Healthier, But Worth The Cost?

I think I understand the frustration behind what state Department of Health Services Secretary Dennis Smith said when asked why the department wouldn't support requests from UW-Madison's student health center and the Milwaukee Health Department for federal grants aimed at preventing obesity, smoking cigarettes and other public health risks.

"Why are we asking for taxpayers' money for stuff that we are already doing?" he told the Milwaukee Journal Sentinel. "How long have people been doing tobacco cessation, for heaven's sake? This is stuff that goes on all the time."

Indeed it does. Moreover, it's not like anyone with halfway functioning frontal lobes doesn't know that smoking cigarettes is bad for you, or that eating too much is bad for you, or not wearing a seat belt - and so on and so forth.

Still, the percentage of adults who smoke cigarettes cheap cigarettes in Wisconsin was about 19 last year, down only from about 24 percent in 2001, according to the Centers for Disease Control and Prevention. Weight problems were worse, with about 27 percent of our state's population officially overweight or obese, up from about 22 percent in 2001.

"We do have programs now that we're involved in that get at some of these chronic challenges," DHS spokeswoman Beth Kaplan told me, and pointed to three in particular that are funded to the tune of about $22.7 million to prevent smoking cigarettes, obesity, heart disease and other health problems.

Kaplan denied DHS refuses to support the additional federal grants because they are being offered through the federal health reform law - which Smith opposes and the state is suing to overturn. Rather it's "more a sense of not wanting to do what we're already doing," and to be good stewards of taxpayer dollars.

But it's not like Wisconsin's prevention programs have reached the point of diminishing returns, said Donna Friedsam, a researcher at UW-Madison's Population Health Institute, nor that the programming doesn't work.

There is a "range of research that's showing some very promising programs," she said. "They don't do these things because they say, ‘let's try it and see what happens.'"

I believe DHS could be eschewing the federal dollars to avoid the hypocrisy of taking money from an initiative state Republicans assail. But I also have doubts that a few million more will result in a healthier population 10 years from now.

What I do know is that consumption is probably the strongest cultural force in American society - and that we vary widely in willpower and in the genetic makeup and social backgrounds that partly determine our health.

Which brings to mind the obese man in the battered minivan who pulled up next to me at a stoplight a few days ago. He was smoking cigarettes a cigarette and I think there were a pair of empty children's car seats in the back. I looked at him and thought, with some disgust: "For God's sake, dude, get it together."

An hour later, after the kids were in bed and despite a full dinner and the extra five to 10 pounds around my midsection, I was headed to the local frozen custard shop.

I wanted a milkshake.