TMA Written Testimony
Senate Committee on Health and Human Services
Written Testimony on:
Senate Bill 1119 Senate Bill 1121
Senate Bill 1313 Senate Bill 1312
by Sen. Eddie Lucio Jr.
April 9, 2019
Chair Kolkhorst and members of the committee, the Texas Medical Association, representing nearly 53,000 physicians and medical students, is pleased to share our comments on Senate Bill 1119, Senate Bill 1121, Senate Bill 1312, and Senate Bill 1313 by Sen. Eddie Lucio.
TMA members supported Senate Bill 1680 in the 85th Texas legislative session because we recognized it as a call to action for state and local public health officials to collaborate on a study and plan for increased support for the health of border county residents. We do not take a position on all of the components of each bill named above but focus on the challenges in Texas in the management and prevention of vector-borne diseases and certain chronic diseases.
SB 1121 and SB 1312
Residing in both rural and urban communities, millions of Texans live, work, and travel within miles of the Texas-Mexico border. In addition, thousands of people cross the Mexico-U.S. border each day. This international movement supports Texas’ commerce and family relationships but also presents a challenge in the monitoring and management of communicable diseases. Further, the climate and severe weather events in border counties are more amenable to certain vectors (e.g., mosquitos, ticks) that can transmit disease to residents and animals such that Texans now must be prepared throughout the year to avoid previously unheard of infectious diseases such as chikungunya, West Nile virus, dengue, or Zika.
Our state’s recent history with Zika as well as the Ebola cases in 2014 highlight medicine’s concern for strong surveillance and management of vector-associated and travel-related transmission of diseases. Both SB 1121 and SB 1312 offer action to address the lack of adequate laboratory testing resources and management of vectors that can spread diseases. Texas is fortunate to have one of the premier public health laboratories in the country, but it is supplemented with federal support that is not readily available throughout the state. Yet the need for planning and funding for laboratory support is eminently concerning in the border counties because of the vastness of this area along with substantial population movement and migration. We do not support further strain on the state’s limited laboratory resources, but we strongly encourage you to ensure state and local public health officials have the resources to remain engaged in strategic planning for supporting border county efforts to reduce the widening spread of old and new vector-borne and zoonotic diseases.
SB 1119 and SB 1313
Decades of research on obesity and physical activity inform us that obesity is associated with various individual factors throughout the lifespan including sleep patterns, daily nutrient intake and physical activity, metabolism, and genetics. But obesity has increased exponentially around the world because we are less physically active at work and at home and because of our low intake of nutrient-dense foods that are typically much less affordable and accessible than lower-cost manufactured foods.
In a part of the state that grows much of the foods Texans eat every day, studies show that families living in border counties are more likely to lack the resources and information to purchase nutrient-dense foods, and they live in an environment that does not promote physical activity. We support these proposals to develop public health initiatives for childhood obesity and chronic health conditions as they will ensure collaboration with educational experts, state agencies, and researchers in this field. Physicians are now providing care to children with obesity who are much more likely to develop metabolic disorders and other chronic conditions. They are also more likely to struggle socially among their peers. We recognize that the management and treatment of childhood obesity starts with the parents, and all must be involved to make healthy changes in the family and community setting and support a reduction in obesity and disabling chronic conditions.
In closing, the funding of these activities presents a challenge at the state and local level. Each year Texas gains more than half a million new residents, and many of these residents – children and adults – live and work in the counties bordering Mexico. Both urban and rural border counties have varying levels of public health resources but all face growing challenges to protect the health of their residents. Our local and state public health infrastructure must be prepared to respond to emerging health threats. Texas will continue to grow, so we must continue to look for and promote improvements in our public health systems with evidence-based and community-based initiatives. We applaud the Texas Legislature and Senator Lucio for highlighting the need for short- and long-term plans to support a healthy environment for the children and adults living along the Texas-Mexico border and offer our support in implementing this legislation.
86th Texas Legislature Letters and Testimonies
TMA Legislative main page