Prevention: The cure for what ails us

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The Affordable Care Act provides new incentives to keep people healthier — with more people insured, profits won’t come from “heads on the beds” but from decreasing medical visits and building healthier communities.
 
Now that we’re at that tipping point, we must think strategically and creatively about how we can make sure our elected officials, and our entire healthcare system, continue to prioritize prevention and support the health of every American.
 
When a child is rushed to the emergency room with a life-threatening asthma attack, doctors do everything they can to treat that child, from breathing treatments to prescribing expensive asthma medication. But if that child returns to a moldy home, or breathes in air pollution from freeways and factories, his asthma will be triggered again, landing him back in the emergency room. Asthma alone costs our country 56 billion dollars every year.
 
While high-quality medical care is essential, the truth is that most of what influences our health is found where we live, work, learn and play.
 
In Oakland, Calif., the Public Health Institute’s Regional Asthma Management and Prevention (RAMP) program works with doctors, public health workers and community health workers to improve housing conditions by helping to tighten inspection and giving renters access to resources and legal support. RAMP is disseminating clinical best practices, advocating for insurance coverage of asthma management supplies and promoting reduced diesel emissions, projected to prevent more than 150,000 cases of asthma over the next 15 years.
 
They’re keeping families healthier.
 
Asthma, of course, is just one example. From obesity to hypertension, diabetes to cancer, medical providers spend their time, and our nation spends increasing resources, treating chronic diseases that are preventable. Obesity alone costs our country more than $147 million a year, and is projected to rise to $344 billion by 2018.
 
One way to change those numbers is by strengthening clinical and community preventative services. Payment mechanisms should make it even easier for medical practitioners to provide preventive services and to address community-level conditions that affect health. Improved health information technology will boost quality of care and identify individually tailored prevention. By linking clinical health with community health, we give patients access to safe places to play in their neighborhood when a doctor prescribes exercise, for example, and access to healthy foods to decrease diabetes.
 
At John Muir Health, a “patient-centered” pilot program combines the best of these approaches, using technology, tailored programs and case workers to coordinate care — in and out of the clinic — for its highest-risk chronic disease patients. They’ve saved $253 per patient each month, and reduced hospitalizations by 43 percent. We need to make it easy for every clinic and every healthcare system to do the same.
 
Communities must have infrastructure to keep their families healthy, too. Thanks to federally funded Community Transformation Grants, community health workers trained and supported by local health departments will soon provide diabetes and chronic disease management services in clinics and serve as a bridge to community efforts to prevent chronic diseases — saving money and lives.
 
Our elected officials can no longer afford to see healthcare as separate from these vital initiatives that keep our people healthy. Cost-effective protection and promotion of health must be at the top of Congress’s agenda. We need to protect and strengthen our investments in community prevention, beginning with the innovative Prevention and Public Health Fund.
 
Congress and the president must also work together to avoid sequestration and the potentially devastating effects that it could have on our nation’s health. They must protect the discretionary funds that are at the core of creating a healthier America, from medical and scientific research to public health, housing and social services. A legislator truly committed to reducing the deficit won’t slash the public health funding that strengthens the economic health and security of our nation and the well-being of individual Americans.

We all share a vision for a healthier America. We now must share a commitment to the path that will get us there. A healthy America depends on healthier Americans, and it is prevention that helps ensure all individuals can reach their fullest potential.

Pittman, Ph.D., is president of the Public Health Institute, dedicated to promoting health, well-being and quality of life across the country and around the world.

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