States Raid Tobacco Settlement Money

Life expectancy is dropping in rural parts of the U.S., a harbinger of what may lie ahead for the rest of the country, according to researchers who published the study in today's issue of PLoS Medicine.

The authors looked at county level data for two broad spans of time: the two decades after the election of John F. Kennedy; and the two decades after the election of Ronald Reagan. Here's what they found (the green areas indicate counties adding life expectancy compared to the national average with dark green being the largest increases; the light orange indicate areas whose life expectancy stayed the same -- which was below the national average, which increased as a whole; and the dark orange indicate areas where life expectancy was falling):

The authors blamed high rates of smoking, rising obesity rates and associated diseases (cancer, chronic obstructive pulmonary disease, Type II diabetes). They also noted that the last two decades of the 20th century marked a period of stagnant wages and rising income inequality, with the hardest hit areas being those left behind what has generally been considered a period of rising prosperity.

The lead author, Christopher Murray, an epidemiologist at the University of Washington, suggested the alarming data called for targeted public health campaigns to combat the physiological causes of declining longevity: smoking, obesity and sedentary lifestyles.

Which brings me to a less reported news item from yesterday: the American Legacy Foundation, which is the national organization that gets money from the 1998 tobacco settlement to run anti-smoking campaigns, will be in court later this week in an effort to stop Ohio from raiding its tobacco settlement trust fund to help balance the state budget. The southern tier of Ohio counties are among those whose life expectancy were either stagnant or declining as its economic fortunes declined.

Most cash-strapped states have already funneled their tobacco settlement money into the general revenue coffers. Only 11 states established trust funds to ensure the money was used for public health. Now Ohio is seeking to become the first to undermine those trusts.

Gov. Ted Strickland (D), who is sometimes mentioned as a potential vice presidential candidate for either potential Democratic nominee, says he needs the money for an economic development program, which, like most such state efforts, is designed to lure business to the state with special incentives. But as Michael Roizen, a nationally known wellness expert at the Cleveland Clinic told an audience at Case Western Reserve University last week, "If you want to do something to help, you write the damn governor and tell him he gets more jobs by keeping the money there and cutting down medical costs so we can afford to have jobs in the state."

So here's what it has come to in the good old U.S.A.: a declining state (sort of like Pennsylvania, where primary voters will be voting today), desperate to attract jobs, takes money away from citizens who are trying to reverse the effects of having no jobs in the first place.

Of course, if the anti-smoking campaign were taking place in Iraq, there'd be plenty of taxpayer money available to do both. On the other hand, when it comes to declining longevity, the Iraqis have a lot more to worry about than their sky-high smoking rates.