Relaxing shelter-at-home requirements must be done judiciously with health in mind

As Georgia governor Brian Kemp more aggressively lifted restrictions yesterday, joining other states like South Carolina, Oklahoma, etc., a concern that is not getting talked about enough is some of these same states have the worst national health care rankings. More on this below. Per two separate surveys in the past few days, 70% of Americans want the focus to be on health first, before reopening. Americans seem to get where the focus needs to be more so than some leaders.

I understand the desire to reopen more fully, but we must be smart about it. I was pleased to see the North Carolina governor Roy Cooper extend the shelter-at-home requirement for two weeks, but actually announcing a three phased plan to reopen. That is what is needed. It could be postponed if the numbers do not improve, but it is an articulated plan.

This is a state-by-state issue. The relative health of the state is important as it increases the relative risk. The Commonwealth Fund is an organization that measures the relative health of a state based on a number of factors and have been doing so for years. A link below is to the 2019 state rankings. As you think about states that are reopening sooner than others, consider the following:

The worst twelve states (and District of Columbia) for overall healthcare, from worst to twelfth worst, are as follows:
51 – Mississippi
50 – Oklahoma
49 – Texas
48 – Nevada
47 – Arkansas
46 – West Virginia
45 – Louisiana
44 – Florida
43 – Missouri
42 – Georgia
41 – South Carolina
40 – Tennessee
39 – Alabama

The Commonwealth Fund uses a robust number of variables to rank the states and is one of the more comprehensive tools. These states tend to have a higher degree of obesity (BMI greater than or equal to 30), some have a greater degree of child hood obesity, and have a greater degree of people who claim poor health. With the higher degree of obesity comes higher propensity of diabetes, although this data is inconsistently reported. Please click on the link and go through the most recent report.

Obesity and diabetes are critical factors. Data from the COVID-19 reported this week noted diabetics are not faring well when diagnosed. People with breathing difficulties – asthma, COPD, etc. also are at greater risk. It should be noted Florida ranks poorly on childhood asthma. Again, this is an underreported data point in other states.

Another key factor for poor ratings is access to health care providers and insurance. Many of these states did not expand Medicaid. Many of these states have seen more rural hospitals close than others. Many of these states have more food deserts and higher degrees of drug overdoses, alcoholism, and suicides.

I mention all of the above, as the states have varying degrees of preparedness and risk exposure. In fact, many businesses have noted they are ignoring the governor’s orders to reopen their doors. That is also telling.

I get it. I understand the desire to reopen the doors. I also know pandemic diseases spread more readily than other diseases. If we do venture out – please use social distancing and face masks. There are many restaurants who are practicing good procedures to protect the staff and customers through take out and delivery orders. Support their efforts. That is a way to invest in our economy.

And, please listen to the truthtellers, the doctors, nurses and disease scientists. Listen to the folks not patting themselves on the back or making the issue more political. Facts must trump politics. But, we should also be mindful, we are learning more about this virus with increasingly better data. Just because new data sets aside a previous notion, that is not unusual with pandemic risks. AIDs and Ebola revealed this based on their initial discoveries (AIDs was thought to impact only gay men at first, until women and heterosexuals started dying, eg).

These truthtellers understand this is an uphill climb. We must be vigilant and patient. And, judicious and humble.

https://scorecard.commonwealthfund.org/rankings/