Health and Politics

Stanton Shanedling: Hello, everyone! Welcome to Health Chatter! We hope you're enjoying your summer and staying cool amidst the heat. Today, we have an exciting episode with just three of us from the Health Chatter team, discussing politics and its effects on health. This topic is vast—we could probably do multiple episodes on it.

Before diving in, I’d like to recognize our amazing team: Maddie Levine-Wolf, Erin Collins, Deondra Howard, Matthew Campbell, and Sheridan Nygard. They handle research, marketing, and recording to bring this podcast to life. I also want to acknowledge my colleague, Clarence Jones, who co-hosts these shows with me. It’s been a fantastic journey as we approach our 100th episode. Thanks, Clarence, and thanks to our sponsor, Human Partnership—a great community health organization. Check them out at huemanpartnership.org, and visit us at the Health Chatter website to leave reviews or questions.

Now, Clarence, let’s dive into today’s topic: the intersection of politics and health. From my perspective working for the State of Minnesota, health policies and their impact vary across local, state, and federal levels. What strikes me is how little people generally know about what these agencies actually do. What do you think?

Clarence Jones: I completely agree. Most people don’t connect politics with health. For instance, many don’t understand how decisions by governmental bodies directly affect their well-being. There’s a disconnect in understanding how these agencies operate and their role in shaping health outcomes.

Stanton: Aaron compiled some research that’s really eye-opening. Studies suggest politics can significantly impact mental health, contributing to stress, physical symptoms, and fractured social networks. The COVID-19 pandemic brought some of this to light. Health often feels "invisible" until a crisis arises.

Clarence: Absolutely. Political decisions—or indecisions—can deeply affect public health. For example, I recently learned that the Flint, Michigan water crisis could have been prevented for about $2,000. Instead, poor political decisions led to a massive health disaster. It's a stark reminder of how critical political will is in health matters.

Stanton: That’s such a powerful example. There’s also a lack of understanding about how federal health agencies connect with state and local levels. For instance, the Centers for Disease Control (CDC) and other federal bodies often fund state health initiatives. When I worked in cardiovascular health at the state level, we used CDC grants to fund community interventions. These programs had tangible benefits, but the public rarely connects them to federal funding.

Clarence: Right. Agencies like the National Institutes of Health (NIH) or the National Institute on Drug Abuse (NIDA) play critical roles, but their work often feels abstract to most people. Understanding the real-world impact of their research and funding is crucial.

Stanton: Exactly. Federal funds not only support interventions but also fuel academic research that states often can’t afford. While the results of these efforts benefit communities, the connection to their federal origins often gets lost. The federal government, you know.

Clarence Jones: I was going to say, our topic today is politics and its effect on health. I really don't think many people understand how who you vote for impacts health. Making sure we have people who understand the importance of health is critical. You put people in office who don’t want to provide coverage for certain groups, and that has a huge effect.

Politics plays a major role in community health. Zoning laws, for example—people get put into office and decide to put incinerators right next to communities. That’s politics. People need to understand the connection between these decisions and health. It’s not something we normally explore.

Stanton Shanedling: Yeah. And there’s confusion, too. For instance, I remember being in DC when they were voting on the Affordable Care Act. I overheard a woman in line at a museum saying, “I don’t want the government involved in my health.” Being who I am, I turned around and asked her if she had Medicare. She said, “Well, yeah.” So I said, “You just said you don’t want the government involved in your health. Does that mean you don’t want Medicare?” She said, “No, no, I want Medicare.”

People say one thing but don’t recognize the connections. The Affordable Care Act, Medicare, Medicaid—even Social Security—all link to health. But there’s this disconnect. They don’t want government involvement but don’t want to lose these programs either. This back-and-forth creates confusion.

Clarence Jones: I was at the Academy of Health in Baltimore recently. One poster there showed the coverage of mental health services in communities. The creator mapped out available services and found that coverage is often better than we think, but only if you have the right kind of insurance.

There are huge gaps in communities that don’t have proper coverage because of inadequate insurance. This ties back to politics—we need ways to close those gaps. The topic of politics and health is broad and nuanced, with many underlying issues.

Barry Baines: Politics, for me, often ties back to policy. Policy development happens federally, like the Johnson Administration creating Medicare and Medicaid. But the state and local levels also play critical roles. For most people, it’s hard to understand how all these layers interact.

Our political system involves policy creation, legislative control of funding, and private insurance, which causes inequality. Some plans have robust mental health coverage, others don’t. How does the average citizen even begin to engage with this? People often focus on specific issues that matter to them, but with so many issues, it becomes hard to make progress.

Stanton Shanedling: Do we even know what to expect from government? What do we want from these entities for our health? And then there’s trust. Where does trust fit into this? During the COVID pandemic, people expected certain things from the government, but when trust got compromised, communication problems arose, creating confusion.

Clarence Jones: When you asked what we should expect, I thought about it. I think I expect access. I expect that when I need healthcare, it’s there for me. But earlier, I was thinking about pharmaceutical deserts and food deserts.

Clarence Jones: And you know, what role does politics play in the fact that I think they're saying something like 25% of Walgreens stores are closing? I mean, what does politics have to do with that? How does it affect the health of the community? And how does it impact rural Minnesota or rural counties across the country? It's pretty unclear.

Stanton Shanedling: Yeah.

Clarence Jones: I think there's a pie-in-the-sky kind of thinking about what we're supposed to have. There's a root cause: it's not there because the political will, the community's will, or the government's will isn't there. So, we're caught in this space where people are trying to figure out what’s real. What can I really expect from my government? And then we get into this "fake news" stuff. That messes with my mental health.

Stanton Shanedling: Yeah.

Clarence Jones: For a lot of people, it affects their mental health. For me, I just cut off the TV. I don't want to hear it anymore. Let me figure things out on my own. But that's my initial thought. What would I want? I'd want appropriate access to care, but that's not always available for me or for others.

Stanton Shanedling: Let’s dig deeper on that. When you say access, what specifically do you mean? Access to care? And how does that connect to insurance and government involvement?

Clarence Jones: Right.

Barry Baines: I'll add to that. Over the 50 years I’ve been in medicine, I've seen tremendous changes. It used to be mostly small practices—doctors in communities. Over time, because of our private-oriented system, there’s been consolidation. Government plays a role in regulating private insurance and health systems, but there are issues like monopolies and anti-competitiveness. Now, especially in Minnesota, just a handful of systems control a significant portion of care.

Stanton Shanedling: Health plans dictate much of that access. The government has some oversight but limited involvement with private insurance.

Barry Baines: True. But we've seen the impact more acutely in rural areas. Hospitals close, and access becomes harder. In urban areas, government-funded community clinics play a larger role, often tied to Medicaid. But the government doesn’t decide where private providers set up shop. I don't know how systems like Canada’s handle that.

Stanton Shanedling: Here's a question: would a single-payer system make things easier? Would it help with access and simplify things for patients?

Clarence Jones: I think it would help. But as I’ve discussed with others, politics plays a big role. Confusion equals money. That’s the unfortunate reality. There’s a financial gain in maintaining the status quo. A single-payer system would provide clarity and access, but money always plays a part.

Barry Baines: Right. When I started, doctors would even make house calls.

Clarence Jones: Exactly! I remember my doctor coming to my house. It was a different era.

Stanton Shanedling: That tradition is reflected in the medical symbol with the staff and serpent—it symbolizes the traveling physician. Growing up, my pediatrician came to the house to treat me.

Clarence Jones: Yes, but now we’re also dealing with corporate politics. It’s not just government; there’s a collaboration between corporate and governmental interests that shapes these policies. That dynamic complicates things even further.

Clarence Jones: Because, you know, the government can pass laws that kind of restrict organizations from doing certain kinds of things that might be very helpful for the community. They may not say it like that, but yeah, all these factors we have to take a look at. And we have to be much more attuned to what's really going on in order for us to really affect our community's health.

That's one of the things for me. And I'll be totally honest with you—I was talking to somebody recently about the work that we do at Huma. At one time, we did like 250 health fairs a year. You know, but that was a long time ago, when I was much younger.

Now, I find it’s important for me to be more involved in public policy-making to affect change. That’s hard for me because, you know, I don’t want anything to do with politics. But that’s where we have to go to really make changes in our communities.

At this point in my life, I see politics and health as really connected. So, I have to readjust myself to be able to do these things. And it’s a struggle because, you know, I’m like a kumbaya kind of guy. But kumbaya doesn’t work.

Stanton Shanedling: Yeah, right.

Clarence Jones: I mean, so...

Stanton Shanedling: You bring up a good point. You have to have good representation to help people navigate things—not everybody has the tools to do so. Which gets to this whole idea of leadership.

We’ve got governmental leadership—commissioners, assistant commissioners at the state, local levels, and so on. Then we’ve got heads of agencies like the CDC. And of course, we have politicians.

So how do we integrate leadership to positively affect health? I think that’s central to this whole conversation.

Clarence Jones: Yeah. Well, I’ll say this real quick, and again, I’m not being political. I have to talk like this. Okay.

Stanton Shanedling: Yeah, yeah.

Clarence Jones: I remember when Congress was talking about healthcare. They’re covered. If you’re a member of Congress, your healthcare is covered. But when you don’t have to worry about something, you’re not as sensitive to what other people might need.

And I think that’s part of the challenge. Some people already have it made, so they don’t have to think about these issues. It’s not something they need to worry about. But for the rest of us, we have to think about this stuff. We have to figure out how to use the political system to make sure our communities are getting the services they need.

Stanton Shanedling: Yeah, so we’re coming up into an election cycle. What kind of message do we, as people in the healthcare environment, want to share with our audience when it comes to elections? Especially when politicians and health intersect—what’s worth thinking about?

Clarence Jones: Well, I’ll tell you. A lot of people are definitely talking about mental health and politicians. There’s a lot of concern about mental health, capacity, and leadership at the top levels of government.

But at the community level, I’m driving through neighborhoods and seeing so many people with mental health issues walking the streets. What do we do, as community members and as politicians, to address that? A lot of it comes down to money—having funding to provide services for people.

I remember when they started closing down institutions and releasing people back into the community. It’s been a snowball effect. We’re seeing more mental health issues emerge, compounded by pressures like housing, food insecurity, and other stressors.

If these issues aren’t addressed, they become health issues—mental or physical. If it’s not mental health, it’s pneumonia from being out in the cold. All these factors point to the strong connection between politics and community health.

Stanton Shanedling: Is it more complicated today than it was before?

Clarence Jones: Barry, I see you shaking your head. What do you think?

Barry Baines: Yeah, no. I think it’s gotten extremely more complicated. And part of that is progress in healthcare—things keep advancing, and the system becomes more and more complex.

But from my perspective, what’s made it even harder is the extreme polarization in politics. It’s weaponized health issues. Take vaccines during COVID, for example.

In science, we test hypotheses. Sometimes we’re right; sometimes we’re wrong. That’s how progress works. But in politics, it gets oversimplified. People act like the first answer has to be the final answer, forever.

And when health becomes a political weapon, it divides people. We lose the ability to have civil conversations and reach agreements. Instead of tackling issues, we’re fighting each other.

At our core, don’t we care about the well-being of our communities? How do we break through this polarization? If I knew the secret sauce, I’d gladly share it.

Stanton Shanedling: Right. Erin, I’d like to get your perspective on this from a younger generation’s point of view.

Erin: I’m a little disheartened by our chat on politics and health. It feels like there shouldn’t be “sides” here. This is a topic where people should agree that they want to be healthy, want their families to be healthy, and want their communities to be healthy. It’s disheartening that politics has such a massive influence on health and well-being, and there are people who would rather spend less on keeping communities healthy. This feels like a grim episode because this is what we’re facing. It makes me nervous about the upcoming election.

Stan: What’s in your mind when you think about electing officials or leaders, Erin?

Erin: I really appreciated the earlier conversation about expectations. For me, my expectation of government is to keep me safe, including with healthcare. There are instances where I don’t feel safe. For example, as a Type 1 diabetic, healthcare is extremely expensive. I’m in the middle of a job transition, and I don’t feel secure because I’m worried about employer insurance and how the transition will go. In my mind, it’s the government’s job—not my employer’s—to keep me safe. So, when I’m voting for an official, I want someone who will advocate for safe communities, including healthcare.

Clarence: Thank you for sharing that, Erin. I think back to a time when I was doing a training session in an agricultural community. People were criticizing welfare, but I asked them, “What’s the difference between welfare and farm subsidies?” That question upset them. It’s how we define things that sets us up for unhealthy conversations. Instead of thinking “them versus us,” we need to recognize how interconnected we all are. If an epidemic breaks out in one area, it impacts everyone. Politics should be about creating safety nets for our communities. Otherwise, we all end up paying more in the long run. These are the things I can’t let go of.

Stan: Let me share more about that woman I mentioned earlier. We were in line to see the Declaration of Independence. I told her, “The government is us. You’ll see it in a moment—it’s we the people.” But many see the government as overbearing or negative, which creates a disconnect that hurts us.

Barry: My takeaway is an increased awareness of how politics and health are intertwined. It’s a complicated and ubiquitous relationship that impacts so many aspects of our lives. We can’t divorce politics from health. I encourage people to take a moment to reflect on how political decisions impact health. Also, start conversations with your friends and neighbors. You might find you have more in common than you realize. Dialogue and shared understanding are steps toward positive change.

Clarence: When I saw this topic, I thought about how emotional both politics and health are. It’s hard to combine the two and move the conversation forward. But having discussions like this is critical. We’re all at different places, but talking is important. Thank you all—Stan, Barry, Erin—for this conversation. I feel like I can see things a bit clearer now.

Stan: My last thought is that the intersection of politics and health is increasingly linked to power—whether it’s political leaders, agencies, or local entities. Unfortunately, I think the public doesn’t fully appreciate this dynamic, and it gets in the way of progress. Power and money are intertwined, and we need to reflect on how to embrace healthier concepts going forward.

Maybe after the elections, we can revisit this topic and discuss what the outcomes mean for our future. For now, thank you, Barry, Erin, and Clarence, for this great conversation.

Stan (closing): Our next Health Chatter episode will explore “fake news” and its implications, which ties into today’s discussion. Stay tuned and keep health chatting away.