State, local initiatives fight Indiana's subpar life expectancy rate

Aug. 26—A Hoosier born in 2020 has a 75-year life expectancy, according to the Centers for Disease Control and Prevention. If they were born a year earlier, their life expectancy would have been two years longer.

The National Center for Health Statistics' provisional life expectancy estimates showed a national decrease in life expectancy. However, the national life expectancy fell by 1.5 years, compared to Indiana's two years.

The Governor's Public Health Commission took notice of the state's declining life expectancy. In its report to Gov. Eric Holcomb, submitted Aug. 1, 2022, the Commission noted Indiana ranks 40th among the nation's life expectancy.

A key factor in the state's falling life expectancy is the increasing rate of mortality among working-age Hoosiers (people aged 25-54), explained Matt Kinghorn, senior demographer with the Indiana Business Research Center at Indiana University.

While cancer- and heart disease-related deaths have declined since 2001, drug- and alcohol-related deaths have sharply increased, Kinghorn noted in research published in the Indiana Business Review's 2021 summer edition. There's also been a rise in suicide among working-age Hoosiers.

In 2021, Indiana saw an increase of fatal drug overdoses. According to the CDC, the state went from 36.7 deaths per 100,000 people (2,321 total deaths) to 43 deaths per 100,000 people (2,811 total deaths).

"First and foremost, these are personal tragedies," Kinghorn said. "And so when you see these numbers going up (mortality rates), it's a lot of lives that are seeing despair and negative impact."

At a statewide level, Kinghorn said, the rise in working-age Hoosier mortality creates problems for community development, labor force development and economic competitiveness.

There are serious economic implications when you consider the rising mortality is driven by drug addiction and alcoholism, Kinghorn added.

"For each person who succumbs to those causes, there are probably many, many more who are suffering from those same afflictions and probably aren't able to really participate in the economy to the fullest as a result," Kinghorn said.

"It's something that's been going on 20 years now. And so I think that you could probably talk to a lot of employers who would tell you that it's a big problem," Kinghorn said. "And again, these are secondary impacts. The first thing, the most immediate concern, is obviously getting help and trying to address the public health crisis."

Spreading the word

Early into the Indiana Senate's 2023 legislative session, the governor's Public Health Commission met with legislators with proposed changes to the way Indiana tackles public health.

During a Jan. 18 presentation to the Senate's Health and Provider Services Committee, Luke Kenley, co-chair of the Commission and a former state senator, acknowledged he had a frugal reputation as a senator.

Still, he urged legislators to increase state health funding.

"To continue the successes that we have, we really do need to improve our preventative health care, our public health care system," Kenley said after noting the state's investments in education and infrastructure.

Dr. Kristina M. Box, Secretary of the Commission and then-State Health Commissioner, delivered the bulk of the Jan. 18 presentation.

"I think what a lot of Hoosiers are not aware of is the fact that Indiana's life expectancy has been declining since 2010," Box said.

She went on to explain Indiana once boasted one of the highest life expectancy rates in the nation, then mirrored the nation's life expectancy for decades. The state began diverging in the early '90s.

Those decreases in Hoosiers' life expectancies haven't been due to Hoosiers 65 or older dying, she told the Committee. That population has seen an increase in life expectancy.

The decline comes from populations aged 25 to 64 years old.

When she was asked what could be attributed to the contrast between Indiana's and the nation's life expectancy rates, Box said traumatic injuries, overdose and suicide were the likely culprits.

She noted there was an increase of 16 trauma centers across Indiana since 2008, when the American College of Surgeons first assessed the state.

However, she noted, the new trauma centers lacked data collection, quality improvement and training. There are also regions that have restricted access to trauma centers, Box said.

Legislative session shows public health support

Senate Enrolled Act 4 mirrored the Governor's Public Health Commission's recommendations by setting up methods to transfer state health funds to localized health providers.

Additionally, SEA 4 established the Indiana Trauma Care Commission, which will develop plans to improve performance and access to the state's trauma care centers.

And when the Indiana General Assembly passed its primary budget bill April 28, state health funding had increased.

Specifically focused on decreasing overdoses, $5 million from an opioid settlement fund was allocated to the Substance Abuse Prevention, Treatment, and Enforcement Program to combat addiction.

Another $18.7 million from the state's opioid settlement fund was approved for substance abuse treatment and overdose intervention. The funds will be split between fiscal years 2024 and 2025.

Additionally, Senate Enrolled Act 1 allocated $100 million over the next two years to boost mental health care access.

Local initiatives drive solutions

Shane Beal, director of adult recovery services at Turning Point, explained the Howard County mental health and addiction recovery organization measures its success through the recovery of its patients and the popularity of its programs.

The nonprofit organization gets its funding through Medicaid — which Beal said is currently unsustainable — as well as grants, fundraisers and private donations.

"We stay pretty busy here," Beal said. "We're a recovery community organization, so we're different than a regular treatment facility because we have a lot of different things."

For example, he said, Turning Point opened a recovery stabilization center in December 2022 where patients can detox from drugs or alcohol. The stabilization center also helps patients with post-detox support like finding housing or medication assisted treatment.

Turning Point also has a low-barrier recovery cafe, where the only requisite for a meal or educational opportunities is the visitor's ability to not use drugs or drink alcohol in the last 24 hours.

The stabilization center, Beal noted, has drawn statewide popularity. He said there aren't many organizations in Indiana that have the same approach to addiction recovery.

"We have a unique opportunity to meet people and to get them the help they want pretty much immediately," Beal said. "We do everything here. People can come in with nothing, and we'll help them get kind of reestablished and restart their life."

In May 2022, Turning Point began distributing free packages of naloxone nasal spray. Better known as Narcan, the nasal spray reverses the effects of opioid overdose.

On Dec. 15, 2022, the organization worked with the Kokomo-Howard County Public Library to install the first naloxone vending machine in a public Indiana library.

"People went crazy," Beal said, adding Turning Point's Facebook post about the vending machine drew noticeably more social media interaction than any of the organization's other posts. Not all of the responses were in support.

"What I think it did was open people's eyes that, 'hey, we've got a problem.' And this is a way to solve it," Beal said. "It may not be the way you would solve it, but we have to meet people where they are."

The director of adult recovery services added he supports harm reduction services because it keeps people alive until they're able to find their path to recovery.

Between the vending machine and boxes Turning Point has installed across the county, the organization distributes an average of 650 naloxone doses a month. In December 2022, Beal said, Turning Point gave out 973 doses. More than 900 doses were distributed in January, as well.

"I think that tells you we're saving lives," Beal said. "650 doses is a lot."

Beal said there were likely myriad reasons Hoosiers struggle with addiction.

"I would say I don't know what the exact root cause is, because it's different for everybody. I just know it's prevalent," Beal said. "We're in a time period where we are dealing with a lot of addiction and really a lot of untreated mental health, too."

The emergence of cheap and addictive synthetic opioids, like fentanyl and xylazine, have certainly exacerbated overdose rates, though, he said.

Despite the challenges, Beal said he's optimistic Indiana can flatten the number of its drug- and alcohol-related deaths. As more people seek treatment and more recovery centers open across the state, he said, more people will get help.

"I don't think it's a lost cause. I think what we have is a business situation where we need to get more people help," Beal said. "For me, there's no lost cause. Every life is important. Every life is valuable. Every person is whole, respected and answers to their own journeyer within themselves."

James Bennett III can be reached at 765-454-8580 or james.bennett@kokomotribune.com.