NATIONAL. Social service shortfalls hinder health, boost medical spending (USA Today)

BERKELEY SPRINGS, W.Va. — States that spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t, a study out today by a prominent public health researcher found.

The study comes as the Obama administration prepares to fund its own research to support the idea that higher social service spending can improve health and lower health care costs. Last week, the Department of Health and Human Services proposed a long-awaited rule that will pave the way for more doctors and hospitals to work closely with social services providers to keep people healthier, such as with home visits or help with housing.

Health care and social services experts in West Virginia, where jobs and access to health care can be hard to come by, cite daily reminders of how improved services can save money later. Their challenge is expanding the reach of the programs they do have. "There's always more need than resources," says Audrey Morris. director of the non-profit Starting Points of Morgan County here.

The new study is the first to compare state spending on social services — which are generally less expensive than medical costs — to spending on Medicare and Medicaidand to residents' health. Many state officials, including those here, say Medicaid claims are busting their budgets and federal officials struggle to rein in Medicare spending on drugs and medical treatments, especially for chronic disease.

Politicians from both parties say health care spending increases,  although slowing, are unsustainable, but they disagree often vehemently over how to address the problem. Yale University public health professor Elizabeth Bradley, lead author of the study,  is urging more efficient — not more — government spending.

Bradley and her co-authors found that for every dollar of Medicare and Medicaid spending for residents of the average state, an additional $3 was spent on social services and public health between 2000 and 2009, the latest available. Washington, D.C., and states including Colorado and Nevada had the highest ratios of social service and public health spending relative to medical costs - about $5 for every dollar of medical treatment — and were much healthier.

New York and Massachusetts joined traditionally poor-health states including West Virginia, Kentucky and Louisiana with the lowest ratios of social services to medical spending, averaging about $2.30 on social services for every medical dollar spent. People in these states also tend to have higher rates of heart attacks, lung cancer, mental illness and obesity, the study showed.

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