“An ounce of prevention is worth a pound of cure.”

 “An ounce of prevention is worth a pound of cure.”  Yes, it's a cliché, but it definitely makes sense for health care.   Who can argue with the fact that it’s easier to stop something from happening in the first place than to repair the damage after it has happened?

Yet, our health care system highly rewards the life-saving medical services that treat people once they’re already sick, and invests little in cost-effective public health programs.  Consequently, while state spending on health care services continues to grow, public health has endured significant budget cuts in recent years.

The basic premise of public health is ‘if we take care of ourselves today, we’ll save big by avoiding huge medical bills tomorrow.’   Investing in widespread prevention efforts prevents sickness in thousands of people, and save millions of dollars in future medical expenses.

An article published in the journal Health Affairs demonstrates that a greater investment in public health produces substantial health gains in communities. The thirteen year study examined spending changes in 3,000 local public health agencies across the nation, and their impact on community health in terms of preventable causes of death, such as infant mortality and deaths due to heart disease, diabetes, and cancer. The most striking results: for each 10% increase in public health spending, researchers observed statistically significant decreases for infant mortality (6.9% decrease), cardiovascular disease mortality (3.2%), diabetes mortality (1.4%) and cancer mortality (1.1%).  If your eyes start to blur at the site of statistics, this means public health prevention efforts are actually saving lives.

Chronic diseases account for 70 percent of all deaths in the United States and these diseases affect the daily lives of an estimated 25 million people, according to the Centers for Disease Control and Prevention.  Many of these diseases are preventable since the underlying causes of most chronic diseases are lifestyle choices.  These lifestyle choices or risk factors include using tobacco, being overweight or obese and physical inactivity.

The majority of today’s health care dollars are primarily spent on secondary prevention such as controlling high blood pressure with medication rather than preventing the development of high blood pressure by controlling risk factors.  Preventative programs would educate the individual concerning lifestyle changes that could achieve the same positive results without medication.

In some instances, lifestyle changes can prevent the onset and progressions of diseases such as Type 2 Diabetes and Chronic Obstructive Pulmonary Disease.  Once a disease has been diagnosed, the amount of money needed for treatment may be astronomical.

A survey report released by the Trust for America’s Health and the Robert Wood Johnson Foundation, found that Americans overwhelmingly support increased funding for health prevention programs.   In particular, programs that will help reduce the underlying factors that lead to chronic illnesses received the most support.

Recent research shows that every $10 invested in prevention programs will result in a five-fold savings in health care costs.  The programs most often cited are those that would increase physical activity, improve nutrition and eliminate tobacco use as well as eliminate the exposure to second-hand smoke.

The Health Affairs article provides strong evidence that investing in our community health will yield huge payoffs in the future. Not only do public health initiatives benefit a greater number of people, they are also less costly than comparable health care services that target the same diseases.

In an economic downturn, policy-makers must confront difficult choices regarding program funding cuts. In Missouri, public health has consistently made it to the chopping block.  In fact, our state is the lowest ranked state in the nation as far as dollars spent on public health.    Locally, state public health funding has been reduced by 53% in the last ten years.