HEALTH CARE/Joan Retsinas

Budgeting for Health

Government budgets, state and federal, feature the usual line-items for “health.” Governments pay for health insurance, research, inspections. Local governments, though, are generally out of the health-loop. Presumably they pick up the tab for police, fire, schools, sanitation, and, if the town is sufficiently solvent, recreation – all important, but not “health.”

Maybe it is time to reconsider the prerequisites of health – and the chance for local governments to enhance health. Let me proffer a modest non-health “health” agenda for cities and towns.

Plant trees. Lots of them. Even inexpensive spindly trees will, with luck and rainfall and some tending, grow bigger. I hear the naysayers: the leaves drop –somebody will have to rake them. An expense. They die – somebody will have to cut them down, cart them away, before they injure a pedestrian or car. Another expense. They provide a haven for squirrels. A menace for homeowners. Their roots clog up sewers, uproot sidewalks. As the litany of woes mount, you wonder why Joyce Kilmer would have extolled them.

The benefits are worth it. Trees improve air quality. And they offer an aesthetic boost that must lower blood pressure, lower anxiety, and induce smiles in the most neurotic pedestrians. I concede: double-blind clinical trials have not proven the benefits of trees on the psyche, but surely we can take all the poems, odes, and paintings as evidence of a psychic uplift. The United States has swatches of sheer ugliness: acres of asphalt, strips of stores, multi-lane highways (not enough bear the wonderful legacy of Lady Bird Johnson’s Highway Beautification campaign). We can’t plant redwood forests near all that asphalt, but we can easily, inexpensively infuse a bit of natural green.

Put in bike lanes, bike paths, bike roads. The research on the safety of bike lanes mounts. Should they be on the shoulders of the road? Adjacent to parking lanes? Should we construct separate protected bike paths? The optimal – a protected path – is not just the safest but the most expensive. Clearly, though, all lanes that offer some protection for bicyclists – even painted “bike-only” lines on the side of the road — offer drivers an option to bike. As a nation we are getting fatter; and some of us drive short treks – 5 miles to the supermarket, 10 miles to work. Many of us would do well to leave the car at home and get onto a bike. American cities are not going to morph into Copenhagen or Amsterdam, but we could wean ourselves a bit from our cars. In so doing, we might pump up our aerobic capacity, stretch our muscles, slim down – and, crucially, enjoy it. We Americans gobble down an impressive number of anti-depressants and anti-anxiety medications. Cycling might help.

Make walking safer. Put in walk-signals at intersections, and make sure that they work reliably. Again, walking can do good things for our body, and perhaps elevate our mood as well. Some people walk for pleasure; some walk to and from bus stops and subway stations. But if a pedestrian courts death when he crosses a busy intersection, the pedestrian will soon rush to a car.

Turn abandoned city lots into community gardens, and invite residents to take up shovels and hoes. Many neighborhoods have community-based groups. Invite them to sponsor a garden in their midst. The city will gain a spot of green; the compost piles will absorb some of the waste that goes into landfills. And maybe city-dwellers will eat more locally grown fruits and vegetables. You can’t grow junk. Nobody reaps bushels of potato chips or candy bars. Instead, gardeners reap zucchini, tomatoes, and kale.

Health is too important to stay within the confines of traditional “health” budgets.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, August 15, 2013

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