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03/09/2011

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As usual a very measured and reasonable response. It is not however clear that the budget represents the thinking of reasonable people. Therefore the question inevitably is what do we do when measured reasonableness fails?

You might be interested in the Health impact assessment of the NH state budget:
•The New Hampshire Center for Public Policy Studies, a nonpartisan, independent organization that pursues data-based research on public policy issues, will develop an HIA that will inform state lawmakers on the budget process beginning January 2011 and ending in June of the same year. The HIA will evaluate proposed state budget changes and show how funding changes in these areas might affect the health of residents. A synthesis of HIA findings and recommendations will be presented at a policy forum in mid-2011 and will be made available to legislators for their consideration during the budget process. The HIA will be guided by an interdisciplinary advisory group with participants from the legislature, state agencies and several advocacy groups to maximize the effect the information has on the budgeting process.

Thanks for your thoughts, Dave! Was hoping you would discuss the WI budget issues through the lens of population health.

Great to get your perspective on this. I think you've hit most things right on. However, I would argue that taking away people's rights to collective bargaining has the potential to have a major impact on population health. The reasons are many, but the underlying mechanisms are likely similar. This law will likely hurt strong communities within the state. Unions are examples of organizations that work for collective good of their members and can increase people's sense of job security and enfranchisement. By increasing a sense of insecurity and disenfranchisement, this law may to lead increased stress and anxiety -- known predictors of ill health. After the passage of this bill, members of these groups may feel that their voice in the democratic process has been lost. I would anticipate higher levels of depression for these folks in the coming years and would not be surprised by other negative stress-related health outcomes. In fact, one could even invision for 'spill-over' effects in which all citizens in the state may feel more anxious and insecure because of the 'example' they see in the way the unions were treated. In sum, I think this move may actually be an important contributer to the health of Wisconsin in the coming years.

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