It's too costly with too few results, they say. Advocates insist it's too soon to draw any conclusions on effectiveness.
An ambitious program intended to help Minnesotans slim down, eat nutritious food and ditch unhealthy habits is losing momentum and financial support, and officials caution that a goal of saving nearly $1.9 billion in future health care costs is slipping out of reach.
The Statewide Health Improvement Program, known as SHIP, burst out across the state in 2009 as community gardens, fresher food in schools, employee wellness programs for small businesses and efforts to make public places smoke-free.
Now, in the wake of its funding being slashed by more than two-thirds last year, the program -- envisioned as a years-long effort to change how people think about their health -- faces an uncertain future.
At the Capitol, some in the Republican majority question the value of designating millions of dollars for the prevention-oriented public health program.
"I don't believe, and have not seen, any evidence that the money being spent has any measurable effect on anything," said Sen. David Hann, R-Eden Prairie, who chairs the Health and Human Services Committee.
"Is it the duty of the state government to provide bike racks to people?"
Program advocates, however, disagree.
Thousands of people of all ages are participating in hundreds of programs all across the state, they say, and it's just too soon to measure broad health and financial benefits.
"This doesn't just happen in two years," said Pat Adams, director of the Office of Statewide Health Improvement Initiatives at the Minnesota Department of Health.
"We know that our obesity problem didn't happen over the last two years. It happened over the last decades as our lifestyle has changed. This is about communities changing their norms to embrace healthy behaviors."
SHIP was the biggest expense in the Legislature's 2008 bipartisan package of health care reforms aimed at cutting future costs.
The pitch was that spending money on sustainable ways to make healthy choices easier would save money in the long run because there would be less obesity and chronic disease.
The program got $47 million in its first two-year cycle, but that was cut to $15 million for the next two years in the budget wrangling that led to last year's state shutdown.
According to a Minnesota Department of Health report released this month, SHIP grants sent to counties and tribal governments were spent to plant community gardens, teach day-care providers how to incorporate healthier snacks and more physical activities, allow farmers markets to accept food stamps, install bike racks, make plans to improve walking and cycling trails, and put up signs declaring smoke-free parks, hotels and apartment buildings.
'Changed the conversation'
Many counties also worked with hospitals, clinics, businesses and nonprofits to help build wellness plans and networks of community health resources.
"SHIP has really changed the conversation in the state about how to really look at health," said Dr. Edward Ehlinger, state health commissioner.
"As I go around the state and talk with folks, they see this as a way of really improving the health in their community."
At Diversified Plastics, a Brooklyn Park manufacturer with about 50 employees, a Hennepin County SHIP program helped energize a fledgling wellness initiative, recommending ways to get employees' attention and then keep health and fitness programs fresh.
Many employees now work out or walk during their lunch hour and participate in "Biggest Loser"-style weight-loss contests.
At company meetings, employees snack on fruit instead of doughnuts.
Roger Vang, CFO and human resources director, said health insurance claims are down and insurance premiums have stayed largely flat even as premiums at many companies have gone up, saving about $100,000. "The payback was astonishing," he said.
But those kinds of dollar figures aren't available yet on a broader scale, in part because it takes time for behaviors to change and be reflected in statewide data or formulas used to project savings. And, supporters say, that wasn't a goal of the first two years of the project.
"It's not even realistic to think you could find those right now," said Lara Tiede, who manages SHIP programs for the city of Minneapolis.
Hann and his Republican colleagues, who have floated the idea of cutting SHIP even further, have noticed. The Legislature next year will decide whether funding for SHIP will continue.
"Unless the department is willing to show more rigor in terms of making an argument this money is going to result in something specific and measurable, I think we ought to quit doing it," Hann said.
The funding to keep SHIP going through June 2013 comes with the new requirement of a report on the program's health-care cost savings by next February.
But already, in the report released this month, the Health Department says the original cost-savings goal -- $1.9 billion by 2015 -- will have to be reevaluated because of the decreased funding.
The $15 million offered in the second round, for instance, wasn't enough to keep paying for SHIP programs statewide, and many counties lost some or all of their funding.
"The kind of cuts that SHIP has faced have been a real blow to the project," said Dr. Marc Manley, chief prevention officer for Blue Cross Blue Shield of Minnesota, which has offered grants to supplement SHIP work in some communities.
"What it does is makes it more likely that we're going to continue to face higher health care costs caused by higher tobacco use and obesity."
And local public health officials are hoping for a renewed commitment.
"So much momentum was created statewide," said Tiede, of Minneapolis.
While they got -- and are quick to say they are grateful for -- some SHIP funding in the second round, it wasn't enough to sustain all the programs they had offered in the first two years.
"There's a lot of work still to be done," Tiede said.
Katie Humphrey • 952-746-3286
The promise: The Statewide Health Improvement Program was to save $1.9 billion in health care costs by promoting healthy lifestyles and fighting obesity.
The problem: With some legislators doubting results, and state money woes building, its two-year budget was trimmed from $47 million to $15 million, curtailing programs.