Why Government Loses Public Trust–Indiana Version

Most of us would avoid patronizing a butcher shop where the butcher routinely put his thumb on the scale.  We would take our business elsewhere.

When our state government lies to us, however, most of us can’t simply move elsewhere. Worse, we may not even find out that we have been misled.

I don’t know how it is in other states, but here in Indiana, we are most likely to encounter biased information when the people running the state are religious zealots. Mike Pence was uninterested in the nitty-gritty of governing, but he was intensely focused on imposing his religious beliefs on Hoosiers–he saved his real enthusiasm for his anti-gay, anti-woman efforts.

I had a much better impression of current Governor Holcomb, who has seemed refreshingly free of the urge to sermonize and actually appears to be tending to the issues facing Indiana. But then I came across this report.

Indiana ranks as one of the worst states in the nation when it comes to its infant mortality rate. In his state of the state address earlier this month, Gov. Eric Holcomb (R) called attention to this crisis and announced the goal of improving the state’s status in the coming years. As part of that process, in November 2017 the Indiana State Department of Health (ISDH) launched a new mobile app for its existing statewide campaign aimed at improving Indiana’s infant mortality rate. The app, Liv, was developed with state funding and includes pregnancy and parenting guidance.

It also provides users with contact information for health and service providers, along with basic descriptions of what the users can expect from those providers. But the app’s resource list excludes evidence-based family planning clinics and centers, such as Planned Parenthood and All-Options Pregnancy Resource Center (PRC), while including crisis pregnancy centers (CPCs): fake clinics that do not provide medically sound reproductive health care and actively lie to people seeking services.

Public health research shows that access to comprehensive family planning programs and services can help reduce infant mortality. Nonetheless, continuing the legacy of former Indiana Gov. Mike Pence (R), this app—and ISDH’s larger infant mortality initiative—promotes ideology over evidence.

Infant mortality is the result of a combination of factors, including poverty and lack of prenatal care. But research shows that comprehensive contraception and family planning help reduce infant mortality rates.

For example, as research from the Guttmacher Institute shows, access to contraception gives women the tools to space their births: “By allowing women to time and space the number of children they want, contraception prevents unintended, often high-risk pregnancies—too close together, too often, too early or too late in life—that can lead to maternal and child death and injury.” Additionally, addressing unintended pregnancies by increasing access to contraception and family planning services also contributes to increased prenatal care provision by establishing connections between patients and providers.

When policymakers allow ideology to trump evidence, and erect barriers to access for family planning services, you get the results we have been seeing in Indiana. In 2011, only 68 percent of infants in the state were born to women who had received prenatal care in their first trimester–and nearly half of all pregnancies in Indiana are unintended.   

Using taxpayer dollars to direct vulnerable women to crisis pregnancy centers, while omitting information about high-quality health services available through Planned Parenthood, is worse than irresponsible. Crisis pregnancy centers are purveyors of dogma, not medically-accurate information. They have no place on a state-run registry.

Women using the app don’t have to go to Planned Parenthood. But they are entitled to know that it is an option. For state government to omit a medically-appropriate service from a directory it has created and disseminated while including a “service” that offers dishonest “counseling” is unforgivable.

It certainly isn’t the way to cultivate public trust.


Evidence Can Be Such A Downer….

Last week in Indiana, as our legislature geared up for its short session, Governor Holcomb delivered his State of the State address. One of the major emphases of that speech was about the importance of worker retraining.

Gov. Eric Holcomb used his nearly 30-minute speech Tuesday night to set some lofty goals, primarily in the area of educating and training Hoosier workers.

He identified more than a million Hoosiers who need better skills and set a goal of educating or retraining 55,000 Hoosiers over the next year who didn’t finish college or don’t have a high school diploma.

Although the Governor’s emphasis upon jobs and attention to other actual governance issues represents a welcome change from his predecessor’s obsession with imposing his version of biblical obedience on citizens of Indiana, this focus on retraining ignores an inconvenient reality: data continues to demonstrate that these programs mostly don’t work.

A recent article in the Atlantic summarized our current situation.

The article begins by noting that the problem is very real: automation has decimated manufacturing employment; estimates are that nine out of ten manufacturing jobs have been replaced by automation since 2000. Trade (mostly with China) has cost America another 2.4 million jobs. Of the 1.6 million manufacturing jobs that were lost during the 2008 recession, only 200,000 came back.

It’s true that trade and automation also create jobs, but they are jobs calling for very different skills than those being lost.

Most jobs that are available–primarily in computer technology, health care, and high-skill manufacturing– require training beyond high school. But despite what the article calls “decades of investment” in job-retraining programs, numerous studies have found them to be ineffective.

One problem, according to experts, is that job-retraining programs “remain rooted in the industrial era.” They haven’t evolved with the economy.

Workforce-development officials and labor economists describe four main trends in the job market that make the road from unemployment to retraining more treacherous now than it was even a decade ago. These trends, according to observers, have turned the government programs to support dislocated workers into relics of the past.

Not only do we live in an era where the skills needed to keep up in any job are changing at a much faster pace than before, but states have added licensing requirements to an enormous number of occupations. According to some estimates, those licensing requirements have cost the economy some 2.85 million jobs nationwide. Nearly 30 percent of American workers need a license these days; in the 1950s, only 5 percent did.

Do we really need to license interior decorators, travel agents, painters and auctioneers?

Researchers have also determined that the speed of retraining is critical–being jobless for a year or more permanently hinders a worker’s chance of new employment. (Retraining is actually most successful if it starts before a worker leaves his old job, but few people have the benefit of sufficient advance notice to make that feasible.)

Finally–and this pains me, but I recognize its accuracy–retraining typically is offered through a college or university, and most laid-off workers, especially older ones, have minimal interest in starting or returning to college. Worse, most colleges take far too long to create or update retraining programs. (As I discovered when I joined the faculty at my own university, lack of urgency may be the defining factor of higher education–followed closely by lack of flexibility. Unfortunately, speed and flexibility are critically important to retraining.)

Perhaps the biggest obstacle of all is the “chicken and egg” character of the problem. As the Atlantic article concludes, workers aren’t likely to waste their time retraining simply to retrain. Unless there is a specific job at the end, they won’t bother.

As with so many of the issues we face in public administration, it’s more complicated–and daunting– than it seems.

As Chambers of Commerce endlessly reminds us, employers look to locate in places with an educated workforce. In the long term, we’d get a better return on our investment of tax dollars by increasing funding for public schools.

But this is Indiana. I won’t hold my breath.