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Hunger is a public health problem – Kansas Public Health Association, Virginia Lockhart Health Education Award, 9/19/13

Dr. Deborah Ballard-Reisch’s remarks upon receipt of the Virginia Lockhart Health Education Award from the Kansas Public Health Association, September 19, 2013


1) I wish to thank Pamela O’Neal a former student, constant friend and support, and public health cliff jumper for nominating me for this award

2) I am thankful to the KPHA for honoring me with an award named after a true KS public health pioneer, Virginia Pence Lockhart

3) I am eternally grateful to the Kansas Health Foundation for endowing Wichita State University and the Elliott School of Communication with the gift that funded the Kansas Health Foundation Distinguished Chair in Strategic Communication which I have been honored to hold since August 2007. This position has allowed me to follow my passions in support of community-based approaches to research & health promotion 

4) I would like to thank my students, friends and family who both jump off cliffs with me and show me other cliffs to conquer

5) I would like to especially thank my son Stefan who is with me today and my daughter Alyssa who is a junior at UNLV for their constant love, support, and adventurous spirits. 


 I would like to build on the perspective of Virginia Pence Lockhart – who stated in 1965 “Health cannot be given to the people, it demands their participation – beneficial action follows self education”. From my perspective, individuals and communities need to educate themselves on public health issues, while public health educators need to educate themselves on communities. Effective public health initiatives must be appropriately tailored to contexts.


 In the words of Rick McNary, founder of Numana Inc. of El Dorado, KS, I am in the hunger space. 

1) It gives me PAUSE that in 2012, 14.5% of US households were food insecure – 72% of them families with children. Food insecurity impacts more than 49 million Americans.

2) It gives me PAUSE that the US House of Representatives is considering a proposal to cut the SNAP program while millions of Americans are struggling to find good jobs and to afford healthy food for their families.

In public health, we talk about obesity epidemics – 1/3 of adults and 17% of children – 25.5% of the total U.S. population are obese – that’s 79 million people.

We talk about a diabetes epidemic – 8.3% of the U.S. population, 25.8 million people have type 2 diabetes.

However, it gives me PAUSE that we often overlook the potential role food insecurity may play as an underlying contributor to these problems.

 While these issues give me pause, 

1) I am INSPIRED that there are legislators who “get it”. More than 30 legislators took the SNAP Challenge to eat on $4.50 a day during August. I am grateful for the insights they gained.

Congresswoman Robin Kelly  IL stated – “You can’t get the healthiest foods because they’re too expensive”. 

Congressman Jim McGovern MA concluded – “People in this country should have a right to food, to have enough to eat, to have access to nutritious food. 

2) I am INSPIRED by Numana, Inc. and Stop Hunger Now and their food packaging efforts that allow people to “get their hands dirty” to “feed the starving” people around the globe. Empowering people leads to sustainable change.

3) I am INSPIRED by my students who even today are planning what has morphed from a WSU Hunger Awareness Day in 2010 to a month long campus-wide collaboration.

4) I am INSPIRED by our community and university partners around the world who have shared their experiences with us and invited us to speak on their campuses using our experiences as a model to help them form their own initiatives.


 1) We can educate ourselves:

Join the Wichita State University Hunger Awareness team and me. Take the SNAP Challenge and live on $4.50 a day for food! We’ll be doing this over the next two weeks. We want your blog posts, facebook posts, tweets, emails.  We understand people best when we can walk in their shoes.

2) We can take steps in our daily lives to make a difference:

Shop the Feed USA Target/ Feeding America collection sponsored by Lauren Bush at local Target stores.

Take part in the No Kid Hungry Campaign – You eat at their restaurants; they donate. Participating restaurants in the Wichita area taking part are Arby’s, Orange Leaf Frozen Yogurt, Cici’s Pizza.

Join me for the 4th Kansas Hunger Dialogue – which will be held at the Hyatt Regency in Wichita on February 26, 2014. Join university and community partners to discuss strategies to wipe out hunger here in Kansas and talk about model programs we have already developed.

Lobby Congressional representatives! Critical decisions that impact the most vulnerable Americans are under consideration now. We must make our voices heard.

In closing, I would like to quote Bob Dole & Tom Daschle in their LA Times article published September 19, 2013. “As a nation blessed with a bounty of food, we are a nation with a duty to fight hunger”.  

Food insecurity is a public health problem.  

Food insecurity is a public health problem that impacts many other public health problems.

ImageEducated, we’ve got the power to end hunger and food insecurity, perhaps not by 2015 as the UN Millennium Goals outlined, but in our lifetimes. 

Thank you again for bestowing this prestigious award on me. 

Communication Strategies to Keep Marriages Strong

My colleague, Dr. Dan Weigel and I have been conducting research with committed married and romantically involved couples for over two decades.  The article attached is a compilation of the findings of our research condensed into 10  Communication Strategies to Keep Marriages Strong.

Some folks using MAC computers are having trouble getting to the above link. Try copying it, opening it in a new browser and accessing from there. Sorry for the inconvenience!

Responses to questions on health care reform

First, thanks for all the feedback on my prior blog with powerpoint on health care reform. Below I’ve tried to address some of the remaining issues that have arisen.  I am more committed than ever to REAL reform and this this ongoing conversation is critical to that end. Our health care system is broken. Worse yet, it is destroying businesses and individuals. It must be fixed now! I’m not convinced we yet have THE answer. I am convinced ongoing dialogue is critical to getting us there. Special thanks for my friend Chris Purk for constantly challenging me. Much of the response below was culled from an ongoing conversation we are having on facebook! Please join in! A great source for discussion on the health care needs of our nation, check out the nonpartisan National Coalition on Health Care at:


Premise #1:

If this health care bill isn’t the answer, our representative MUST craft one that IS! The power of special interests and lobbyists in the realm of health care reform have stopped the process of real reform for decades. We have been trying to take small steps for a very long time. PPOs, HMOs, managed care have all been stop gap efforts to control costs and increase the quality of care. They haven’t done so.

Premise #2:

There is simply no incentive for insurance companies, pharmaceutical companies, or health care providers to lower rates. It’s in their best interests to keep the run away price increases going. Bottom line: They make more money this way!

Premise #3:

Any cost estimates on either side: that health care reform won’t cost a thing OR that it will cost trillions are flawed. NO ONE can anticipate the contingencies that will ACTUALLY lower costs. The capitalist model says if you increase competition, costs will drop. That’s what a public option would do.

Premise #4:

This issue is NOT just about the un and underinsured. Health care costs are hurting EVERYONE!  We are already paying for the un and underinsured. They go to emergency rooms sicker and take longer to regain health (if they do at all) than those with insurance. They are less likely to get standard preventative care than those with insurance. They pay all they can and we (taxpayers) shoulder the rest. Insurance and preventative care are BETTER options than emergency room visits. Emergency rooms visits, the most expensive health care in the country, should not be the first line of health care for anyone.

BUT, the current health care system is NOT hurting only the un or underinsured. It’s hurting everyone – BUSINESSES that can’t afford to pay premiums are cutting benefits to employees and many are cutting insurance benefits all together or anticipate significantly reducing them in the near future. Business leaders are arguing that the single biggest factor in reduced R&D and their inability to expand the workforce are health benefits. We can’t get jobs for people if employers can’t afford to hire them.

EMPLOYEES are paying higher health care premiums and finding themselves with less coverage. People can’t afford to change jobs due to the fact that they may not be able to get insurance coverage, especially if someone in the family has a chronic or preexisting condition. People are losing their homes to cover medical costs; a large percentage of both personal bankruptcies and home foreclosures are linked to health care costs. And all this for a health care system that is ranked 37th in the world!

My personal “out-of-pocket” costs for health insurance doubled for next year, my co-pays on everything increased at least 20% and more medications are not covered at all. Fortunately except for my daughter’s issues with migraines, we don’t need any medications on an ongoing basis. As you know my daughter has been having problems with migraines. My COPAY for 10 migraine tablets (which she could use up in 5 days) was $90 last week. This is nothing compared to the costs of medications many pay for chronic conditions. On a related note, I don’t know if you’re aware of this or not, but the very same drugs that cost so much here cost much less in other parts of the world. We subsidize American pharmaceutical companies to sell drugs overseas by paying more for medications here at home. We attach taxes on international pharmaceuticals so they don’t compete with American makers here in the U.S. hurting the American taxpayer all the way around for the benefit of big business.

I’m LOVING the content ideas many of you have discussed. A number of them are part of the current discussion including not being able to drop people who get sick or refuse to insure them when they have preexisting conditions. None of them, at this point, will reduce costs by increasing competition.  The system is broken! We need to fix it now before it permanently sinks our entire economy! Those we elected to represent us need to get the job done. It’s time!

Help with conversations on health care reform

Last week I was at the National Communication Association Convention in Chicago. As I rode the shuttle from one location to another, I overheard a gentleman pontificating about the “fact” that the overwhelming majority of Americans oppose health care reform. He continued in this vein the whole trip back. I sat there, struggling with myself.  One side of me said “It’s been a long day…This guy isn’t going to listen anyway… If he’s going to blatantly make up statistics that are totally contrary to the findings of actual polls with actual people, there’s no room for discussion….They’re not talking to you anyway and it would be rude to interrupt.”  The other side of me was saying “Seriously, if you don’t challenging these uninformed blowhards at every opportunity, people will accept what they say with such confidence even if it IS blatantly inaccurate”….”You’ve got the stats, call him on this!…. “Seriously, speak up!!!!!”  The tired side won out.

However, that means that you, dear readers, who may have found yourself in similar circumstances and chose not to speak might benefit from the attached powerpoint.  Tammy Allen, Lynn Stephan and I developed this for The Group in Wichita and thought we might share it here. Let us know what you think. Agree…. disagree…. whatever you think.  For us the critical issue is that we engage….which I regret to say I did NOT on the bus ride in Chicago.  

Health care reform and the role of insurance companies “why we NEED a public option”!

I wrote my first speech about the need for health care reform and the contributions insurance companies were making to skyrocketing medical costs when I was a freshman in college.  Very little has changed in the 3 decades since.  … Except in the negative direction.

What I’m sure about:

1)  I am sure that relying on big insurance companies to monitor themselves hasn’t worked in decades and that our health care costs have continued to skyrocket. In the last decade alone the increase in health care costs has been – 119% which is 3 times as fast as wages and 4 times as fast as inflation (Kaiser Family Foundation, 2009).

2) I am sure that these increases is unsustainable and hurt American families. In 2007, nearly 2/3 of personal bankruptcies were linked to medical expenses; 80% were people with insurance (Journal of American Medical Assn., 2007).  1,500,000 American families lose their homes each year due to medical costs (Health Matrix, 2008).  In 2008, about 57 million Americans were in families that had problems paying medical bills, and nearly three-quarters had health insurance coverage (National Coalition on Health Care, 2009).

3) I am sure that these increases are unsustainable and hurt American businesses. The current system decreases American manufacturers’ competitiveness. We spend: $2.38 per worker /per hour for health care costs   vs.$0.96 per worker /per hour for US trading partners (Heritage Foundation, 2008). While some would say the problem is that we pay benefits that are too high to labor union workers, this misses the point! Passing on the costs to workers hurts workers (see numbers above) and does NOTHING to make the cost of health care sustainable. The problem isn’t workers, it’s that COSTS ARE TOO HIGH!  Health care costs are the fastest-growing business expense in the U.S. (National Coalition on Health Care, 2009). They drag down earnings and wages, slow job growth,  and decrease dollars available for research and development.

4) I am sure that shifting the burden of health care insurance and health care costs to American families is NOT the answer (see #2 above). For those firms providing coverage, nearly 3/4ths of those surveyed (73 percent) say they are struggling to continue to provide coverage due to high insurance costs (Small Business Majority, 2009). In the Hewitt Associates 10th annual health care report, results of surveys with 343 executives “found that over half (52%) of employers believe the economic downturn will affect their health care programs in 2010. In addition, 19 percent of these employers are planning to move away from directly sponsoring health care benefits in the next 3 to 5 years, which is almost 4 times as many who reported this in 2008” (National Coalition on Health Care, 2009).

5) I am sure that increased competition is critical. From where I sit the provision of health insurance in many states looks a lot like a monopoly and one that rapidly is growing.

In 2007,  the American Medical Association reported that a single insurance carrier controlled at least 30% of the insurance market in more than 95% of insurance markets.  For 15 of the 44 states reporting, the top two insurance providers controlled 75% or more of the market. Twenty-two more states have 50%  to 74% of the market controlled by the top two insurance companies. For a breakdown of the percentage of the market is controlled by the top 2 insurance providers in the 50 states and the District of Columbia, see  Health Care for America Now, available at

A look at the Government Accountability Office report on Small Group Health Insurance Carriers by State released in February, 2009 comparing 2002, 2005 and 2008 results illustrates how the dominance of a few insurance companies is growing:

In 2008,

•   The median market share of the largest carrier in the small group market was about 47%, with a range from about 21% in Arizona to about 96% in Alabama. In 31 of the 39 states supplying market share information, the top carrier had a market share of a 1/3rd – 33% or more.
•   The five largest carriers in the small group market, when combined, represented 3/4ths – 75% or more of the market in 34 of the 39 states supplying this information, and they represented 90% or more in 23 of these states.
•   Thirty-six of the 44 states supplying information on the top carrier identified a Blue Cross and Blue Shield (BCBS) carrier as the largest carrier, and in all but 1 of the remaining 8 states, a BCBS carrier was among the 5 largest carriers.
•   The median market share of all the BCBS carriers in the 38 states supplying this information was about 51%, with a range of less than 5% in Vermont and Wisconsin and more than 90% in Alabama and North Dakota.

In comparing what states reported in 2008 to what they previously reported to GAO in 2005 and 2002, they found:
•   The median market share of the largest small group carrier has increased to about 47% in 2008 from the 43% reported in 2005 and the 33%  in 2002. Twenty-four of the 29 states providing information in both 2002 and 2008 saw increases in the market share of the top carrier that ranged from about 2 to 39 percentage points. In contrast, the top carriers in 5 states lost market share with decreases ranging from about 1 to 16 percentage points.
•   The number of states with a combined market share of the 5 largest carriers of 75% or more has also increased since 2002. The combined market share of the five largest small group carriers represented 75% or more of the market in 34 of 39 states, compared to 26 of 34 states reported in 2005 and 19 of 34 states reported in 2002.

The full report can be found at:

6) I am sure that it’s time we stand up to insurance companies who DO NOT have our best interests at heart – as evidenced by CEO compensation packages. Below from the Seton Hall University School of Law, Health Law and Policy Program website are the total compensations for CEOs of insurance companies for 2007 & 2008.  Following is a “humorous” analysis of just how much money this is!

“Perhaps a slight bit of context is in order, however: it has struck me that Aetna’s Ronald Williams received $24,300,112 last year. That’s $467,309.85 per week. That’s a house. Maybe not a house that Mr. Williams would live in, but a house nonetheless. The man makes a house a week. And interestingly enough, if Mr. Williams were to eschew the purchase of a house on any given week and instead look to deposit the money in a bank– in order to remain FDIC insured (up to $250,000)– he would actually need to open more than one account–every week. Lest we lament the fate of the other CEOs on the list, in 2008 Ms. Braly had to get by on $189,311.76 per week, and Mr. Hemsley had to somehow manage on $62,327.73 per week (but perhaps he was able to save a little from last year when he made $253,164.02 per week).  May 20, 2009 by Michael Ricciardelli Health Reform Watch weblog Seton Hall University.”

Ins. Co. & CEO With 2007 Total CEO Compensation

  • Aetna Ronald A. Williams: $23,045,834
  • Cigna H. Edward Hanway: $25,839,777
  • Coventry Dale B. Wolf : $14,869,823
  • Health Net Jay M. Gellert: $3,686,230
  • Humana Michael McCallister: $10,312,557
  • U.Health Grp Stephen J. Hemsley: $13,164,529
  • WellPoint Angela Braly (2007): $9,094,271
    L. Glasscock (2006): $23,886,169

Ins. Co. & CEO With 2008 Total CEO Compensation

7) I am sure that a public option that will offer competition to private insurance companies, and if properly formed, will help bring the cost of health care insurance down.

The following video by Robert Reich (Secretary of Labor in the Clinton administration, Professor at UC Berkeley outlines succinctly the points that it’s not too late to get a public option and that insurance companies want it to fail.

8 ) I am sure that it is up to us, the American people, to hold our Congressional leaders accountable and to demand that this decades old problem be addressed, that a workable solution be found, before we permanently damage the economic viability of families and business nationwide. Phone, tweet, blog, email, write your Congressional representatives and demand that they get the job done on health care reform.

Health care should be a right, not a privilege!

Dear Senator Reid – GET A GRIP!

As a long time Nevadan and recent transplant to Kansas, I would like to express the sincere and deep displeasure of myself and many Americans with the sorry state of the U.S. Congress. For the first time in a long time democrats have the majority, have the capacity to make real change to benefit the American people, and have failed to show the leadership necessary to carry that change through. Unfortunately, historically this has been too often the case.

The opposition utilizes clear, concise (often blatantly erroneous if not flagrantly false) statements to support their positions. The democratic response is to pretend these are reasonable claims and to try to answer them – illegal immigrants covered under the reform plans, euthanizing your granny, the list seems endless. What the democratic leadership and the democratic members of Congress NEED to do is state clearly what they stand for and work for real, quality, necessary change, not chase phantoms designed to distract, dissemble and disable quality initiatives.

The democratic desire to compromise on basic principles is flawed and futile as evidenced by the Senate’s inability to support a public option in health care reform. The American people gave President Obama a clear mandate by both electing him and giving both houses democratic majorities. The American people in poll after poll have told you they want a public option in health care reform. You are squandering that mandate to the disadvantage of the American people. You are not acting in the best interests of the American people.

Get it right, Senator Reid. You are wasting the capacity you have as Senate Majority Leader and it is the American people who will ultimately pay for this.

Reflections on 9/11/01 and my life since

Eight years ago, in the midst of my busy, getting-ready-for-school morning, my ex-husband called and said “turn on the TV”. I asked, “what station?” He said, “any of them”. I asked, “what is it?” He said, “I can’t talk about it. Just turn on the TV. You’ll see.” And I saw.

I awoke this morning, eight years later, to a lovely sunrise. Colors muted by a light fog.  It was ethereal. I smiled.  As the morning progressed, it got gray and overcast. Appropriate, it seemed, for this day.

I decided to take  time to reflect on that morning eight years ago and my path since to where I am now. First, I paid tribute to that day. I pulled up facebook and YouTube and searched for tributes. I read what my friends were posting on twitter. I listened to music. I cried.  It amazes me sometimes how something that long ago can still have such a powerful impact.

I am reminded how the difficult, as well as the lovely moments, both take our breath away and define our lives. Mine will never be the same.

The feeling of despair and fear was overwhelming that morning as I watched repeated images of the planes flying into the World Trade Towers, and later, the images of the towers falling, the plane in the Pennsylvania field, the damage to the Pentagon. I felt such vulnerability for myself, for our nation. In the days following, I was so proud of how we, as a nation, as a people responded. I was gratified at the kindness and compassion of the rest of the world. I felt more tuned in to both my place in this nation, and my place as a citizen of the world. I felt humble. I strove to understand.

I vowed, as many did, to live more fully in the present, to move more slowly, to make more thoughtful choices, to make certain that those I love always know it. It seems like a good time to reflect on how I’m doing.

Since 9/11/2001, I’ve made many changes in my life. I moved to Ohio for six months, back to my home town, so my daughter could go to school with her cousin. My daughter and I moved to Kansas so I could take my dream job. I purchased my dream house. “Invested” in real estate (I can’t sell my Reno house because the market is so bad, so that’s how I’ve decided to frame it for myself). I left my son in Reno to pursue college and dance. I could not have imagined how much I would miss our day-to-day patterns of living together. I’ve watched my daughter move from elementary school to high school and marveled at the amazing people my children are. I’ve recently become almost painfully aware that my time as a full-time mother is coming to an end. It’s amazing how years can pass in mothering, filling the gaps and the empty moments with “kid” activities. My daughter drives now and while we share a car, her independence is growing.

For the first time, I am required to take time to think about what I want for the next phase of my life, my post full-time mommy phase. Today seems like an appropriate day to review and reflect. So back to those vows I made to myself on that overwhelming day eight years ago.

1) to live more fully in the present

My prior to 9/11 self could easily be described as a multitasking over achiever. I juggled a significant number of tasks ALL the time. I could never say “no” and my mantra was “I can do that”. I didn’t always know HOW, but I knew that somehow I WOULD do whatever needed to be done. There are a number of characteristics of this style that I ultimately viewed as problematic. I was always focusing on the future. I didn’t take time to appreciate what I had accomplished and was instantly off to the next thing. That meant both that I didn’t appreciate what I had accomplished as it was just something to cross off the list and, more importantly, because I was always focused on the future, I didn’t adequately appreciate the present – except as the space within which I was “getting something done”. Don’t get me wrong, these characteristics have helped me accomplish all I have in both my professional and personal life and in many ways I’m grateful to have had that approach. That said, it became clear to me that I noticed and enjoyed the  awe inspiring  moments, sunrises, sunsets, the sound of my daughter’s laughter, watching my children perform. Those moments could bring me up cold, stop me in my tracks as it were. I was not so good, however, at noticing the beautiful in the everyday, mundane, process of my life. I was not so good at “being” in the moment. I had to either be “doing” or observing, OR and even worse, if I could make myself just stop, just be, I felt guilty for NOT getting anything done, for WASTING time. Historically, I lived too much in my head and not nearly enough in the “real” world.

2) to move more slowly

Related to living more fully in the present is slowing down. When I multitasked, I moved very quickly. When that happened, I  missed the details of what was going on around me. I forgot to eat. I slept poorly and for only 4-5 hours a night. I sat for hours at a time at my desk, my computer. I worked through sickness, exhaustion, I stayed up all night to complete a task. I told my students, “make me make eye contact if you need my full attention”. I told my children, “you’ll likely need to tell me that again because I might not remember”. Productive, yes. Fulfilling, no.

3) to make more thoughtful choices

I’ve always been thoughtful. What I hoped for was to take more time to think through choices. My strategy in my prior life was to take every opportunity that came my way. It was fun, exciting! It led to the multitasking thing I mentioned earlier. I had always had goals. Now I wanted to take time to consider alternatives more carefully, to choose my path.

4) to make certain that those I love always know it

This has probably always been one of my strengths. Those I care about know it. I say it. I show it.

I’ll close for now, at 7:54 p.m. on September 11. In my next post, I’ll assess how I’ve done.

Reflections on the candlelight vigil for Dr. Tiller in Wichita May 31, 2009

I know many people have written about Dr. Tiller’s murder. I know that his death will galvanize and polarize those who supported as well as those who disagreed with his beliefs and actions. I did not personally know Dr. Tiller, but I was compelled to attend the candlelight vigil last night.  I was impressed with the civil, thoughtful, compassionate assembly.  Those in attendance were kind to one another; members of Dr. Tiller’s church passed out candles and walked through the crowd of around 400 people relighting candles that were blown out by the wind.  Strangers stood side by side and shared their sadness, their determination for the future of women’s health, their fears for the future, and lit and relit one another’s candles.  People met and embraced friends who shared their sadness at this tragedy. I left when the singing began with a greater appreciation for Wichita. I appreciate both diversity and conviction. I keep being surprised by both here. I appreciate the careful, thoughtful way those who spoke talked about Dr. Tiller’s life and contributions to the community and to women’s health choices in general. I appreciate the courage of conviction and ability to look at the bigger picture of those who spoke.  It’s always easier not to make waves, to choose the safe, nonthreatening path.  Dr. Tiller lived for years consciously, publicly taking the most difficult of paths, living the courage of his convictions. I am saddened that such a tragedy occurred in my adopted city. I am heartened by those who attended and spoke at Dr. Tiller’s vigil.   In the face of a tragedy, Wichitans in Old Town last night pulled together in thoughtful compassion and proved that the actions of one man did not reflect the views of many. On balance, Wichita earned positive marks from me yesterday.