State lawmakers have trimmed budgets for programs such as bike paths, pedestrian enhancements and obesity prevention in recent years.
By Jasmin Singh
Heart disease is the second-leading cause of death in North Carolina. Diabetes is the seventh. And about a third of kids in North Carolina between the ages of 10 and 17 are overweight or obese.
Despite this, obesity-prevention and physical-activity programs are being cut in the proposed state Senate budget. And advocates for prevention programs say that while this might make fiscal sense in the short run, problems will arise down the road.
“We’re the buckle of the stroke belt,” said Betsy Vetter, a lobbyist for the American Heart Association, referring to a band of high county rates of stroke that stretches through Southern states, with the highest concentration in eastern North Carolina.
Sherée Vodicka, executive director of the NC State Alliance of YMCAs, said lawmakers should increase funding, not cut it. Among the cuts she cited was $30,043 from the bicycle and pedestrian division of the highway fund.
“We certainly would like to see it much larger than that, because kids can’t walk to school if there aren’t sidewalks,” Vodicka said. “People can’t walk to the grocery store, they can’t walk to church, they can’t walk to work.”
The proposed House budget makes no bike and pedestrian funding cuts, but both chambers cut funding for physical-activity, nutrition and chronic disease-prevention programs.
Federal and state downsizing
Loss of funding from the state also means the loss of federal matching dollars for prevention programs, which, Vodicka said, is sometimes two or three times what the state provides.
She estimated that the loss of federal funding could be well into the millions of dollars.
“It’s a big chunk of money,” Vodicka said.
On top of that, the Centers for Disease Control and Prevention has changed the way it funds states. Instead of funding each program individually, Vodicka said, the CDC now groups obesity, heart disease and stroke, diabetes and school-health programs into one funding stream.
“Instead of each of those programs getting a million or more, all four of those program got about $600,000 [total] in funding,” she said.
Vetter said funding for physical activity and nutrition were affected by the change. “It just means less,” she said.
Because of all of these cuts, Vodicka said, state prevention programs have had to downsize just when they should be gearing up to more effectively address obesity.
“When you have that kind of staff reduction, it’s just really challenging to maintain the level of attention that you are paying to any one of those issues,” she said, “You are so divided, and you are working on all of them.”
Vodicka said staff members have had to become experts at everything.
“You used to have people who specialized in diabetes. Now everybody has to kind of generalize and be up on all of those, and that’s, honestly, challenging,” she said.
An even playing field?
Vodicka said that in the past, the CDC targeted its funding for promoting physical activity on states that most needed it and didn’t fund other states at all. The agency changed it’s strategy; now all states get about the same funding.
“It becomes, ‘Do you put more resources where there is the greatest need or do you give everybody a little bit and just hope that does the trick,’” Vetter said.
Vodicka said the differences in state funding had been an ongoing issue that vexed federal officials.
“They’ve just never been able to fund every state to the level that they should have, could have, would have,” she said.
Vetter said that in the 1990s, both the CDC and N.C. General Assembly were investing in the state, investments that changed the numbers “dramatically.” She cited, in particular, improvements in heart disease and stroke.”
Both women pointed out that in 2013, the state did receive some extra funding from a CDC opportunity grant. Vodicka said that money is supporting healthy-community programs that connect clinical and community resources for diabetes, heart disease, stroke and weight loss.
“I think we’ve all kind of pitched in to help out where we can,” she said. “I think that there’s just fewer resources at the state level to help.”