Trends and Transitions: May 2009
Cancer Screening Programs May Soon Serve More
Until there is a cure for cancer, early detection and treatment remain the best options. Although many women take regular cancer screenings for granted, uninsured and low-income women rely on scarce public screening and treatment programs.
States will have the option of tapping into some of the $650 million appropriated for prevention and wellness issues in the American Recovery and Reinvestment Act to fund the 68 state and tribal screening programs that are part of the federal National Breast and Cervical Early Detection Program. The act grants states funds to provide “evidence-based, clinical and community-based prevention and wellness” programs that address the growing chronic disease epidemic.
States support their screening programs from a variety of sources, including specific budget lines, specific lottery ticket sales, income tax check-off programs and cancer awareness vanity license plate registration fees.
Some cancer screening programs—ones that serve mostly women who receive Medicaid and other low-income and uninsured women—have struggled to keep up with demand because of recent state and federal funding cuts.
The Kansas Legislature, for example, appropriates $230,000 every year to screen symptomatic women under age 40. The state funds are used for clinical services, not administration costs. But last year, the program screened only a few more than 5,800 of the 27,000 eligible women before it ran out of money in March 2008. The program then had to place women on a waiting list until July 2008. It also requested $2.3 million in federal funding, in addition to grants from other local cancer research and prevention affiliates
Supreme Court Rules on Redistricting Case
In early March, the U.S. Supreme Court struck down a North Carolina Senate district and affirmed that Section 2 of the Voting Rights Act does not require states to draw districts where a minority group will comprise less than 50 percent of the voting age population.
In the 2000 redistricting cycle, the North Carolina General Assembly created a state Senate district in the southeast part of the state that crossed county lines contrary to the strict prohibition in the state constitution against dividing counties in redistricting. The state argued it was necessary to create a district with a 39 percent African-American population that would allow African-American voters, with additional votes from nonminorities, to elect candidates of their choice, which was required under Section 2 of the Voting Rights Act.
The 5-4 ruling was led by Justice Anthony Kennedy, who wrote that North Carolina was not required to create a “crossover” district under federal law, so this was not a valid rationale for violating the state constitutional provision. Kennedy said that the ruling does not prohibit or limit legislatures from drawing “crossover” or “coalition” districts; however, states are not required to draw the districts under current law.
In a dissenting opinion, Justice Ruth Bader Ginsburg expressed dismay with the majority’s reasoning, saying that it was “difficult to fathom” and calling on Congress to revisit the law and clarify state requirements under Section 2.
The North Carolina General Assembly now must comply with the original ruling and re-draw the Senate district. Another major case, from Texas, challenging Section 5 of the Voting Rights Act, was heard by the Supreme Court in April; a decision is expected in June. Both these suits will add to the already voluminous case law that legislatures must understand when redrawing the 2010 maps.
Protecting Students From Offending Teachers
In an effort to keep sexual offenders out of the classroom, state legislators have been grappling with a classic conflict: Balancing the public’s right to know with an individual’s right to privacy. Traditionally, most states have at least partially restricted access to teachers’ certification and disciplinary employment records. But over the past few years, some sensational news stories have led legislators to re-examine whether current policy adequately protects students.
Several nationwide news stories broke in late 2007 reporting a practice known as “passing the trash,” where school officials let what they thought was a one-time offending teacher quietly leave a school without officially reporting inappropriate sexual behavior. These teachers moved to other schools, sometimes within the same district, and often re-offended. In many cases, school officials did not perform background checks, either because they were not required or because of sloppy compliance with current requirements. But, even if they did, if the first school didn’t report the incident, was reluctant to provide an honest reference, or reports were not accessible, then the hiring district remained in the dark.
State policymakers in at least 22 states worked in 2007 and 2008 to stop these practices by closing existing loopholes and strengthening requirements and penalties. Remedies vary, depending on the context of each state’s existing policies. Generally, states increased penalties for offending teachers and school officials who failed to report, expanded background checks and reporting and disclosure requirements, closed loopholes for passing along bad teachers, and criminalized teachers who have sex with older students.
Motorcycling Can Be Risky
Motorcycle sales increased 30 percent from 2001 to 2007. A rise in injuries and fatalities, unfortunately, has followed the increased popularity of riding. According to the National Highway Traffic Safety Administration, 5,154 motorcyclists were killed and 103,000 motorcyclists were injured in 2007. More motorcyclists were killed in crashes in 2007 than in any year since the agency began collecting data in 1975.
NHTSA estimates helmets saved 1,784 motorcyclists’ lives in 2007. Currently, 20 states and the District of Columbia require all motorcyclists to wear helmets. In 27 states, laws require only some motorcyclists—usually riders under age 21 or 18—to wear them. Illinois, Iowa and New Hampshire do not have motorcycle helmet laws, although Illinois and Maine have introduced universal helmet legislation this year.
In states with universal helmet laws, helmets were used 97 percent of the time in 2008, up from 90 percent in 2002. States without a universal helmet law have about a 54 percent use rate.
Studies in Arkansas, Kentucky, Louisiana, Pennsylvania and Texas looked at motorcycle fatalities in the years before and after these states repealed their universal helmet laws. In all states, there were substantial increases in motorcycle fatalities and brain injuries after the universal laws were repealed.
Carbon Monoxide Detectors Save Lives
Carbon monoxide (CO) is the leading cause of poisoning deaths, and poisoning is second only to traffic injuries as the leading cause of injury deaths in the United States. Approximately half of CO poisoning deaths in residences could be prevented by detectors.
Carbon monoxide is a colorless, odorless gas that causes headaches, nausea and fatigue, and is often mistaken for the flu because it goes undetected in a home. Prolonged exposure can lead to brain damage and even death. Often referred to as a “silent killer,” carbon monoxide poisoning caused on average 439 deaths and more than 15,000 visits to hospital emergency departments per year from 1999-2005, according to the Centers for Disease Control and Prevention.
In November 2008, four members of a Colorado family were killed by carbon monoxide while they were vacationing in Aspen. Shortly after, a graduate student at the University of Denver died in her apartment from CO exposure. As a result of these highly publicized deaths, the Colorado General Assembly passed a law requiring all new homes and apartments, as well as older houses for sale and existing apartments for rent, to have carbon-monoxide detectors.
Sixteen other states—Alaska, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Rhode Island, Utah, Vermont, West Virginia and Wisconsin—have laws or regulations requiring carbon monoxide detectors in residences.
Some states require all residential dwellings to have them, while others require only specific types of dwellings or newer buildings to be equipped with the detectors. Tennessee and Texas have CO alarm requirements related to daycare centers.
So far this session, at least 15 states have introduced bills to create or modify carbon monoxide detector requirements.