Indiana does not fare well in a new report on what state and federal officials are, or could be, doing to discourage tobacco use.

The American Lung Association's "State of Tobacco Control" report evaluates every state and the federal government on their tobacco-control laws and policies, including for e-cigarettes. It assigns letter grades, like a report card.

Tiffany Nichols, advocacy director for the Indiana chapter of the American Lung Association, said there is room for improvement in the Hoosier State.

"We have three 'Fs'; and the 'Fs' are on tobacco prevention program funding, tobacco tax, and on regulating flavored tobacco products," Nichols pointed out. "'Cs' on smoke-free air, as well as 'C' on accessing cessation services."

Nichols noted the Indiana tobacco tax has not been raised since 2007, and her group is advocating for a $2 increase in hopes of deterring young people from buying tobacco products.

Another report, from the Campaign for Tobacco-Free Kids, said every year, almost 15,000 Hoosiers under 18 try cigarettes for the first time, and almost 12,000 adults die from smoking.

The Tobacco-Free Kids' report showed smoking-related illnesses take more lives in Indiana than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined. It estimates the annual health care costs in the state linked to tobacco use are nearly $4 billion.

Nichols hopes the right people are listening to the message.

"We will use the report to work with our Indiana legislators to enact these evidence-based tobacco prevention and cessation strategies," Nichols outlined. "Such as increasing our cigarette tax, properly funding our tobacco prevention program, as well as highlighting the fact that we do have a 'C' in smoke-free air, but we could have an 'A.'"

The American Lung Association also suggests enacting policies to eliminate smoking in all public places and workplaces, full implementation of the Family Smoking Prevention and Tobacco Control Act, which became law in 2009, and eliminating sales of flavored tobacco products.


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By Tim Spears for WISH-TV.
Broadcast version by Terri Dee for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

The intensity on the track during the Indianapolis 500 just might be matched inside the Indianapolis Motor Speedway's Infield Medical Center.

"I think there's lots of jokes about emergency physicians out there," IMS Medical Director Julia Vaizer said. "[Being] adrenaline junkies is one of them that floats around."

When the IMS draws more than 350,000 people for the "Greatest Spectacle in Racing," Vaizer says this the Infield Medical Center becomes the busiest emergency department in Indiana.

Vaizer says the most common issues for fans in the stands are cuts, bruises, and dehydration. While the race crews can need attention for anything from a common cold to a multi-car crash.

"A lot of times on race day, people think 'Oh, you just have intoxicated people there,' but we see patients with any kind of medical emergency," said Laura Stasila, assistant clinical operations manager at Infield Care Center.

The 18-bed clinic is split, separating the fans from the drivers and race teams receiving treatment. The driver's side is also equipped with a x-ray machine, ultrasound, and stocked with blood reserves.

IU Health, which operates the center, also has a helicopter on standby.

First built in the 1940s, Vaizer considers the Infield Medical Center at IMS to be one of the top motorsports medical facilities in the country.

The 200-plus member medical team working the Indianapolis 500 are also deployed in key areas across the track, staff first aid centers, and follow IndyCar to keep teams healthy on the road. It includes a mix of professionals: Nurses, residents, emergency medicine physicians, and specialists, such as a trauma surgeon and a neurosurgeon.

On race day, Stasila says the medical team often arrives in the morning, with some staying at the track already waiting for care. While the end of the race usually brings a rush of race team members who waited until the event ended to get something checked out.

But no matter how quiet or intense it gets, the goal remains the same: Safety.

"When you get this many people in one place, there's bound to be any kind of emergency that would happen," Stasila said.


Tim Spears wrote this article for WISH-TV.


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May is Lyme Disease Awareness Month and the latest state data show Wisconsin recently recorded the highest number of Lyme disease cases in state history.

Experts are urging residents to be mindful of the ticks carrying it as they become more active across the state. There are 16 confirmed tick species in Wisconsin and experts are focused on the "black-legged tick," or "deer tick," in the transmission of Lyme disease. Experts recommended taking preventive measures when spending time outdoors like wearing protective clothing and using insect repellent. They added you should perform tick checks and shower after any outdoor activity.

Dr. Xia Lee, public health entomologist at the Wisconsin Department of Health Services, said some ticks, especially younger ones, may be harder to spot.

"Those are usually the ones that we associate with a lot of the cases of Lyme disease or tick-borne diseases, most active in June and July," Lee explained. "This is also reflected in the number of people who go into the emergency department or go into the physician for tick bite-related illness."

The number of reported Lyme disease cases has tripled over the past 15 years, according to state data. Lee noted the Wisconsin Department of Health Services conducts surveillance and tracking of ticks for the public, including a tick identification service and a dashboard reporting ER visits for tick bites.

Deer ticks have spread from northwestern Wisconsin to every county in the state over the past 30 years. Experts said changes in land use, wildlife management and the environment have helped spread the disease.

PJ Liesch, entomologist at the University of Wisconsin-Madison, said the deer tick is a generalist feeder and can be found on many small mammals, in addition to deer. He added the increasing prevalence of the species has led to an emerging health threat.

"They are still spreading outwards," Liesch pointed out. "They seem to be moving into newer areas, in some cases that can be more like suburban backyards, areas where we haven't seen them historically. And they're still potentially expanding and we don't know when they are going to stop."

Liesch stressed if you are bitten by a tick in Wisconsin, there's about a 50-50 chance it is carrying Lyme disease. He emphasized the risk of Lyme disease transmission increases with the duration of tick attachment, which is why prevention and detection are so important.

"That's a pretty high rate of infectivity, kind of a scary number," Liesch acknowledged. "Even if you have a deer tick that is Lyme-positive, if you are checking yourself and making sure they are not attached to you for very long, that's going to greatly reduce the chances of transmission."

Some early symptoms of Lyme disease include fever, headache, fatigue, swollen lymph nodes, joint and muscle pain and a rash. If left untreated, more complicated conditions can develop.


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A new study showed in 2022, more than 240,000 hospitalizations in California could have been prevented with proper outpatient care.

Researchers said most of the patients had poorly-controlled chronic conditions like diabetes, heart disease or COPD.

Rhonda Smith, executive director of the California Black Health Network, which cosponsored the report, said her organization helps patients learn to advocate for themselves.

"I can tell you countless stories that we hear about patients who just are not listened to and then end up being hospitalized or misdiagnosed," Smith explained.

The report showed patients who rely on Medi-Cal or are Black, Native American, or English-language learners are affected the most. The report found the state could save $400 million a year if Medi-Cal members had the same rate of preventable hospitalizations as people with private insurance.

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, also a co-sponsor of the report, said the savings would help the state's taxpayers.

"Each preventable hospitalization has a significant cost to the system, and that's the cost that's ultimately borne by all of us, by all health care consumers," Savage-Sangwan emphasized. "We pay for our insurance right? Those rates are determined by how much money is being spent in hospitals, etc., and so it comes at a cost."

The report authors suggested policymakers resist calls to cut Medicaid nationally and to eliminate coverage for undocumented people in California. They also recommended hiring more culturally and linguistically responsive primary care physicians.