which would require Texas high school students to complete an additional one-half credit of physical education and one-half credit of health for graduation;
* House Bill 127 by Representative Alvarado, which bans the sale of unhealthy drinks to students in schools; and
* Senate Bill 224 by Senator Nelson, which requires schools to report students’ fitness and academic scores to the Texas Education Agency.