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Dr. Michael Forster

Medical association – “We have a public health crisis here”

Last week, the Mississippi State Medical Association adopted a resolution supporting Medicaid expansion – even though the words themselves, “Medicaid expansion,” were considered too politically incendiary to appear in the document.  That tells you a lot about our condition, both healthwise and politically.

MSMA president Dr. Lee Voulters pithily summed up the health condition – “We have a public health crisis here.”  Along with being the poorest state in the nation, Mississippi ranks as the most unhealthy.  Governor Bryant was even more pithy in his response to the MSMA resolution to expand Medicaid coverage – “No.”

And there’s the rub.  The public officials who need to act to improve health care access won’t.  Indeed, they want to move the state in the opposite direction, toward a progressively smaller government footprint, in line with the “starve the beast” ideology popular on the political right wing.  They are deeply, deeply committed to the notion that government should do less for citizens, not more.  And expanding health care, especially for those least able to pay, would definitely mean doing more.

It’s obvious to the doctors’ association that any form of expanded health care coverage would be a good thing for Mississippi, and saying so was the right thing to do.  But hey, they’re only doctors.  What do they know about public health compared to the governor and the other enlightened leaders of state government?




Dr. Michael Forster

Oh, no! Dobbs to leave post as state epidemiologist

Today’s Clarion-Ledger carries a notice that Dr. Thomas Dobbs is resigning as the state’s epidemiologist.  This is very bad news for Mississippi.

I’m  a huge fan of Dobbs.  Dr. Mary Currier brought him into the critical post of helping defend the state against disease epidemics shortly after she assumed the helm as our state health officer several years ago.  Dr. Dobbs, who formerly served as the health officer for two state health districts, VII and VIII (taking in most of southern Mississippi), is a great friend of Southern Miss and the College of Health.  He’s been an adjunct instructor for our Department of Public Health, and a long-serving member of my advisory Dean’s Council.  Everyone who knows him says you won’t find a more decent and caring individual.

I’ve had no personal correspondence with Dobbs, and the brief news note offers no details, but I feel certain his resignation is tied to the serious budget cuts laid on the state Department of Health.  His entire tenure in the position has been punctuated by cut-cut-cut; now already inadequate resources are shrinking further, with new service reductions and staff layoffs in the offing.  I don’t want to project too much onto Dr. Dobbs, but it’s all too easy to imagine him concluding that enough is enough, it’s time to stop the madness of pretending that all the plates can be kept spinning through ever-greater “efficiency.”

Let’s hope that the doctor’s resignation helps our sometimes myopic guardians of the public purse to see reality more clearly, and move rapidly to reduce the growing risk to the health and welfare of Mississippians.

Dr. Michael Forster

Breaking ground for a new CoH/CoB building at Gulf Park

I was among those university officials, faculty, staff, and friends who participated in the groundbreaking ceremony for a new College of Health/College of Business building on the Gulf Park campus, on a bright and sunny May 23rd morning. Following are my podium remarks (minus a smidgen of ad libbing):

Good morning.  I have two thoughts that I‘d like to share with you about this wonderful new building project.

The first has to do with the connection – and important connection – of learning and place.  The great, archetypal Renaissance learner Leonardo da Vinci wrote in his Notebooks (J.P. Richter 1988 translation) that…“Study without desire spoils the memory, and it retains nothing that it takes in.”

My own recollections of the desire for learning, and the retention of learning, from my earliest schooling through multiple university experiences, are deeply and inextricably bound up with memories of specific places, and very often of specific buildings, learning spaces that I experienced as my own, sturdy supportive structures that buoyed me up, helped carry me along during rough times, and fed the flame of desire for continued learning.  In this digital age of “distributed, asynchronous learning,” we have become fond of saying that one can learn just about anything, anywhere, and anytime.  And certainly there is a wonderful, liberating truth to this notion.  But it is at least equally true that physical space, campuses and buildings that are welcoming and properly designed to purpose, powerfully influences learning and the motivation for learning, enhancing the academic experience in ways that are both general and specific, subtle and profound.  For many, if not most students, they are a key to academic success.  The structure that we break ground on today will be a marvelous enhancement of our supportive learning environment – for our students first and foremost, but for all of us – faculty, staff, and administrators – as well.

My second thought, a related one, is about the vital importance of continuity and commitment to mission through time and across generations.

We read this in Joshua 24:13, “I have given you a land for which you did not labor, cities to dwell in which you did not build, and vineyards and olive yards to eat from that you did not plant.”  Faculty, staff, and administrators in the College of Health do what we do, can only do what we do, because of those who have come before us, who built the buildings and planted the vineyards that sustain us today.

It is wonderful thing, then, that we have this opportunity, the groundbreaking for this new building, to forge another link in the chain of sustenance across time, to reaffirm our commitment to shelter and nourish not only the current generation of learners and knowledge creators, citizens and culture-bearers, but the next generation, and the generation after that.

At our recent commencement here on the coast, just over a week ago, President Bennett extended an impromptu offer, at once simple and extraordinary, to members of the audience.  (Pres. Bennett, you will forgive the free paraphrase, I hope.)  He said something like this – “As I shook hands with each of our new graduates just now, it occurred to me that there may be many of you here today who have wanted to pursue a college degree, but for one or another reason either did not start, or started and got interrupted, and have never been able to complete, and now it seems that either too much time has passed, or it will take too much time to finish.  Well, I’m telling you today (said Dr. Bennett) that Southern Miss is here for you, to affirm your dreams and to encourage and support you in pursuit of those dreams.  Yes, it can take time, but we are here for you, not just today, but tomorrow, and the day after tomorrow, and the day after that.  Southern Miss has been in the business of education for 106 years, and we’re not going away.”

That sentiment really gets to the heart of what we’re about today, I think, in breaking this ground.  The College of Health advances, indeed, and not only with our colleagues and neighbors in College of Business (whom we love dearly, or course!), but with the whole of Southern Miss, all of us together advancing our mission of service to the people and communities of the Mississippi Gulf Coast, with a purpose and commitment as solid, strong, and enduring as any brick and mortar – today, tomorrow, and every day after.

Thank you.

Dr. Michael Forster

Shortsighted SNAP rollback harms public health

While HB1523 perhaps rightly garners the lion’s share of news attention right now, other recent government action threatens to do far more immediate damage to many more Mississippians.  I’m referring to the state’s decision not to request a federal waiver of work requirements to qualify for Supplementation Nutrition (“food stamp”) assistance, as it has throughout the recession up until now.  The Department of Human Services projects that roughly 50,000 state residents are likely to lose benefits.

The logic of the decision is this: Economic conditions in the state have improved enough that the waiver is no longer needed.  Recipients otherwise not exempt for reasons such as disability, or having young children, can now be expected to work or to attend educational programs preparing them for work.  It’s time to steer people toward jobs, as the governor has put it, and not dependence on government aid.

But there’s more wishful thinking than economic reality propelling this “logic.”  Mississippi’s economy continues to drag (precisely the reason public officials cite to explain depressed tax revenue, in fact), underlying one of the highest state unemployment rates in the nation, roughly 7%.   Unfilled jobs, moreover, are far from evenly distributed throughout the state; many rural counties suffer unemployment rates two or three times higher than the state average.  At the same time, Mississippi continues to endure one of the highest overall poverty rates, with fully 22% “food insecure” households.

Food insecurity virtually guarantees poor nutrition; and poor nutrition, if not outright malnutrition, is a salient element in the complex of factors contributing to exceptionally poor health and poor health outcomes in our state.  Cutting SNAP benefits will only worsen the harm to health.

Dr. Michael Forster

Lead in drinking water is a public health catastrophe

It turns out that the water crisis in Flint, Michigan is just the tip of the iceberg.  A USA TODAY investigation making the news today has turned up about 2,000 water systems across the country – 350 of them supplying drinking water to day care centers and schools – indicating excessive lead contamination over the past four years.  Approximately six million Americans are directly affected.

Even small quantities of lead pose serious human health hazards, notably to children and pregnant women, damaging developing brains, reducing intelligence, and prompting attention and other behavioral disorders. Lead is also implicated in a range of adult health problems, including hypertension, kidney disease, and increased risk of stroke. There is no established “safe” level of lead exposure.

Who or what is the culprit in this emergent catastrophe?   More than anything now, it’s decaying public water infrastructure, designed – in many cases upward of 100 years ago –  by well-meaning engineers relying on lead as a pliable and durable pipe material.  Under the best of conditions, some lead will leech into the water supply; aging leaded pipes and pipe joints pose far worse problems for public health.

Replacing hazardous infrastructure is an expensive proposition, but one that must not be dodged.  There is simply too much at stake.