In just two years, the Statewide Health Improvement Program has attacked obesity and tobacco use among Minnesotans with more vigor and focus than any state program in the past decade, supporters say.

Now, the initiative called SHIP could become a casualty of the state budget battle.

The program has added fresh fruit and vegetables to north Minneapolis convenience stores and helped schools replace student lunches that were filled with salt, fat and sugar with healthier choices. It's brought new resources to Anoka County to encourage people to exercise more and smoke less.

Minneapolis and Hennepin County joined developed best-practice guides for doctors on how to talk with patients about health risk factors, something that neighborhood clinics as well as Park Nicollet's Minneapolis clinic are trying.

Dr. Marc Manley, vice president and chief prevention officer of Blue Cross and Blue Shield of Minnesota, called SHIP the state's most effective disease prevention program since it tackled youth smoking a decade ago. Health care costs are the fastest-growing part of the state budget.

"To take on issues like obesity and really help people move more and eat better ... has made a huge difference," Manley said. "We couldn't possibly have the reach that the state health department has. ... It's been a long time since we've seen a program this powerful."

$47 million to 53 groups

SHIP was part of a bipartisan health reform package passed by the Legislature in 2008. Aimed at fighting tobacco use, physical inactivity and poor nutrition, SHIP in two years awarded $47 million in grants to 53 community health boards across the state and nine tribal governments.

The emphasis was on "trying to change the environment so that the healthy option is the easiest option, the default option," said Laura Tiede, Minneapolis SHIP manager. In many communities, SHIP funds helped community leadership teams quickly bridge the gap between theory and practice.

Anoka County was awarded a $2.3 million two-year grant, which has been applied in a number of ways. A few of the uses mentioned in a March update were the purchase of recreational equipment to promote physical activity, development of virtual tours of county parks to highlight recreational opportunities and creation of a healthy-choice after-school concession stand at Fridley High School. In addition, wellness committees were set up at various work sites to promote healthier lifestyles among workers and a large list of online resources was created for health care professionals to access and to use with patients.

Minneapolis used $3.2 million in SHIP funding to create healthier menus at Head Start centers and at some schools, added food stamp capability at some farmers markets and made it easier for city employees to bike to work. They developed a database of community resources that clinics can use to refer patients for preventive activities, like finding a park or community education programs to lose weight. That database is now being used by health departments around the state to add local resources to the list, said Megan Ellingson, health policy and program coordinator for Minneapolis.

Minneapolis, Bloomington and Hennepin County created guidelines that encourage doctors to emphasize prevention by telling patients their body-mass index and asking about physical activity, nutrition and tobacco use.

Doctors "are busy and have a lot of demands on their time," Ellingson said. "This is about handling chronic disease before it happens."

SHIP future in doubt

Gov. Mark Dayton's proposed biennial budget included funding for SHIP, but legislative proposals did not -- one of many budget items to be resolved to end the state government shutdown.

"To lose this would be horrible," said Eileen O'Connell, who led SHIP programs in Bloomington, Richfield and Edina.

Jim Topitzhofer, recreational services director for the city of Richfield agreed.

"We've made a lot of headway with schools and the city, but so much could happen here with clinics and businesses," he said. "The more we do to promote active living, the more it will impact health care costs. It's a lost opportunity."

Mary Jane Smetanka • 612-673-7380