Prevention and Public Health Fund

Transcription

1 Prevention and Public Health Fund Why is the Prevention Fund so important for Americans? An investment in preventing chronic diseases will pay off financially, while providing benefits to Americans health, our economy, our international competitiveness, and our military, with particular benefits for low income communities, communities of color, seniors, and schoolchildren. The Prevention and Public Health Fund will provide a five fold return on investment, with the estimated average return being more than five dollars for every dollar spent within five years. An investment of $10 per person annually in proven, community based public health programs could save the United States more than $16 billion within five years a $5.60 return for every $1 invested. 1 The $16 billion in savings would apply to Medicare ($5 billion) and Medicaid ($1.9 billion), but the majority of the savings ($9 billion) would be experienced by private payers (both private insurance carriers and individuals [either insured or uninsured] through reductions of out of pocket costs). 2 The estimated return on investment by state ranges from 3.7 to 1 up to 9.9 to 1, which is based on the potential reduction in health spending by state in response to the increase in prevention spending. 3 The economic costs of smoking could be reversed by adequately funding prevention efforts. If states funded anti smoking efforts at levels recommended by the Centers for Disease Control and Prevention, they could save 14 to 20 times their investment at least $6 billion for California alone. 4 To make the new health care system work effectively and become affordable under the new mandate, we must raise the overall health of our population. Chronic diseases account for 75% of the nation s health spending. 5 Nationally, Americans use preventive services only half as much as they should. 6 The United States spends an estimated $2 trillion annually on healthcare expenses, more than any other industrialized country. 7 Despite the fact that the U.S. spends more money per person on health care than any other country in the world, 8 the U.S. lags woefully behind in terms of infant mortality and life expectancy. 9 Life expectancy in the U.S. is 50th compared to other nations, behind Japan, Australia, Italy, Canada, France, Spain, Israel, Ireland, Germany, Greece, and South Korea, among others, and barely ahead of Cuba, Libya, and Kuwait. 10 It will only be economically feasible to create a system where all Americans can visit a doctor when they are ill or injured if we ensure that the overall population is vastly healthier with a much lower chronic disease burden. 11 Fully funding the Prevention and Public Health Fund can save thousands of lives and improve the health of thousands more. Effective delivery of just five preventative services colorectal and breast cancer screenings, flu vaccines, and counseling on smoking cessation and regular aspirin use could avert 100,000 deaths each year. 12 In addition, effective cancer screening and early and sustained treatment could reduce the cancer death rate by 29%. 13

2 If we stay on our current course, half of all Americans will be obese by And as a result, there will also be an additional 6.8 million cases of stroke and heart disease, 7.8 million cases of diabetes and 539,000 cases of cancer, which could place an extra $66 billion burden on the nation's healthcare bill, according to the research. 14 If we don t invest in prevention efforts to turn this trend around, today s children are likely to be the first generation to have a shorter lifespan than their parents. 15 Employers and the American economy all stand to reap huge financial rewards from a healthier and more competitive workforce. Health problems result in 69 million workers reporting missed days due to illness each year. 16 Chronic diseases and other health conditions reduce economic output by $260 billion per year. 17 Obesity is costly; obese individuals have health care costs 39% above average. 18 Obesity increases lifetime medical care costs for some diseases by 50%, and severe obesity can almost double them. 19 The United States spent more than 17 percent of its GDP in 2009 on healthcare, higher than any other developed nation. 20 According to the Chamber of Commerce, health care is the single most expensive benefit paid for by employers. 21 GM indicates that healthcare costs add between $1,500 and $2,000 to the sticker price of every automobile it makes. 22 Unless we address the epidemic of obesity and other chronic diseases immediately, the United States risks compromising our national security and military preparedness. Department of Defense data indicates that 75 percent of all young Americans 17 to 24 years of age are unable to join the military because they failed to graduate from high school, have criminal records, or are physically unfit. Being overweight or obese turns out to be the leading medical reason why applicants fail to qualify for military service. 23 As retired U.S. Army General Johnnie E. Wilson says: Child obesity has become so serious in this country that military leaders are viewing this epidemic as a potential threat to our national security. We need America s service members to be in excellent physical condition because they have such an important job to do. Rigorous service standards are critical if we are to maintain the fighting readiness of our military. 24 Obesity increases our dependence on and demand for fossil fuels, posing a long term challenge for our national security. Studies show that the increased weight due to obesity results in increased fuel consumption by up to one billion additional gallons per year. 25 Low income communities and communities of color have the greatest need for prevention services. On average, people of color experience shorter life spans, higher infant mortality rates, and have higher prevalence of many chronic conditions compared to whites. 26 In addition, people of color make up more than half of all Americans without health insurance, 27 and are diagnosed at more advanced disease stages, and once diagnosed, they receive poorer care. 28 Adult obesity rates for African Americans and Latinos are higher than those for whites in almost every state; likewise, low income Americans have obesity rates that are significantly higher than average. 29 Communities of color tend to have fewer parks, fewer sidewalks, and fewer grocery stores with healthy food options. 30 In Prevention and Public Health Fund 2

3 addition, African Americans and Latinos are less likely than whites to be given advice by their physician to eat more healthily or exercise more. 31 Improving the health of low income communities and communities of color would significantly improve average health and reduce costs. 32 The prevalence of type 2 diabetes among African Americans, Latinos, and American Indian/Alaskan Natives is two to six times greater than that of whites ,000 African Americans die each year due to smoking related diseases. 34 African American men are 37 percent more likely to develop lung cancer than white men % of African Americans are exposed to secondhand smoke, compared to 50% of whites. 36 Over half of all Americans with HIV and over 65% of women with HIV are African Americans. 37 Lead poisoning occurs disproportionately higher in low income families and families of color living in older, poorly maintained housing. 38 African American children are at two times greater risk of lead poisoning than whites. 39 African Americans develop high blood pressure at younger ages than other groups, and African Americans are more likely to develop complications from high blood pressure, such as strokes, kidney disease, blindness, and heart disease % of African American adults have a chronic disease, compared to 39% of the general population. 41 In North America, anxiety and depression are nearly twice as prevalent in low income and low education groups as compared to those with higher incomes and education levels. 42 The lower an individual s income, the greater his or her likelihood of developing a mental health or psychiatric disorder. 43 As the population of the United States is aging, we are facing a direct threat to our ability to pay for the increased health care costs associated with old age. A huge demographic shift is underway in the U.S. By 2030, the number of U.S. adults aged 65 or older will more than double, to about 71 million. 44 The number of citizens over age 85 will also double by 2030, and by 2050, 40 percent of the population will be older than Conservative projections show that in 2020 health care for older adults will consume 10 percent of the GDP. 46 Health care costs increase exponentially after age Those who are 85 or older have personal health expenditures that are three times as much as those ages and twice as much as those Part of this increase in expenditures may be related to the fact that only around 25% of adults aged years are up todate on recommended immunizations and cancer screenings. 49 Prevention is effective in improving health and reducing healthcare costs for older adults: Older adults who practice healthy behaviors, take advantage of clinical preventive services, and continue to engage with family and friends are more likely to remain healthy, live independently, and incur fewer health related costs. An essential component to keeping older adults healthy is preventing chronic diseases and reducing associated complications. About 80% of older adults have one chronic condition, and 50% have at least two. 50 The oldest old (those 85 years of age or older) is the fastest growing segment of the elderly population. 51 Even in the "oldest old," a little physical activity goes a long way, extending life by at least a few years for people in their mid to late 80s. The three year survival rate for active 85 year olds is three times higher than for those who are inactive. 52 Active octogenarians also report less depression and loneliness and a greater ability to perform daily tasks. 53 Prevention and Public Health Fund 3

4 Poor health interferes with academic success, leading to an ill prepared workforce and further hurting America s ability to compete globally. Tooth decay is the single most common chronic disease of childhood, affecting nearly 6 in 10 children in the United States. Children with poor oral health and poor general health are 2.3 times more likely to report poor school performance than those with good oral health. 54 Poor health affects students attendance, grades, and ability to learn. 55 Poor health, chronic medical conditions and related poor concentration cost us economically, in lost dollars due to absences, low graduation rates, and lack of achievement. 56 Students with higher grades engage in fewer health risk behaviors than their classmates with lower grades; students who do not engage in health risk behaviors receive higher grades than those who do. 57 A failure to ensure academic success and high graduation rates may lead to long term negative consequences for our economy. 58 High school graduation is an indicator of lifelong health. 59 More Resources Prevention Institute Report: Reducing Health Care Costs Through Prevention, 79/127.html Report: Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities, 75/127.html Trust For America s Health Report: Healthier Americans for a Healthier Economy, Report: Top Ten Priorities for Prevention, Report: Improving the Health of Low Income and Minority Communities, Centers for Disease Control and Prevention Report: Saving Money Through Prevention, 7/prevention/index.html U.S Department of Health and Human Services Prevention & Care Management, Partnerships and Resources for Prevention Services, Research Findings: Low Income, HealthReform.gov Report: Health Disparities: A Case for Closing the Gap, Public Health Law & Policy (PHLP) is a nonprofit organization that provides legal information on matters relating to public health. The legal information in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state Public Health Law & Policy Prevention and Public Health Fund 4

5 1 and and Id. 4 minute interview/2011/11/professor says states could save money funding anti smoking efforts 5 care background.html 6 McGlynn, E.A., S.M. Asch, J. Adams, J. Keesey, J. Hicks, A. DeCristofaro, and E.A. Kerr. The Quality of Health Care Delivered to Adults in the United States. The New England Journal of Medicine, vol. 348, no. 26, June 26, 2003: Available at: (Americans use preventative services at about half the recommended rate based on established national guidelines and the medical literature and proposed indicators of quality for all phases of care or medical functions (screening, diagnosis, treatment, and follow up). 7 science and technology/healthcare costs us competitiveness/p and dyn/content/article/2007/08/12/ar html and world factbook/rankorder/2102rank.html 11 data/assets/pdf_file/0006/96468/e91878.pdf and 12 Woolf, S. A Closer Look at the Economic Argument for Disease Prevention. JAMA 2009; 301(5): Curry, S.J., Byers, T. and Hewitt, M., eds Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: National Academies Press. care background.html (11) /fulltext and obese 2030_n_ html#s305614&title=1_Least_Obese Davis, K. Collins, S.R., Doty, M.M. Ho, A., and Holmgren, A.L.,Health and Productivity Among U.S. Workers. The Commonwealth Fund, August care background.html. 17 Davis, K. Collins, S.R., Doty, M.M. Ho, A., and Holmgren, A.L., Health and Productivity Among U.S. Workers. The Commonwealth Fund, August care background.html 18 care background.html 19 df 20 science and technology/healthcare costs us competitiveness/p Id. 22 Id pdf 24 Id _UI_News.pdf Id bb43 406d a6d5 eca3bbf35af0%7d/placeforhealthierliving_final.pdf and Gordon Larsen P, Nelson M, Page P, et al. Inequality in the Built Environment Underlies Key Health Disparities in Physical Activity and Obesity. Pediatrics 117(2): , Available online at: and Powell LM, Slater S and Chaloupka FJ. The Relationship Between Community Physical Activity Settings and Race, Ethnicity, and Socioeconomic Status. Evidence Based Preventative Medicine, 1(2): , Available at: Powell%20et%20al1.pdf. Prevention and Public Health Fund 5

6 31 (page 86) filesystem action?file=ccf publications/health reform/health reform summary.pdf; smoke.org/pdf/africanamericans_shs.pdf 35 us/our impact/top stories/african americans and lung cancer.html 36 Id %20Fact%20Sheet.pdf Id high blood pressure/hypertension in african americans Id Id profile/elderpop.html 52 aging/t/exercise can extend survival even oldest old/#.tuz9 WNCq0s (inactive = less than four hours of exercise weekly) 53 aging/t/exercise can extend survival even oldest old/ Id dropout prevention.aspx and and and Prevention and Public Health Fund 6