Carla Clark | For The Republic
Be SMART, Bartholomew County Health Department and others offer information about their services during the Columbus/Bartholomew County area branch of the NAACP’s Juneteenth Celebration, Columbus, Ind., Saturday, June 22, 2024.
The Bartholomew County Health Department is hoping to build upon what some officials described a ‘never-before-experienced opportunity’ to expand public health efforts through a statewide initiative aiming to “transform public health” in Indiana, which lags behind much of the country in public health outcomes.
The initiative, called Health First Indiana, seeks to overhaul public health funding in the state, providing funding so counties can determine the health needs of their community and implement evidence-based programs focused on prevention, according to state officials.
The Bartholomew County Health Department received $928,011 through the initiative in 2024, according to the Indiana Department of Health. Next year, county health officials are expecting to receive about $1.78 million in additional funding through the initiative.
Before the initiative, the county health department received $84,058 in state funding in 2023 through the Local Health Maintenance Fund/Trust, according to state records.
Some local health officials have described the initiative as a “never-before-experienced opportunity” to boost public health efforts in the community.
“(The) funding has allowed us to be more whole-person focused — more screenings to provide more services and referrals to an individual at the same time as one service,” said Amanda Organist, director of nursing at the Bartholomew County Health Department. “One example, we have implemented screenings for tobacco use to be able to provide referrals and nicotine replacement therapy for those that are interested in quitting.”
Currently, the nursing division is looking for locations to hold a variety of clinics, including for immunizations and testing for sexually transmitted infections, hepatitis C testing and lead, Organist said.
“We will continue to build upon what we have and what have implemented thus far,” Organist said, referring to the expected 2025 funds.
Link Fulp, director of environmental health at the Bartholomew County Health Department, said employee recruitment, compensation and retention are among the department’s top goals with the funding through the initiative.
The department has used some of the funds to turn a longstanding part-time public health emergency preparedness position with high turnover into a full-time position with benefits in hopes of being able to retain the employee after completing extensive training, Fulp said.
The employee works with local and state agencies to prepare and update all forms of emergency plans for natural, accidental and human-made disasters.
“Recruitment, compensation and retention of trained, certified and degreed professionals, as well as well-trained administrative staff is our most important goal with the Health First Indiana funds,” Fulp said. “…Environmental health has employed the same number of environmental specialists since 1989 even with the growth of the city and county since that time.”
In addition, the environmental health division is working on an updated on-site wastewater ordinance, as well as a tattoo and piercing ordinance, to reflect state standards required with the funding.
“This is a never-before-experienced opportunity, and we are required to outline how spending of funding is assisting our customers,” Fulp said. “The (Indiana Department of Health) has directed local health department to work on the needs outlined in the funding and to plan for future goals. We intend to work with community partners on assessing what ways we can best serve the environment and public health. We’ll know more as the year progresses.”
The Health First Indiana was created through legislation passed during the 2023 legislation session and seeks to boost public health funding in a state that has long spent far less than most others on public health efforts, according to state officials.
In 2019, per-person public health spending in Indiana was $55, compared to $91 per person nationally, according to a recent analysis by the Governor’s Public Health Commission. In Bartholomew County, public health spending was less than $20 per person that year, the analysis states.
Rep. Ryan Lauer, R-Columbus; Rep. Jennifer Meltzer, R-Shelbyville; and Sen. Greg Walker, R-Columbus, voted in favor of the legislation that created the initiative, according to state records. Rep. Jim Lucas, R-Seymour, voted against the legislation.
The Health First Indiana initiative is backed by $75 million budgeted for public health funding in fiscal year 2024 and $150 million in fiscal year 2025 — up from $6.7 million to $6.9 million per year in direct funding for local health departments since 2000.
A total of 86 of Indiana’s 92 counties have opted to participate in the initiative.
Jackson County opted into the funding, receiving $540,251 in 2024, according to the Indiana Department of Health. The county also is expected to receive just over $1 million next year.
Jennings County also opted in and received $333,208 last year and is expected to receive $642,002 next year, according to state records.
The push to boost public health funding in the state comes as Indiana continues to lag behind much of the rest of the country in public health outcomes.
The most recent data from the Centers for Disease Control and Prevention shows that nearly 38% of Indiana adults were obese in 2022 — the ninth highest adult obesity rate in the country that year. By comparison, Vermont had the lowest rate in the country in 2022, with 26.8% of adults in the state being obese, according to the CDC.
Obesity is defined as having a body-mass index of at least 30.
Data from the Indiana Department of Health suggests that the adult obesity rate in the state may be even higher than that, with 43.6% of Hoosier adults being obese from 2018 to 2023.
In Bartholomew County, 44% of adults were obese from 2018 to 2023, according to state records.
Indiana also has one of the highest infant mortality rates in the nation, with 7.16 deaths per 1,000 live births in 2022 — the 7th highest rate among all states, according to provisional data from the CDC. By comparison, the U.S. rate that year was 5.6 deaths per 1,000 live births and 3.32 deaths per 1,000 live births in Massachusetts, which had the lowest rate in the country.
In Bartholomew County, the infant mortality rate from 2018 to 2022 was 7.04 deaths per 1,000 live births, according to the Indiana Department of Health. The state rate over that period was 6.8 deaths per 1,000 live births.
Bartholomew County has a higher smoking rate among pregnant women than much of the rest of the country. In 2022, 8.7% of pregnant women in the county smoked during pregnancy, compared to 6.6% statewide and 3.7% nationwide.
Overall, life expectancy in Indiana from 2019 to 2021 was 75.6 years, while life expectancy in Bartholomew County over that period was 76.9 years, according to the Indiana Department of Health.
Life expectancy in the U.S. ranged from 80.7 years in Hawaii to 71.9 years in Mississippi in 2020, according to the CDC. That year, life expectancy for Hoosiers was 75 years.
