Debra Patt, MD, past chair of the TMA Committee on Cancer, says such a policy costs nothing up front and would improve health and save the state money in the long run. “The failure to pass a statewide com-
prehensive smoke-free policy is less about economics and more about per- sonal liberty. There has not been enough support within Texas government for a comprehensive statewide smoke-free policy largely due to the concern about infringement on the personal liberty of Texas smokers,” Dr. Patt said. Physicians say the failure to pass
statewide smoke-free workplace legis- lation puts many Texans’ health at risk. Comprehensive smoke-free workplace ordinances now cover 36 Texas cities. Twenty-nine states are smoke-free. “In the long term, lack of a compre- hensive smoke-free policy will leave many areas in Texas unprotected. Chil- dren and workers will continue to have
little control over exposure to tobacco smoke,” Dr. Patt said. Representative Crownover says thou-
sands of Texas workers will unnecessar- ily be exposed to benzene, formaldehyde, arsenic, and other carcinogens because HB 400 didn’t pass. For that reason, she intends to file the legislation again in 2015. “We need to educate the Senate. They
need to understand how much money is wasted and how many lives are being lost due to inaction. They need to hear from the voters about our individual rights to breathe clean air. They need to understand that the pregnant mother working two waitressing jobs can’t afford to choose between the health of her un- born child and her paycheck,” she said. To pass the smoke-free workplace leg-
islation, Representative Crownover says physicians must speak to their elected officials during the interim about the dangers of secondhand smoke. “Don’t wait until the legislature comes back to Austin in two years. Go to the town hall meetings and campaign events, and ask your senators where they stand on the issue. Make sure they understand that 74 percent of the voters in Texas support the right to breathe clean air,” she said. Eduardo Sanchez, MD, American
Heart Association deputy chief medical officer, is disappointed the legislature didn’t pass HB 400. “Tobacco continues to be the single biggest factor contributing to prevent- able premature death and disease and the avoidable associated costs. TPHC will be back in two years with some of the same priorities related to tobacco use, immunizations, and childhood obe- sity if our state’s health trends continue on their projected paths,” said Dr. San- chez, a TPHC member.
Obesity assessment debated The FITNESSGRAM was a hotly debated topic this session. Sen. Bob Deuell, MD (R-Greenville), filed Senate Bill 684 to make FITNESSGRAM testing optional for schools, and Rep. Dennis Bonnen (R- Angleton) filed House Bill 1156 to elimi- nate FITNESSGRAM testing in schools. Neither bill passed.
44 TEXAS MEDICINE August 2013
The FITNESSGRAM is a physical education assessment and reporting program required under current law for children in grades 3 through 12. It mea- sures a child’s aerobic capacity, muscular strength, muscular endurance, flexibility, and body composition TPS President Kimberly Avila Ed-
wards, MD, a pediatrician at Austin Regional Clinic, is happy the FITNESS- GRAM remains intact.
“The long-term data this assessment
provides will continue to help identify areas of increased prevalence of over- weight and obesity that can help deter- mine where initial targets for prevention and intervention should be focused. The FITNESSGRAM will also help identify successful interventions that are influ- encing long-term decreases in over- weight and obesity and that should be replicated.” The FITNESSGRAM may have gener- ated debate this session due to budget struggles among Texas schools, Dr. Avila Edwards says. “Given the cuts to school funding in 2011, it is reasonable to try to limit un- funded mandates. Lawmakers want to help school districts cut costs, but cut- ting the FITNESSGRAM should not be a target, as it is necessary for their stu- dents’ health and related academic suc- cess,” she said. Lisa Swanson, MD, a Mesquite pedia-
trician and a member of the TMA Com- mittee on Child and Adolescent Health, testified against SB 684 before the Sen- ate Education Committee on behalf of TMA, TPS, and TPHC. She asked com- mittee members to help schools imple- ment the FITNESSGRAM and to allow them to continue capturing critical data that can be used to fight Texas’ costly obesity epidemic. TMA and TPHC successfully lobbied for additional money in the state budget to keep the FITNESSGRAM assessment alive in schools and to collect data to ad- dress the state’s obesity epidemic. Despite support from TMA and TPHC,
lawmakers failed to pass some obesity prevention bills during the session. TPHC again advocated restoring a
half-credit of health and physical educa- tion (PE) as a requirement for gradua-
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