North East Ohio

Moral and religious concerns may interfere with scientists’ studying how to prevent the spread of the human immunodeficiency virus (HIV) and other diseases and conditions caused by unhealthy behavior. Up to half of the deaths in the United States are preventable, many of them caused by unhealthy behavior. Yet a small fraction of the research funded by the federal government is devoted to understanding why people behave in unhealthy ways and how to encourage them to change these behaviors.

 

Such research tends to be highly controversial and is vulnerable to attacks by conservative groups. Another example of federal influence over state health programs is the Medicaid program of providing health care for the poor. The federal government provides 50 to 80 percent of the funding for Medicaid. States and counties administer the Medicaid program, providing the remaining funds, and must follow the guidelines established by Congress.

 

Since World War II, the federal government has used these powers to steadily widen its role in public health, among other matters. That trend began to reverse in the 1980s. In a political climate hostile to government, especially the federal government, there was a strong movement in Congress and the Supreme Court to cut government regulation and return more powers to the states.