Category Archives: Prevention
Today, New York State Health Commissioner Nirav R. Shah, MD, MPH, released the 2013-17 Prevention Agenda: New York State’s Health Improvement Plan—a statewide, five-year plan to improve the health and quality of life for everyone who lives in New York State. The plan is a blueprint for local community action to improve health and address health disparities, and is the result of a collaboration with 140 organizations, including hospitals, local health departments, health providers, health plans, employers and schools that identified key priorities.
Dr. Shah, the architect behind today’s prevention agenda, was confirmed as New York State’s youngest Commissioner of Health two years ago. The state’s governor, Andrew Cuomo, had three critical goals: reduce the state’s annual Medicaid growth rate of 13 percent, increase access to care and improve health care outcomes.
Shah, a former Robert Wood Johnson Foundation Physician Faculty Scholar and Clinical Scholar, has already made important inroads in all three goals and the prevention agenda builds on that. NewPublicHealth spoke with Dr. Shah about prevention efforts already underway in the state, and what it takes to partner health and health care to achieve needed changes in population health.
NewPublicHealth: How does improving the social determinants of health help you achieve your goals in New York State?
Dr. Shah: New York’s Medicaid program covers 40 percent of the health care dollars spent in the state. We were growing at an unsustainable rate, and we needed a rapid, but effective solution. So, we engaged the health care community, including advocates, physician representatives, the legislature, unions, management, and launched a process that enables continuous, incremental, but real change toward the Triple Aim—improved individual health care, improved population health and lower costs.
Collectively, these efforts resulted in a $4 billion savings last year in the State’s Medicaid program, increased the Medicaid rolls by 154,000 people, and resulted in demonstrable improvements in quality throughout the system.
NPH: What opportunities do you see for public health and health care to work together in New York State?
While this is the first year that the American Public Health Association has used “return on investment” as the theme for National Public Health Week, which runs through April 7, it’s far from the first time that public health practitioners have made the case to policymakers that the work of public health can save lives and money.
Research on the impact of public health services includes the critical fact that spending just $10 per person in programs aimed at smoking cessation, improved nutrition and better physical fitness could save the nation more than $16 billion a year, according to the Trust for America’s Health. That’s a nearly $6 return for every $1 spent.
Over the last two years, NewPublicHealth has reported frequently on the value of investing in public health. Some of our favorite ROI articles, reports and other resources include:
- >>UPDATE: Trust for America's Health released Investing in America's Health: A State-by-State Look at Public Health Funding and Key Health Facts today. The report examine public health funding and key health facts in states around the country, finding inadequate and cut funding and wide variation in health outcomes by state and county.
- Making the Case for Prevention: A Q&A with James S. Marks, Senior Vice President, Robert Wood Johnson Foundation, about the great potential for investing in prevention.
- National Prevention Resources Starter Guide:
A collection of resources that showcase how different fields can work together and take action to prioritize prevention.
- Strategies to Move from Sick Care to Health Care: The Trust for America's Health identifies high-impact steps that the nation can take to prioritize prevention and improve Americans' health.
- Workplace Wellness Perspectives: A Q&A with two very different businesses—one big, one small; one academic, one industrial—on creating healthier workplaces.
- Employers Join Community Health Movement: A Q&A with Trust for America’s Health and the National Business Coalition on Health about the critical role of employers in community prevention efforts.
- Stories of the value of investing in prevention from Wyandotte County, Kan., and Hernando, Miss.
>>Read more on the value of prevention from RWJF.org.
It’s that time of year when public health enthusiasts rejoice and remind the rest of the world why this field is so critical—this is National Public Health Week, a yearly observance since 1995. For 2013, the theme is "Public Health is ROI: Save Lives, Save Money." According to the American Public Health Association, (APHA), a key organizer of the yearly observance, this year’s theme was developed to highlight the value of prevention and the importance of well-supported public health systems in preventing disease, saving lives and curbing health care spending.
In honor of National Public Health Week, NewPublicHealth spoke with Georges C. Benjamin, MD, executive director of the APHA.
NewPublicHealth: Is this the first time that National Public Health Week has focused on the return on investment in public health?
Dr. Benjamin: I think it’s the first time we’ve done so directly. There’s no question that we have always talked about the value of public health and we’ve often talked about savings, but this is the first time we’ve really focused like a laser on that investment.
NPH: What reaction have you seen in states and local communities to this year’s theme?
“Death is an inevitable part of life. But death from preventable causes like cervical cancer, early heart disease, or gun violence is a tragedy. Whether expressed in dry, cold numbers or by the images of first graders smiling at the camera for their school picture, these tragedies will continue to motivate us to use both left-brain science and right-brain passion to improve human health and prevent unnecessary death.”
That paragraph is from the foreword by Michael Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health (JHSPH) in the current issue of the school’s magazine. The issue is devoted to how public health researchers and practitioners probe, investigate, understand and fight death.
The full issue is well worth reading. A few notable pieces include:
- An interview with Vladimir Canuda Romo, PhD, a demographer and assistant professor at the school who says his research shows American life expectancy is on the rise.
- A critical article on making palliative care a public health issue.
- A summary of a recent forum at the school on dealing with gun violence.
- A piece on prescription drug abuse, which the author calls the “biggest public health issue you’ve never heard of."
Perhaps most poignant are a collection of essays by JHSPH alumni including a thoughtful look at the last minutes of a deer.
>>Bonus Link: In a new book, Happier Endings , Erica Brown, PhD, the scholar in residence at the Jewish Federation of Greater Washington, tells her readers: “we are all going to die, but some of us will die better.” The book, which Dr. Brown calls “a meditation on life and death,” looks at the deaths of several people and shares intimate details of last months, last weeks, last seconds—sometimes peaceful, sometimes not. It’s an important reminder that communities and populations, the building blocks of public health, are made up of individuals who are loved, and missed when they pass away, and that death is indeed a public health issue worth attention.
As the year draws to a close, the most recent installment of the NewPublicHealth series on the National Prevention Strategy is especially appropriate. We spoke with Wendy Spencer, the CEO of the Corporation for National and Community Service (CNCS), a federal agency that engages more than 5 million Americans in volunteer community service. The mission of CNCS is to improve lives, strengthen communities, and foster civic engagement through service and volunteering.
Guiding principles of CNCS that help promote the National Prevention Strategy include:
- Put the needs of local communities first
- Strengthen public-private partnerships
- Use programs to build stronger, more efficient, and more sustainable community networks capable of mobilizing volunteers to address local needs, including disaster preparedness and response
- Build collaborations wherever possible across programs and with other federal programs
- Help rural and economically distressed communities obtain access to public and private resources
- Support diverse organizations, including faith-based and other community organizations
During Hurricane Sandy, which struck the East Coast in late October, close to 900 national service members were deployed to states affected by the storm, and nearly 900 more were on standby. National service members assisted with shelter operations, call centers, debris removal, and mass care. “Before the recovery is complete,” said Wendy Spencer, “we expect thousands of national service members from AmeriCorps and Senior Corps programs to help families and local and state officials rebuild these communities.”
For its Hurricane Sandy response effort, CNCS coordinated with the Federal Management Agency (FEMA), National Voluntary Organizations Active in Disaster, the American Red Cross and state and local authorities.
NewPublicHealth recently spoke with Wendy Spencer, the CEO of CNCS, Asim Mishra, the agency’s chief of staff and Erwin Tan, MD, the CNCS designee on the National Prevention Council and Director of Senior Corps and Strategic Advisor for Veterans and Military Families.
NewPublicHealth: What is the mission of the Corporation for National and Community Service (CNCS)?
This summer the National Prevention Council, made up of 17 federal departments that are incorporating prevention into their activities, released its first annual report detailing successes in implementing the National Prevention Strategy and laying out next steps to help achieve its goals.
At the release, Surgeon General Regina Benjamin, MD, MBA, who is also chair of the Council said, “This Action Plan highlights how the National Prevention Council departments are working together—in conjunction with state, tribal, local, territorial, public, and private partners—to begin to move our health system from one based on sickness and disease to one based on wellness and prevention.”
As part of our conversation series on the National Prevention Strategy, with key leaders in federal agencies who are shaping the Strategy, NewPublicHealth spoke with Dr. Benjamn about the regional meetings she is spearheading across the country to implement the strategy and her vision for healthier lives for all Americans.
Listen to a short podcast with Dr. Benjamin, and read the full interview below.
GUEST POST by Lisa Junker, CAE, director of communications for the Association of State and Territorial Health Officials (ASTHO)
At the opening session of the ASTHO Annual Meeting in Austin, Paul Wallace, vice president of The Lewin Group, pointed toward the need for collaboration and partnership between the health care and public health sectors to overcome key challenges and trends facing the United States at the federal, state and local level.
>>Read our earlier interview with Paul Wallace on public health and primary care integration.
“What are the opportunities to create a shared conversation around prevention?” asked Wallace, who chaired the Institute of Medicine (IOM) Committee on the Integration of Primary Care and Public Health.
He gave attendees an overview of the process his IOM committee underwent to develop the recently-released report “Primary Care and Public Health: Exploring Integration to Improve Population Health.” The committee was charged with identifying the best examples of effective integration and the factors that promote and sustain those efforts, examining the ways federal agencies can use the provisions of the Affordable Care Act to promote integration, and discussing how Health Resources and Services Agency (HRSA) supported primary care systems and state and local public health can promote those efforts moving forward.
James S. Marks, MD, Senior Vice President of the Robert Wood Johnson Foundation, recently spoke on a keynote panel at the annual ASTHO meeting in Austin, Texas, on making the case for prevention. NewPublicHealth spoke with Dr. Marks about the great potential for investing in prevention.
NewPublicHealth: What do you think are the big issues facing state health officers across the country?
James Marks: The thing that I am most struck by is that we all know that public health, like so many of our sectors, is struggling in these tough economic times. But I’m seeing state health officers look increasingly at how they and medical care can connect and integrate and support each other as something we need increasingly in this country. They have to ask where they are going to get the best value in health. Sometimes it will be in medical care, many times it will be in prevention and public health, and they should be working to create common purpose.
NPH: What is the training of health officers for that?
The National Prevention and Health Promotion Strategy offers a comprehensive plan to increase the number of Americans who are healthy at every stage of life. A cornerstone of the Strategy is that it recognizes that good health comes not just from quality medical care, but also from the conditions we face where we live, learn, work and play—such as healthy homes, clean water and air and safe worksites. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies including the Department of Education, the Department of Housing and Urban Development and others.
As the Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about their prevention initiatives. Follow the series here.
We spoke with Arne Duncan, Secretary of the U.S. Department of Education, about the connection between health and education. Listen to the short podcast, and read the full interview below.
NewPublicHealth.org: The Department of Education is a member of the National Prevention Council. Why is health a priority for the Department?
Secretary Duncan: Very simply, if children aren’t healthy they can’t fulfill their academic and social potential. I always talk about the foundation of building blocks for great education, which includes good physical and emotional health. If children can’t see the blackboard they can’t do well. If children are hungry they can’t do well. If children are obese they are not going to do as well as they should. So we have to collectively make sure that children are physically and emotionally healthy so they can think about AP Chemistry and Biology and Physics and the rest of their learning.
NPH: What are the Department of Education’s key target areas and specific initiatives in implementing the National Prevention Strategy?
A group of professionally-attired policy-makers, influencers and public health professionals in Washington started their day this morning the way students at Namaste Charter School in Chicago do every day—doing upper and lower body exercises and stretches to make physical activity the first learning component of their school day. The Washingtonians—and some key education and health officials from around the country—were at the launch of “Health in Mind,” a project of the Healthy Schools Campaign and Trust for America’s Health (TFAH) that has released actionable recommendations focused on improving student learning and achievement through healthier schools. The recommendations were presented at today’s event to U.S. Department of Education Secretary Arne Duncan and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius.
“Unless we address health and wellness in schools, our nation’s efforts to close the achievement gap will be compromised,” said Rochelle Davis, president and CEO of the Healthy Schools Campaign, a national group that has focused on improving food and fitness in Chicago public schools.
Health in Mind aligns with the National Prevention Strategy introduced two years ago by the National Prevention and Health Promotion Council, which brings together 17 federal cabinet offices and agencies. The Strategy commits the entire federal government, not just the health agencies, to integrate health into their work and make a healthier nation a priority across sectors.
“The Strategy and these recommendations represent a major culture shift in how the nation views health—health will no longer be separated from education, transportation, housing and other clearly connected policies,” said Jeff Levi, executive director of TFAH and chair of the Advisory Group on Prevention, Health Promotion and Integrative and Public Health. “Health in Mind’s focus on students and schools promises to have a long-term payoff by improving education and quality of life for today’s kids as they grow up—they will do better in school and be healthier.”