Indiana is often touted as having one of the best business climates in the country. Our high marks in this area contrast starkly with our miserable health metrics.
As an Indiana Chamber of Commerce report released in June made clear, Indiana's much-touted economic edge is under threat by our high rates of smoking, obesity, and heart disease and our consequently higher-than-average health care costs and health insurance premiums, all of which inflate the cost of doing business in Indiana and undermine the cost-saving measures of other pro-business policies.
For years, Indiana has taken no awards for building or preserving good health. We've consistently ranked near the bottom when compared to other states on key health metrics such as obesity, smoking, diabetes and heart disease rates. A few years ago, we were 38th in overall health. By 2019, we'd fallen to an abysmal 41st. Forty states do better than we do – some much, much better. Only nine are worse off.
We must ask ourselves, are we really OK with being outperformed by 40 other states? Do we want our poor health metrics to undermine our ability to attract and retain business?
We are among the nation's lowest investors in public health. This holds true even for tobacco prevention and cessation programming, despite ample funding made available to us under the terms of the 1998 Master Tobacco Settlement Agreement.
Although Indiana receives nearly $130 million annually under the agreement to fund tobacco prevention and cessation efforts, only about 5% of those funds now go to that effort. Over time, our lawmakers have chosen to divert more and more to other purposes when they draw up our state budgets.
Given that Big Tobacco invests $293 million annually in marketing its products to Hoosiers, it's little wonder that Indiana's adult smoking rate remains 57% higher than the national average. We apparently don't care enough about the problem to invest even funds that we are given for combatting it.
It almost feels like public health is an afterthought in our state. It's as if we imagine we can build a thriving, healthy economy while the people upon whom it depends for its very existence are given little incentive to resist relentlessly marketed cheap toxins and little help to avoid the ever-greater burdens of obesity and chronic illness. This is not smart business planning, and it shows little thought to what matters most – our people.
For years, health and business groups have united in advancing policies that we know are proven to be effective at decreasing tobacco use and lowering business costs: higher cigarette taxes and greater investment in public health. Somehow, though, despite broad public support for these measures, our lawmakers have failed to act.
Last session, they took a step to decrease youth tobacco use, bringing Indiana into alignment with a new federal law raising the legal age to purchase tobacco to 21. This did nothing, though, to address adult smoking in the near term.
If state leaders are serious about improving Indiana's poor health metrics, they need both to raise the tax on tobacco and to invest robustly in tobacco prevention and cessation programs and services.
In the 2021 legislative session, the Indiana General Assembly will be tasked with writing the next two-year state budget, a tall order in this time of deeply declining tax revenue and great need. Let's hold them accountable to not pass this time on the opportunity to improve both our health and our economy by raising the cigarette tax significantly.
In the era of COVID-19, exposure to respiratory toxins like tobacco smoke and vaping aerosols carries even heavier consequences than normal, raising the risk of contracting the virus and of it creating more severe disease in lungs that are already compromised. It is high time to act.
Let's make this the year we get it done.
Nancy Cripe is executive director of Tobacco Free Allen County.