This has been an unprecedented time in public health in the Garden State: Obamacare celebrates its tenth anniversary. COVID19 spread widely across New Jersey, with a recent uptick in reported cases. Many are still without adequate health coverage.  New Jersey ranks #35 in terms of obesity in the nation and #12 in terms of aging population.

The annual ranking of healthy counties in New Jersey was released by countyhealthrankings.org based on a data analysis of key factors: lifestyle habits; crime, disease and mortality rates; educational and financial success; and the availability of doctors, parks and grocery stores. 

It's no surprise that wealthier counties (ie Hunterdon, Somerset, Middlesex) rate very highly while the economically challenged counties (ie Salem, Camden, Atlantic) rank at the bottom of the health scale. 

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In a state that is the "medicine chest to the world" as the center of the world’s pharmaceutical industry, along with access to Jersey fresh home grown foods, no county should rank so low. 

What, if anything, should Trenton be doing to ensure that all New Jersey counties rank highly when it comes to health? 

Michael Patrick Carroll, Conservative Republican:

The question assumes that there is anything – salutary – that state government can – or should –
do to affect health, save, perhaps, around the edges. That assumption is wrong. As with most
other things in life, the responsibility for one’s health rests primarily on the shoulders of each
individual.

There ARE exceptions. To the extent that crime constitutes a health concern, government can
vigorously enforce the law and throw violent criminals in jail. So, for instance, adopting an
aggressive stop and frisk policy, which gets illegal guns out of the hands of criminals, would, all
by itself, save countless lives – mostly PoC – and prevent myriad catastrophic injuries, without
costing a single additional dime.

So, too, to the extent that education influences health, government can advance that cause by
adopting universal educational vouchers, enabling every parent to choose the school best suited
to her child’s individual needs. (That would also reduce costs, and lower taxes are healthy.)
But there’s little government can do about “lifestyle” (he writes, sitting at his computer instead
of exercising. The Fitbit is NOT my friend. And no amount of governmental pressure will get the
author to eat his peas or carrots.)

Better health likely attends financial success, but prosperity requires responsibility. Poverty is a
choice; one chooses it by making a baby out of wedlock; committing crimes; dropping out of our
hideously expensive schools; or abusing substances. Government could, certainly, stop
rewarding bad behavior by providing large handouts expressly conditioned on irresponsibility,
but such “tough love” comes with difficult optics. The best – only – way to avoid poverty, and its
attendant health effects, is to act responsibly.

Certainly, increasing rewards for hard work and responsibility are within government’s
legitimate sphere, albeit sometimes out of Trenton’s control. Sending illegals home and ending
unskilled immigration would immediately create labor shortages, thereby increasing wages, to
the great benefit of poorer Americans. Cutting taxes on businesses – the correct corporate rate is
0% – creates even more upward pressure on wages. Repealing eco-extremist regulations enables
construction, to everyone’s benefit. In short, smaller, less expensive government is conducive to
health.

Too, governmental policy unnecessarily inflates health care costs. Repealing insurance mandates
so that people can buy policies which cover the things they need, not the things government says
they should have, will reduce costs, as would interstate competition among carriers. (It also
uncouples insurance from one’s job, another great idea.) Encouraging HSAs would get people
back in the habit of paying for their own health care and becoming more careful consumers.
Couple that with price transparency – if your lawyer or mechanic needs to tell you what it’s
going to cost in advance, so should your doctor – and market pressures will reduce costs, as they
do everywhere. (Lasix being proof that it works in medicine, too.)

Put simply, prosperity is the key to good health, and liberty – starting with small government and
low taxes – is the key to prosperity.

Ray Lesniak, Liberal Democrat:

The overall health of a region of the State is significantly impacted by two factors that can be
influenced by good public policy: infant and maternal mortality and obesity.

New Jersey has a high rate of infant and maternal mortality in low income families. Wrap around
community schools in low income districts would significantly lower that mortality rate. Wrap
around community schools provide health and education services to families from prenatal to
three, this includes health and education counseling. As an added benefit they would close the
large gap in education performance by low income students in the highest ranked education
system in the country.

The most significant time in a child’s education development is prenatal
to three. Wrap around community schools would provide family counseling to improve these
children’s learning capacity, but I digress. They would also increase life expectancy and improve
the overall health. And wrap around community schools are not costly. Much of the services
needed are available in the community but need coordination to make them available. Kean
University in Union County is preparing a curriculum for training students in wrap around
community school services. New Jersey should advance this needed program to improve both
health and education performance in low income areas of the state.

Obesity is a major contributor to adverse health consequences and it’s most prevalent in low
income areas where residents do not have access to supermarkets which provide healthy, fresh
food at a lower cost than is available in the smaller food stores in these areas. New Jersey is
already attacking this problem. The Economic Recovery Act of 2020 signed into law by
Governor Murphy provides tax incentives for supermarkets to locate in low income areas which
are not otherwise profitable for these businesses.

Wrap around community schools and availability of less expensive, healthy food will go a long
way to improve the overall health of New Jersey residents, particularly of low income families.