Indiana: Why Government Loses Public Trust
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.