--By Steve Rowe, Endowment for Health President
It was a pleasure presenting at the Nashua Chamber of Commerce last week alongside Dartmouth-Hitchcock CEO Dr. Jim Weinstein and NH Department of Health and Human Services Commissioner Nick Toumpas.
Dr. Weinstein emphasized that our current health care system is weighted toward costly medical procedures, many of which are unnecessary. Commissioner Toumpas highlighted the rising costs of health care services under the state’s Medicaid program. We all agreed that our current health care system places too much emphasis on treating health problems and too little on preventing them.
My remarks to the business leaders in attendance went beyond the obvious need to improve our health care system. I emphasized the need to take the long view when thinking of health and the need to focus more attention on the social and economic determinants of health - the conditions in which people are born, grow, live and work. I also emphasized that the future health of New Hampshire people will determine, to a large extent, the health of our state’s economy.
We need only look at New Hampshire’s changing demographics to realize that it’s in everyone’s interest to advance the health of Granite Staters in the broadest sense.
First, we are aging in place. New Hampshire’s population is among the oldest in the nation. This presents multiple challenges for everything from clinical health care and long-term care to transportation.
Second, New Hampshire has one of the lowest birth rates in the country. Indeed, only about 13,500 babies will be born in the state this year – about 37 a day. More than 4,000 of these new babies will be born into low-income families. Moreover, current demographic patterns indicate that the number of babies born into low-income families will increase in the future.
Third, in-migration of educated and skilled workers has declined. In the past, the state has seen a steady influx of highly educated and skilled young and middle-aged adults. This trend has stopped.
These changing demographic patterns reveal the need to focus more attention and resources upstream – particularly to those families and children most at risk. Trajectories for lifelong health outcomes and learning are set early. That’s why early childhood investments have such high economic returns.
We can no longer sit back and expect highly educated and skilled workers in fields such as science, technology, engineering and math to show up at our company doors looking for employment. Here, in the aging Granite State, we will have to grow our own healthy, smart and innovative workers. And, with our low birth rate, we won’t have many to work with. That’s why every child matters. Not just some or most, but every single one.
The quality of New Hampshire’s economy will depend on the quality of its workforce. It’s as simple as that. That’s why one of the most important actions that business leaders can take is to encourage public policymakers to focus much more attention and resources upstream. Short term planning and budgeting won’t work. Neither will isolated investments. We must start connecting the “cause and effect dots” over a longer time period. The future health of the New Hampshire economy depends on it.