“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.
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