Lawmakers must do more to fight cancer in Hawaii, report says


A national report by the American Cancer Society Cancer Action Network illuminates the need for more legislative work to combat cancer in Hawaii.

“How Do You Measure up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality,” released this month, evaluates each state’s activity on issues crucial to winning the fight against cancer. The report found Hawaii measured up to benchmarks in five of the 10 measured areas: tobacco tax and price increase, tobacco tax increase rates, tobacco prevention and cessation funding, and Medicaid expansion.

Rep. Nicole Lowen, D-North Kona, thinks Hawaii has done pretty well when comparing its efforts to prevent and treat cancer with other states. Still, she said Hawaii can always do more to improve health care, particularly when it comes to investing in preventive health services and promoting healthy, active lifestyles. She added, preventive health services can save lives and also money, as well as help people be healthier and increase productivity.

Sen. Josh Green, D-Kohala, Kona, who chairs the Senate Health Committee and is a full-time doctor, said Hawaii is making progress in regards to several of the highlighted issues, but part of the problem is Hawaii’s provider shortage and care access challenges. Mindsets can also be obstacles.

Green agreed the state is falling short in physical education time requirements. According to the report, Hawaii requires less than 90 minutes per week of physical education or doesn’t require physical education at all. This is alarming because of the nation’s soaring obesity rates, as well as the fact that weight control, dietary choices and physical activity are the greatest modifiable determinants of cancer risk for the majority of Americans who do not use tobacco. One in three cancer deaths is due to factors relating to poor nutrition and physical inactivity, including obesity.

Green spoke about the state’s early childhood obesity task force, charged with identifying potential legislation to address obesity, such as taxes on unhealthy foods to discourage poor eating choices, funding for more sidewalks and bicycle lanes to promote a healthy lifestyle, and offering more physical education classes for students. He thinks physical education should be mandated for every student in every grade, but said there has been opposition from some Department of Education officials who cite cost as a prohibitive factor when legislation has been introduced.

Green said he’s trying to impress on DOE that education is more than books and the state agency is neglecting physical education. For him, physical education goes beyond simply building a healthy physique through exercise and emphasizing essential life lessons, such as teamwork and sportsmanship. It should also help set the precedent of an active, healthy lifestyle for students to maintain as lifelong habits, he added.

According to the report, Hawaii is also one of five states that have no state funding for breast and cervical cancer screenings. Numerous organizations, including the American Cancer Society, recommend yearly mammography for women older than 40 and regular cervical cancer screening from women older than 21.

Green said the report does not take into account the state’s mammography self-referral law, which went into effect last year. The law allows women older than 40, for the first time, the right and ability to choose when, where and with whom they’d like to schedule their annual breast-screening exam, without a referral from their primary care physician or permission from their health care provider.

He also mentioned that legislation was passed allowing nurse practitioners to play a lead role in providing basic health services and preventive care, which may include screenings.

Hawaii has made moderate movement toward promoting pain control for patients and responsible pain medicine prescription practices to relieve suffering and improve quality of patient care. It has also improved access to palliative care.

Nationally, the report finds 38 states have reached benchmarks in three, or fewer, of the 10 legislative priority areas measured by the American Cancer Society Cancer Action Network. Only 12 states and the District of Columbia met between four and six of the benchmarks. No states met the benchmarks in seven or more.

“State legislators must take action on laws and policies that help people fight cancer by emphasizing prevention, making health care affordable, curbing tobacco use and prioritizing quality of life,” said Cory Chun, government relations director. “Missed opportunities to pass laws fighting and preventing cancer could limit state revenue and health savings, but could also limit the potential for saving countless lives from a disease that will kill 2,400 Hawaii residents this year.”

The report offers a blueprint for effective legislation on matters such as effectively implementing the Affordable Care Act for cancer patients and their families.

“As advocates, we have a duty to inform the public about ways to prevent and treat cancer, but our voice is not enough if state and local policymakers don’t take action to fund and implement policies and programs that we know work,” said Chun. “The best solutions will save lives and possibly millions of dollars in health care costs, and in many cases, it would cost Hawaii little or nothing to do the right thing.”

To view the report, visit acscan.org.