A recent briefing hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation, focused on initiatives that can prevent chronic disease and save money. A recent policy brief by the Foundation found that chronic diseases such as heart disease, cancer, stroke and diabetes are responsible for seven in 10 deaths among Americans each year and account for nearly 75 percent of the nation’s health spending. However, according to the brief, an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition and prevent smoking and other tobacco use, could save the country more than $16 billion annually within five years—a return on investment of $5.60 for every $1 spent. Additional research shared by the Alliance finds that per person health spending for obese adults is 56 percent higher than for normal-weight adults, and that community-based interventions can save 4.5 million lives and $600 billion over 25 years.

Speakers at the briefing included Ursula Bauer, MD, director of the CDC National Center for Chronic Disease Prevention and Health Promotion, Thomas Farley, MD, MPH, commissioner of the New York City Department of Health and Mental Hygiene; Matthew Myers, president of the Campaign for Tobacco-Free Kids, and Linda Bilheimer, Assistant Director for Health, Retirement, and Long‐Term Analysis at the Congressional Budget Office.

>>Recommended viewing: Watch the briefing.

Read a New York Times profile of Linda Fried, MD, dean of the Mailman School of Public Health at Columbia University. Fried has been a pioneer in the study of healthy aging and a founder of Experience Corps, a program now in 19 cities that links people age 50 and older as mentors and tutors for children in grades kindergarten through third grade.

Also catch up some of the latest thinking around creating healthier communities for older adults--critical given the following stats on the aging population:

• Nearly 40 million U.S. resident are age 65 and older; this will grow to 70 million in the next 20 years
• The number of Americans age 85 and older will grow by 74 percent in 20 years
• Three-quarters of older adults live in low-density communities, making it harder for them to get around and age in place
• More than half of people over age 75 have disabilities

>>Read the full profile of Dean Linda Fried.

This morning, in a historic decision, the Supreme Court of the United States (SCOTUS) upheld the Affordable Care Act (ACA). Read the SCOTUS opinion here. In a statement released by the Robert Wood Johnson Foundation following the ruling, Foundation President and CEO Risa Lavizzo-Mourey commented on the landmark decision:

Today’s ruling by the Supreme Court allows the nation to move forward on the road to better health. The Affordable Care Act, when fully implemented, will expand the number of people with health coverage, introduce strategies for improving the quality of health care, and support plans to make our communities healthier places... Today’s ruling by the Supreme Court permits the implementation process to continue in full force, and we look forward to working with everyone who shares our goals to make meaningful improvements in the health and health care of our country.

The Foundation also posted a compiled listing of resources related to the ACA decision, including full and abbreviated analyses of the different scenarios that could have played out today.

>>Read the full statement from the Foundation.

A recent article in the medical journal The Lancet gives due credit to New York City as a public health leader. And not just because the city now boasts the highest life expectancy rates in the United States, but also because of some of the proven prevention and treatment initiatives that resulted in those increases.

"'From a nadir in 1990, when life expectancy in the city trailed the US average by 3 years, it had lengthened by 8 years to 80·6 years, surpassing the country."

The article notes that life expectancy has increased in the city because significant reductions in violent crime and more effective treatment of people with HIV/AIDs, but also because of drops in heart disease, cancer, diabetes and stroke. According to the authors, prevention initiatives have included a citywide smoking ban in parks and other public places, television ads by the health department about the dangers of prescription drug abuse and the benefits of breast feeding, and efforts to make healthy choices the easy choices such as mandated calorie labels for food sold in chain restaurants, banning transfats and the development of "hundreds of miles of new bicycle lanes."

While many cities might find it hard to afford the most ambitious projects New York City has introduced, such as a public transportation ad campaign that has improved minority colonoscopy rates, the Lancet authors provide an example of a new national initiative that started in the Bronx, the poorest county in the United States. Eight years ago, one school in the Bronx replaced whole milk with low-fat and fat-free versions, and the next fall, all of the schools in the Bronx had made the same change. In 2006, the city of New York followed that model practice, and this past January the U.S. Department of Education issued a rule that all schools in the nation follow the milk replacement example of that trend-setting county in New York.

Other New York City innovations that NewPublicHealth has reported on previously include the city’s Taxi of Tomorrow and a web portal devoted to driving out bed bugs.

>>Read the article in The Lancet.

>>Read a NewPublicHealth interview with New York City’s health commissioner Tom Farley, MD, MPH, on creating a prevention agenda.

>>Weigh In: What ideas from other communities have you implemented to improve community health?

As the school year heads to a close, fewer school nurses will be able to say “see you in the fall.” A recent article in the Wall Street Journal says that school districts across the country are slashing school nurse positions in order to make up budget shortfalls. But parents and policy-makers say the cuts impact children’s health, especially kids with chronic illnesses who rely on school nurses for care during the day. And for many underserved kids, a school nurse is often the only health professional they see regularly.

Read an interview on NewPublicHealth with Carolyn Duff, RN, president of the National Association of School Nurses, and Thomas G. DeWitt, MD, FAAP, director of the Division of General and Community Pediatrics at the Cincinnati Children’s Hospital Medical Center, about the vital role of school nurses.

With the summer season just getting underway, among the most critical front-line public health workers in place right now, are lifeguards. The Washington Post recently wrote about the grueling but critical training young lifeguards undergo before they’re allowed to take climb to their posts at Ocean City, Md., a popular beach destination in the Washington region. One veteran lifeguard racked up seventeen rescues in a single day.

The Centers for Disease Control and Prevention (CDC) has a continually updated website on safe swimming in all types of water including pools, oceans and lakes. CDC also has related resources on preventing illness that can spread through recreational swimming and other water activities.

"Can people easily get to work by using public transportation? Can kids walk and bike to school safely? When they get to school, do these kids have healthy food options? This shift in thinking and action is the X factor: converting personal motivation into community transformation."

Those questions and more paint a new picture of the path to a healthier nation. An essay by Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey argues that instead of focusing on treating disease, we should keep people out of the doctor’s office in the first place by investing in proven, community-based prevention efforts.

As part of an online discussion series in the Atlantic about how to solve the health care crisis, Lavizzo-Mourey discusses the economic arguments for prevention and offers several examples of places in the United States where health is regularly considered in community planning and policy decisions, resulting in increased opportunities for better health. Some of the startling statistics shared in the piece include:

• A disproportionate share of the $2.6 trillion we spend on health care each year goes toward treating the sickest people.
• For every dollar spent on health care, less than four cents goes toward public health and prevention.
• Spending just $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking could eventually save more than $16 billion a year.

>>Read Risa Lavizzo-Mourey’s essay and catch up on the Atlantic’s “America the Fixable” health care debate here.

>>Catch up on the Atlantic’s “America the Fixable” health care debate.

Late in the afternoon on May 22, 2011, a multiple vortex tornado struck Joplin, Mo., a city of about 50,000 people. The tornado and its aftermath left 161 dead and more than 900 injured along with the destruction of thousands of homes, businesses, schools, and one of the community’s major health care facilities, St. John’s Medical Center.

Yesterday marked a day of reflection on the anniversary of the deadly tornado. Residents gathered to commemorate the losses, but also to focus on what's next on the continued path to recovery, reports the Associated Press.

We also reflect on our coverage of the events at Joplin and the efforts of public health and preparedness professionals to both recover and capture lessons learned in preparedness:

• Melissa Friel, Director of the Center for Emergency Response and Terrorism at the Missouri Department of Health and Senior Services, spoke with NewPublicHealth about lessons learned.
• Paul Jarris, MD, Executive Director of the Association of State and Territorial Health Officials, talked about what cuts in public health preparedness funding mean for state and local health departments and for the health and safety of Americans.
• Social media was a critical tool in Joplin disaster relief efforts.
• Improved tornado warnings were a feature of the post-Joplin preparedness discussion, both about Joplin and regarding subsequent tornadoes.

>>Read more about Joplin and public health preparedness.

This week is the 49th International Making Cities Livable Conference, taking place this year in Portland, Ore., which will explore how cities can be built and re-shaped in a way that increases opportunities for residents to be active, social and healthy. This year's conference focuses on the theme of "Planning Healthy Communities for All," through inclusive design.

Between 350 and 400 delegates will convene in Portland, "consistently ranked as one of the most livable cities in the United States," to collaborate across the spectrum of fields that play a role in creating healthier communities, including elected officials, urban planners and designers, public health officials, architects, transportation planners, land use developers and more.

Some of the public health speakers on the docket include Richard Jackson, MD, MPH, Chair of the Department of Environmental Health Sciences at UCLA, who recently pioneered a documentary series exploring the development of healthy communities; Andrew Dannenberg, MD, MPH, Professor at the School of Public Health at University of Washington, who will present on health impact assessments; and Lou Brewer RN, MPH, director of the Tarrant County Public Health department in Fort Worth, Texas, who will offer a local "how-to" guide on developing healthy planning policy.

If you couldn't make it to Portland this week, check out the Livable Cities blog, which has interesting articles such as:

• Tips for launching a successful bike-share program.
• A post about why young people aren't buying cars.
• A guest post from Zurich on how most cities are livable—if you're male, older, wealthy and have a car.

>>Read more on building healthier cities.

A new study released online yesterday in the American Journal of Public Health finds that young smokers are more likely to progress from tobacco products with menthol to non-mentholated versions in just a short period of time. The study, which looked at switching between menthol and non-menthol brands of cigarettes over a two year period by young people ages 16 through 24, was conducted by researchers at the Schroeder Institute for Tobacco Research and Policy Studies at Legacy Foundation, and funded by the Robert Wood Johnson Foundation.

Menthol is the only flavoring that was not banned by the Family Smoking Prevention and Tobacco Control Act that became law almost three years ago.

The researchers found that the youngest menthol smokers were most likely to switch to non-menthol cigarettes. "We know that a majority of African American smokers smoke menthol cigarettes," says Andrea Villanti, PhD, the study’s lead author. “The lack of switching among these smokers may reflect the predominance of menthol brands in African American communities throughout the lifespan," said Villanti. "Banning menthol could prevent a significant portion of youth smoking initiation and help many smokers – including African Americans – quit by disrupting the progression of experimentation to regular smoking," says Villanti.

>>Read the study and more about the findings.