Healing Connections

“Everyone deserves to breathe smoke-free air regardless of where they live or work,” according to the President and CEO of the American Lung Association, Bernadette A. Toomey. The CDC estimates that in 2007 the percentage of people in the United States who still smoked was below 20 percent. France and Ireland, countries with strong smoking cultures, have successfully gone smoke-free; and it is the goal of the American Lung Association that the U.S. be smoke-free by 2010.

People in the U.S. are smoking less, with secondhand smoke definitely on the decline in America. Laws and policies banning smoking in restaurants, office buildings, apartment buildings, and all manner of public places, even the beach in some areas, have been increasing passed and enforced since the early 1990s.

The U.S. Centers for Disease Control and Prevention tested approximately 17,000 nonsmokers, aged 4 and older, comparing the years 1988 through 1994 with the years 1999 through 2004, and the conclusion they reached was that the smoking rate in the U.S. had declined, but was not yet low enough.
The study found that nearly half of the nonsmoking population of the U.S. is still being exposed to secondhand smoke. There was progress: 84 percent of the nonsmokers had tested positive for signs of nicotine in their blood during the late 1980s and early 1990s tests; that number had decreased to 46 percent by the time the tests were repeated in 1999 and 2004.

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Call them stoic, call them cost-conscious, call them under- or uninsured…but almost 20 percent of the U.S. population either went without or delayed needed medical care at sometime during 2007. That figure is up from 14 percent in 2003, and if you are counting, is an additional 9.5 million Americans who didn’t get the medical care they needed in 2007.

People had numerous reasons why they had postponed or had completely forgone medical care for themselves during the year. Chief among them was out-of-pocket medical costs and deductibles they couldn’t afford to pay, followed by a list that included things like a lack of acceptable clinic hours of operation, difficulty getting to clinics during working hours, problems with doctors being overbooked that resulted in difficulty getting timely appointments, and doctors and hospitals not accepting their insurance plans.

It wasn’t just people without medical insurance that were avoiding medical visits, but both people with and without insurance that were either delaying or forgoing medical care, according to a random national phone survey. The survey was conducted by the Center for Studying Health System Change, a nonpartisan policy group, who called 18,000 people, with a 43 percent response rate.

The study’s lead author, Peter Cunningham, noted that as health care costs increase, a larger share of cost, often in the form of higher deductibles, is being shifted to people and families, requiring them to pay more out of their own pockets. “To the extent that cost increases are passed on to individuals, continued declines in access to care are inevitable,” wrote the co-authors of the study.

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