Is Foundation Funding of Environmental Health the Answer to a Challenge to Prevention in the Supreme Court ACA Ruling?
August 30th, 2012
As a former state legislator and foundation CEO, I worry about how the majority opinion of Chief Justice John Roberts on the constitutionality of the Affordable Care Act of 2010 (National Federation of Independent Business v. Sebelius) may affect our approach to prevention programs. Funding environmental health may be the best way to go.
In its ruling on the individual mandate, the court came down hard against the authority of the federal government to tell individuals what they can or cannot do. In its ruling on the Medicaid expansion, it limited the federal government’s ability to “coerce” states to accept new national health programs by threatening to withhold federal dollars for existing programs.
Both of these court rulings could influence the way that funders think about public health and prevention in the future, as well as the sustainability of prevention programs they begin.
There are really only two ways to do prevention, and both have champions in the funder community.
The first option is to focus on individuals—that is, to get them to change their behaviors. A national example is the wonderful Let’s Move program, a joint effort of First Lady Michelle Obama and the Partnership for a Healthier America.
However, despite this (recent) compelling call to action…
Over the past three decades, childhood obesity rates in America have tripled, and today, nearly one in three children in America are overweight or obese. The numbers are even higher in African American and Hispanic communities, where nearly 40% of the children are overweight or obese. If we don’t solve this problem, one third of all children born in 2000 or later will suffer from diabetes at some point in their lives. Many others will face chronic obesity-related health problems like heart disease, high blood pressure, cancer, and asthma. (Source: Let’s Move website).
…the Let’s Move campaign is essentially just promoting lifestyle change through education–and, clearly, nothing in a court decision limiting federal mandates on individuals and states is going to open the door to much more.
The second option for funders is to focus on communities—that is, to change the environments in which people live. When people hear the phrase “environmental health,” they usually first think of big things like climate change, ozone depletion, carcinogenic chemicals, and oil spills in ocean water. But numerous examples of community-level environmental health programs can be found in the work of members of the Health and Environmental Funders Network (HEFN) or the Environmental Grantmakers Association. Read the rest of this entry »