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Fifteen Years after Tobacco Settlement, States Falling Short in Funding Tobacco Prevention: Q&A with Danny McGoldrick
On November 23, 1998, 46 states settled their lawsuits against the nation’s major tobacco companies to recover tobacco-related health care costs, joining four states—Mississippi, Texas, Florida and Minnesota—that had reached earlier, individual settlements.
These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years.
Yesterday a coalition of health advocacy groups released the latest edition of A Broken Promise to Our Kids, an annual report on state use of tobacco funds for tobacco prevention and cessation efforts. As in years past, the report finds that most states fall short in the amount of money they allocate to prevent kids from smoking and to help current smokers quit.
The groups that jointly issued the report include the Campaign for Tobacco-Free Kids, the American Heart Association, American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights.
Key findings of the 2013 report include:
- Over the past 15 years, states have spent just 2.3 percent of their total tobacco-generated revenue on tobacco prevention and cessation programs.
- The states this year will collect $25 billion from the tobacco settlement and tobacco taxes, but will spend just 1.9 percent of it—$481.2 million—on tobacco prevention programs. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.
- States are falling short of the U.S. Centers for Disease Control and Prevention’s (CDC) recommended funding levels for tobacco prevention programs. Altogether, the states have budgeted just 13 percent of the $3.7 billion the CDC recommends.
- Only two states—Alaska and North Dakota—currently fund tobacco prevention programs at the CDC-recommended level.
To discuss the ramifications of the latest edition of the Broken Promises report, NewPublicHealth recently spoke with Danny McGoldrick, vice president of research at the Campaign for Tobacco-Free Kids.
NewPublicHealth: Can you give us some background on the Tobacco Master Settlement Agreement?
Danny McGoldrick: This is the 15th anniversary of the Tobacco Master Settlement Agreement, when 46 states and the District of Columbia settled their lawsuits against the tobacco companies mostly to recover the costs that they’d incurred treating smoking-caused disease in their states. Four other states had settled individually with the tobacco companies prior to the Master Settlement Agreement, and so this provided for some restrictions on tobacco company marketing; they promised never to market to kids again, which is ironic, but it also resulted in the tobacco companies sending about $250 billion over just the first 25 years of the settlement for the states to spend as they saw fit. They left that to the province of the state legislators and governors to decide how those funds should be spent.
NHTSA: Motorcoaches, Large Buses to Require Seatbelts for All Passengers and Driver
New motorcoaches and large buses will be required to provide lap and shoulder seatbelts for all passengers and driver, under a new rule issued by the U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA). While the buses are an overall safe way to travel, the large numbers of people they carry and the high speeds at which they travel mean a single collision can lead to a significant number of injuries, according to NHTSA. An average of 7,934 riders are injured each year in motorcoaches, and an average of 21 passengers are killed. "Buckling up is the most effective way to prevent deaths and injuries in all vehicular crashes, including motorcoaches," said Federal Motor Carrier Safety Administrator Anne S. Ferro, in a release. "Requiring seat belts in new models is another strong step we are taking to reach an even higher level of safety for bus passengers." The rule will apply to buses with a gross vehicle weight rating (GVWR) greater than 26,000 pounds,) excluding transit buses and school buses. Read more on transportation.
Study: Women With Breast Cancer Should Get Mammograms Every 12 to 18 Months
Breast cancer patients should undergo mammograms every 12 to 18 months to determine whether their cancer has spread to the lymph nodes, according to a new study to be presented today at the annual meeting of the Radiological Society of North America. Study researcher Lilian Wang, MD, evaluated more than 300 women who were diagnosed with breast cancer because of a routine mammogram, dividing them into three groups based on their treatment history. She found that only 9 percent of the women who had 12- to 18-month intervals between mammograms saw their cancer spread to their lymph nodes; the rates were 21 percent for those who waited one-and-a-half to three years and 15 percent for those who waited three or more years. "If you catch someone with early stage cancer, they are going to need less extensive surgery, and maybe no chemo," said Laura Kruper, MD, director of the Cooper-Finkel Women's Health Center at the City of Hope Cancer Center, in Duarte, Calif., who was not a part of the study. "[The new study] adds more power behind the fact that we do need screening mammograms starting at age 40 and every year.” Read more on cancer.
FDA: Certain HeartStart AEDs May Not Work During Cardiac Emergencies
The U.S. Food and Drug Administration (FDA) announced yesterday that certain automated external defibrillator (AED) devices made by Philips Medical Systems may not function properly when needed. In a new safety communication, FDA revealed that the devices may not deliver the needed shock to restore normal heart rhythm during a cardiac emergency. “The FDA advises keeping all recalled HeartStart AEDs in service until you obtain a replacement from Philips Healthcare or another AED manufacturer, even if the device indicates it has detected an error during a self-test,” said Steve Silverman, director of the Office of Compliance in the FDA’s Center for Devices and Radiological Health. “Despite current manufacturing and performance problems, the FDA considers the benefits of attempting to use an AED in a cardiac arrest emergency greater than the risk of not attempting to use the defibrillator.” Read more on heart health.
Several weeks ago, the Harvard School of Public Health celebrated its Centennial with fanfare, fundraising and a panel discussion featuring world health leaders who are graduates of the school. Following the centennial, NewPublicHealth spoke with the School’s Dean, Julio Frenk, MD, MPH, PHD, who has a joint appointment at the Harvard Kennedy School of Government. He is also a former health minister of Mexico and a former senior fellow in the global health program of the Bill and Melinda Gates Foundation.
NewPublicHealth: What do you think have been the key changes in public health efforts since the Harvard School of Public Health was founded 100 years ago?
Julio Frenk: The 100 years that have passed since the School of Public Health was founded are not just any 100 years—they’re the 100 years with the most intense transformations in health in human history. We have seen a more than doubling of life expectancy since the school was founded. Around 1900, the global average for life expectancy was 30 years. At the end of the century, the global average was about 65 years. It more than doubled in the 20th century, and that increase has continued with some setbacks, most notably the AIDS epidemic in Saharan Africa. And we have had a qualitative shift not just in the level of mortality, but in the causes of death. So we went from a preponderance of acute infections to now a predominance of mostly chronic non-communicable diseases, and that’s an incredible transition.
A critical change is that the experience of illness became very different starting from the beginning of the 20th century. Before then, illness was mostly a succession of acute episodes, from which one either recovered or died. If you recovered, you went on to get your next acute illness. Now, illness is more a condition of living. People live with cancer. People live with AIDS. So that’s a big transformation of the patterns of health, disease and death.
Another big change is the emergence of complex health systems, and that’s—again—a process that started at the beginning of the 20th century. Before the 20th century, the social function of the sick was mostly trusted to undifferentiated institutions, such as the family or religious institutions, and it’s not until the 20th century when you see this incredible explosion of specialized institutions and specialized human resources, doctors, nurses and other health professionals. In the 20th century, healthcare is 10 percent of the global economy and employs millions of people, including eight million doctors. These are all profound transformations.
NPH: How has the training of students of public health changed in the last 100 years?
Frenk: There has been profound change. What happened at the beginning of the 20th century was the emergence of public health as a field of action. The practices of engineering emerged in Europe, especially with the rapid urbanization there starting around the 17th century, but then greatly expanded in the 18th century. Engineering allowed for access to clean water and taking care of waste, which resulted in some diseases coming under control. In the 19th century the discovery of microbiology gave rise to the abolishment of the germs as causes of illness. That is the junction that gives birth to public health, along with the idea of social policy, of social activism that actually changed social conditions. It’s in that mix that public health gets shaped.
Chicago Announces Trio of Anti-tobacco Initiatives to Curb Youth Smoking
The city of Chicago and Mayor Rahm Emanuel this morning announced a trio of anti-tobacco initiatives designed to reduce youth access to tobacco. The first would regulate e-cigarettes as tobacco products, while the second would restrict the sale of flavored tobacco products near schools and the third would work to educate the public on the dangers of menthol-flavored cigarettes. Further details:
- By defining “tobacco products” as products that are made of tobacco or include tobacco-derived nicotine, the city would be able to regulate e-cigarettes as they do any other tobacco product. This would mean that under the Chicago Clean Indoor Air Act, e-cigarette use would be restricted everywhere where smoking is restricted, including almost all public places and places of employment.
- Flavored tobacco products, including menthol products, could not be sold within 500 feet of schools, and existing stores would not be grandfathered in. This would be the first regulation of menthol-flavored cigarettes anywhere at the federal, state or local levels.
- Understanding that menthol-cigarettes are often—and wrongly—viewed as less unhealthy than other tobacco products, as well as that fact that the flavoring makes them more appealing to kids, the city is launching a public service advertising campaign on the realities of the products.
“E-cigarettes, as well as flavored products, are gateway tobacco products targeted at our kids,” said Emanuel. “The tobacco industry has spent years developing products that are aimed at hooking our youth on nicotine and getting them smoking for their entire life.” Read more on tobacco.
FDA to Investigate Reports on Weight-related Problems with the Morning-After-Pill
Following yesterday’s report that the European equivalent of the Plan B One-Step “morning after pill,” Norlevo, is less effective for women who weigh 165 pounds or more and ineffective for women who weigh 176 pounds or more, the U.S. Food and Drug Administration (FDA) has announced it will perform its own investigation into the product. The agency is "currently reviewing the available and related scientific information on this issue, including the publication upon which the Norlevo labeling change was based," said FDA spokeswoman Erica Jefferson said in a Monday statement. "The agency will then determine what, if any, labeling changes to approved emergency contraceptives are warranted." By law, the morning-after pill is available to all U.S. women of child-bearing age, over the county and with no point-of-sale restrictions. Read more on sexual health.
Concerns Over Cost, Sexual Activity Keep Many Parents From Having Kids Vaccinated Against HPV
Costs and parental concern over their kids’ sexual activity may be the reason that so view children—both girls and boys—are not being vaccinated against the human papillomavirus (HPV), according to a new review of 55 studies appearing in JAMA Pediatrics. HPV vaccines protect against the strains of genital warts that cause approximately 70 percent of cervical cancers, and they are recommended for girls aged 11 to 12. Boys are recommended to receive the vaccine as young as age 11, as it protects not just against genital warts, but also oral, penis and rectal cancers. However, the review found that many parents put off the vaccination either because they believe their child is not sexually active—so doesn’t “need” the vaccine—or because they fear it will encourage them to become sexually active. Researchers determined that a physician’s recommendation was one of the strongest motivators toward deciding to accept the vaccination, although this did not happen nearly enough. The researchers recommended improving these statistics by educating doctors and parents on the importance of the vaccine. Read more on cancer.
Kids Today Slower, Less Fit than Their Parents as Kids
An average child in 1975 in a one-mile race with an average child today would win by an average of a minute and a half, according to new research. Kids today are also about 15 percent less aerobically fit, with heart endurance falling an average of 6 percent per decade from 1970 to 2000. That means today’s kids are more likely to be unhealthy in adulthood, with weaker hearts, thinner bones and overall lower quality of life. Grant Tomkinson, a senior lecturer in the University of South Australia's School of Health Sciences, pointed to a number of factors, including communities designed to discourage walking, bicycling and backyard play; reduced or even completely absent physical education in schools; and the prevalence of television, computer, tablet and smartphone screens that keep kids indoors. "We all live in an environment that's toxic for exercise, and our children are paying the price," Tomkinson said. Tomkinson said in order to reverse this trend, kids need at least 60 minutes of serious physical exercise a day, such as running, swimming or cycling. "You want exercise to be fun, but there needs to be some huff and puff there as well," he said. "It needs to make them somewhat tired." Read more on physical activity.
Study: Symptoms of ‘Sudden’ Cardiac Arrest Can Be Seen Up to a Month Earlier
Symptoms of “sudden” cardiac arrest can be seen up to a month beforehand in middle-age men, according to new findings presented this week at the annual scientific sessions of the American Heart Association, held this year in Dallas. Researchers looked at the medical records of 567 men, ages 35-65, who had out-of-hospital heart attacks, finding that approximately 53 percent showed symptoms beforehand. They included chest pain (56 percent); shortness of breath (13 percent); and dizziness, fainting or palpitations (4 percent). Sumeet Chugh, senior author of the study and associate director for genomic cardiology at the Cedars-Sinai Heart Institute in Los Angeles, said the “entirely unexpected” findings show that people may be able to prevent heart attacks if they seek treatment earlier for these symptoms. "The findings were entirely unexpected," said "We never thought more than half of these middle-aged men would have had warning signs so long before their cardiac arrests,” Chugh said. “Previously we thought most people don't have symptoms so we can't do anything about it." Read more on heart health.
ACS Tips on Quitting Tobacco for Tomorrow’s ‘Great American Smokeout’
Tomorrow is the American Cancer Society (ACS) Great American Smokeout, held every year on the third Thursday of November. The annual event was founded to encourage people to quit using tobacco—perhaps to stop smoking on that day, or to make a plan on how to quit at a later date—and to provide the tools and resources that can help the decision stick. According to ACS, research shows that people are most successful at quitting tobacco when they have support, and recommends combing two or more of the following tactics to improve the odds:
- Telephone smoking-cessation hotlines
- Stop-smoking groups
- Online quit groups
- Nicotine replacement products
- Prescription medicine to lessen cravings
- Guide books
- Encouragement and support from friends and family members
Construction Workers Frequently Impacted by Pain and Stress
Construction workers are frequently stressed about work-related injuries and pain, but often fail to get help for either, putting themselves at risk for additional injuries and mental health issues, according to a new study in the Journal of Occupational and Environmental Medicine. The researchers, based at the Harvard School of Public Health, reviewed data compiled by the School’s Center for Work, Health and Wellbeing and found that the construction industry has one of the highest rates of work-related injuries and suicides in the U.S. workplace, as well as a high prevalence of musculoskeletal pain among its workers. The researchers also conducted a mental health survey of 172 New England construction workers at four construction sites. Sixteen percent of the workers reported being distressed, 75 percent had experienced musculoskeletal pain over the previous three months and 42 percent reported one or more work injuries in the preceding month. A follow-up survey found that more than half of those who previously said they felt distressed had not sought professional help—likely, say the researchers, because of fear of stigmatization or job loss. Read more on injury prevention and mental health.
USPSTF: Cannot Recommend For, or Against, Vitamin Supplements to Help Prevent Cancer, Heart Disease
Citing the fact that there is simply too little evidence to make a conclusion either way, the U.S. Preventive Services Task Force (USPSTF) has concluded at this time that it can’t recommend for or against taking vitamin and mineral supplements to help prevent cancer and heart problems. In a draft statement, the panel also ruled that neither beta-carotene nor vitamin E should be taken to prevent heart disease or cancer; beta-carotene was previously found to exacerbate the risk of lung cancer for people who were already at high risk. The researchers analyzed data from 26 studies between January 2005 and January 2013, which included people across an array of demographics, finding no difference between those who took the supplements and those who took placebos. Vitamin supplements are a $12 billion per year industry in the United States. Read more on prevention.
Study: Simple Urine Test Could Identify Young Type 1 Diabetes Patients with Highest Risk of Heart, Kidney Disease
A basic urine test could help doctors prevent heart and kidney disease in kids who are at higher risk due to their type 1 diabetes, according to a new study in the journal Diabetes Care. As many as 40 percent of youth with type 1 diabetes may be at increased risk for the health problems. Researchers at the University of Cambridge, in England, analyzed data on more than 3,300 diabetes patients between the ages of 10 and 16; an estimated 490,000 kids worldwide have type 1 diabetes. "Managing type 1 diabetes is difficult enough without having to deal with other health problems," study lead author David Dunger. "By using early screening, we can now identify young people at risk of heart and kidney disease. The next step will be to see if drugs used to treat heart and kidney disease—such as statins and blood-pressure-lowering drugs—can help prevent kidney and heart complications in this young, potentially vulnerable population.” Read more on pediatrics.
Survey: Violence in PG-13 Films Tripled in Past Two Decades
When the movie rating PG-13 debuted, PG-13 movies and R movies tended to have about the same amount of gun violence. Today PG-13 sometimes have more gun violence than R movies, and the overall amount of gun violence in the movies approved for the younger demographic has more than tripled in the past two decades, according to a new study in the journal Pediatrics. The researchers looked at 945 films sampled from the 30 top-grossing films annually between 1950 and 2012. "It doesn't take a lot of imagination to figure out there are going to be disturbed kids who are going to see this kind of content," said Daniel Romer, of the University of Pennsylvania's Annenberg Public Policy Center in Philadelphia. "The problem for parents is they can no longer rely on the PG-13 rating to tell them there isn't a lot of violence in those films.” James Sargent, MD, from the Geisel School of Medicine at Dartmouth and the Norris Cotton Cancer Center in Lebanon, New Hampshire, who was not involved in the study, said the findings demonstrate that the Motion Picture Association of America needs "to go back to the drawing board and fix their rating system so those movies are rated R for violence." Read more on violence.
New Federal Rules Ensure Mental Health Treatment Equal to Physical Health in Health Plans
New rules issued by the U.S. Departments of Health and Human Services, Labor and the Treasury on Friday will ensure that mental health is treated equal to physical health when it comes to co-pays, deductibles and visit limits that are features of health plans. Among the specific protections:
- Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings
- Eliminating the provision that allowed insurance companies to make an exception to parity requirements for certain benefits based on “clinically appropriate standards of care,” which clinical experts advised was not necessary and which is confusing and open to potential abuse
- Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law
“These rules will increase access to mental health and substance abuse treatment, prohibit discriminatory practices, and increase health plan transparency,” said Labor Secretary Thomas E. Perez. “Ultimately, they’ll provide greater opportunities for affordable, accessible, effective treatment to Americans who need it.” Read more on access to health care.
Women of Limited Financial Means Often Wait to Seek Help with Breast Lumps
High costs of examination and treatment may be keeping younger women with limited finances from seeking early medical attention for breast lumps, according to a new study in the journal Cancer. Researchers found in a survey of women aged 40 and younger that while 80 percent found an abnormality in their breast on their own, 17 percent waited at least three months before seeing a doctor, with 12 percent of those who delayed treatment also having to wait at least 90 days between their appointment and receiving a diagnosis. Kathryn Ruddy, MD, of the Mayo Clinic in Rochester, Minn., said that future development of interventions should focus on this financial disparity that is also a health disparity. "The findings may lead to research focusing on whether reducing co-pays and hidden costs of seeking medical care—such as parking charges, child-care expenses and lost wages—may improve the timeliness of diagnosis in this population," she said. Read more on cancer.
FDA Takes Another Step to Reduce Consumption of Trans Fats
The U.S. Food and Drug Administration has taken another step to reduce American’s consumption of trans fats with a preliminary determination that partially hydrogenated oils (PHOs) are not “generally recognized as safe” for use in food. PHOs are the primary dietary source of artificial trans fat in processed foods. Up next is a 60-day comment period to collect more information and input on exactly what it would take for food manufacturers to reformulate products so that they do not include PHOs. “While consumption of potentially harmful artificial trans fat has declined over the last two decades in the United States, current intake remains a significant public health concern,” said FDA Commissioner Margaret A. Hamburg, M.D. “The FDA’s action today is an important step toward protecting more Americans from the potential dangers of trans fat. Further reduction in the amount of trans fat in the American diet could prevent an additional 20,000 heart attacks and 7,000 deaths from heart disease each year—a critical step in the protection of Americans’ health.” Read more on food safety.
Lack of Light Disrupts Sleep Cycles During Hospital Stays, Increases Patient Discomfort
Hospital stays may be even more uncomfortable for most patients than necessary because of an overall lack of adequate light, according to a new study in the Journal of Advanced Nursing. The small study found that lower levels of daytime light exposure were connected to worse mood, as well as more fatigue and pain, in patients. The poor light interfered with their bodies’ ability to adopt a normal sleep-wake cycle. Researchers found the lowest levels of daytime light exposure were tied to worse mood and more fatigue and pain among patients, compared to those whose rooms were better-lit during the day. "Until now, no one has looked at the associations among light and outcomes such as sleep, mood and pain experienced in the hospital," said Esther Bernhofer, lead author of the study and a nurse researcher at the Cleveland Clinic's Nursing Institute. "This study forms a basis for testing future lighting interventions to improve sleep-wake patterns, mood and pain in hospitalized adults.” Read more on mental health.
Study: No Link Between IVF, Increased Risk of Cancer in Kids
Despite years of concerns, a new study on in vitro fertilization (IVF) found no link between the conception technique and an increased risk of cancer in children. The findings were published in the New England Journal of Medicine. Researchers analyzed data on more than 106,000 children born through assisted reproduction between 1992 and 2008, finding the risk of them developing cancer was "the same as naturally conceived children," according to lead researcher Alastair Sutcliffe, MD, a specialist in general pediatrics at the University College London. More than 5 million children have been born through IVF since the first successful birth in 1978. "This study is extremely reassuring and should relieve anybody's anxiety about IVF," concluded Lawrence Grunfeld, MD, an associate clinical professor of obstetrics, gynecology and reproductive science at the Mount Sinai Icahn School of Medicine, in New York City. Read more on cancer.
BSR: New Ways U.S. Companies Can Improve Population Health
U.S. companies can improve population health by improving how they engage with employees, customers, local communities, suppliers and the general public, according to a new BSR report supported by a grant from the Robert Wood Johnson Foundation. BSR interviewed 40 leading authorities on health and wellness, public health, corporate social responsibility and corporate affairs, as well as reviewed more than 35 corporate CSR reports across 10 industries and surveyed nearly 30 U.S.-based BSR member companies about their current activities on health and wellness. The report emphasizes how CSR teams can help lead the charge in improving population health. “Within business, the corporate social responsibility (CSR) teams are well-positioned to lead this work—helping their companies look carefully at the positive as well as negative impacts on health and wellness, and helping them identify opportunities to deliver better business results and health outcomes,” said Mark Little, BSR’s healthcare director. Read more on business.
CDC: Colorectal Cancer Screening Rate Remains Low
Despite continued research showing that colorectal cancer screening tests saves lives, as many as one in three adults ages 50 to 75 have not been tested, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). The cancer type is the second-leading cause of death for both men and women in the United States, and screening can help prevent it or even detect it early, when treatment is more effective. “There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, MD, MPH. “Screening for colorectal cancer is effective and can save your life.” the United States Preventive Services Task Force recommends that all adults age 50 and older be screened by at least one of three tests, which can variously be performed at home or by a doctor, and once every year, three years or decade. Read more on cancer.
Study: Eating Disorders in Young Men Often Different Than Those in Women
While not as widely discussed or researched, young men—just like young women—can become obsessed with their appearance and develop dangerous eating disorders, according to a new study in the journal JAMA Pediatrics. The problem can resemble a traditional eating disorder such as anorexia nervosa or bulimia nervosa, or involve the use of drugs and supplements. The disorders are often paired with depression, binge drinking and recreational drug use. The researchers’ survey of 5,527 boys, ages 12-18, found that 31 percent had at some point binged on food or purged, 9 percent had a high level of concern with their body's muscularity and about 2 percent were both concerned about muscularity and had used some type of supplement, growth hormone derivative or anabolic steroid to enhance it. "The results of our studies would suggest we need to be thinking more broadly about eating disorders and consider males as well," said Alison Field, the study's lead author and an associate professor of pediatrics at Boston Children's Hospital. "For a lot of males, what they're striving for is different than females. They're probably engaged in something different than purging." Read more on pediatrics.
New research presented at the American Public Health Association (APHA) annual meeting in Boston today finds that when public health funding increases in a community, its rates of infant mortality and deaths due to preventable diseases decrease over time, with low-income communities experiencing the largest health and economic gains.
According to the research, conducted by Glen Mays, PhD, MPH, director of the University of Kentucky’s National Coordinating Center for Public Health Services and Systems Research, each ten percent increase in public health spending over 17 years led to a 4.3 percent reduction in infant mortality, as well as reductions of 0.5 to 3.9 percent in non-infant deaths from cardiovascular disease, diabetes, cancer and influenza.
However, these health gains were 20-44 percent larger when funding was targeted to lower-income communities. Increases in public health spending also correlated with lower medical care costs per person, especially in low-income areas. The study, which analyzed data compiled by the National Association of County and City Health Officials from 3,000 local public health agencies over a 17-year period, also found that lower death rates and health care costs were seen especially in communities that allocated their public health funding across a broader mix of preventive services.
“The results clearly show that better health and lower health care costs are possible if we simply change how and where we allocate public health funding, even if new money isn’t available, said Mays. “And it also shows that new resources, such as funding from the Affordable Care Act’s Prevention Fund, can have a larger impact if targeted to lower-resource, higher-need communities and if spread across a range of prevention strategies.”
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
NewPublicHealth spoke with Mays about the new study just before the APHA annual meeting began.
NewPublicHealth: What are the key findings of the study?
Glen Mays: We’ve done prior studies that show communities that invest more on public health realize gains in health status and, over time, those communities see slower growth in medical care costs. So the goal of the study is to look at who benefits most from investments in public health.
What we found was that, not all that surprisingly, communities that are more economically constrained, that have lower income communities with higher poverty rates and lower socioeconomic status, tend to benefit the most from investments in public health activities over time. These low-resource communities see larger reductions in their preventable mortality, and they also see larger reductions in their medical care costs over time from investments in public health spending compared to more affluent communities. We expected to find that, but this is the first time we’ve been able to document the size of that effect. Those communities see about twenty percent higher rates of health and economic gain from their spending compared to more affluent communities.