Category Archives: Public health system and finance
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?
At this month’s Public Health Preparedness Summit, John Lumpkin, MD, MPH, senior vice president and the director of the Health Care Group at the Robert Wood Johnson Foundation, presented about the National Health Security Preparedness Index. The Index, when completed, will be a single annual measure of health security and preparedness at the national and state levels. The Index will help inform decisions about how to prioritize investments and continual quality improvement of public health preparedness, and will also identify and highlight strengths and novel approaches. With input from many stakeholders, the Association of State and Territorial Health Officials, in partnership with the Centers for Disease Control and Prevention, is coordinating development of the Index.
Prior to joining the Foundation in 2003, Dr. Lumpkin served as director of the Illinois Department of Public Health for 12 years. In an interview at the Summit, Dr. Lumpkin described how the Index will help improve the quality of public health preparedness. He also shared his insights from his first-hand experience in coordinating a sustained response to public health emergencies that extends well beyond the initial response.
NPH: In the aftermath of a disaster such as Hurricane Sandy, how can public health agencies balance their focus on immediate needs such as shelter, food and emergency services, with longer-term challenges such as mental health, housing solutions and resilience?
Dr. John Lumpkin: While the immediate impact of homes being destroyed, people being forced to relocate and lives being lost, is devastating—there is also an ongoing public health impact of a disaster such as Hurricane Sandy, which is tremendous.
>>Watch a video on the ongoing public health response to Hurricane Sandy.
State legislatures recently got underway across the country and many will be considering some critical public health law measures, according to a recent blog post from the Network for Public Health Law.
Critical issues include:
- A smoking ban in Kentucky which could stall in committee
- A bill in Kentucky which could restrict the work of local boards of health.
- A law in Ohio that would require health departments to enter into agreements for shared services and to become accredited.
- Read the Network blog post.
- Use the state legislative tracking page from the Association of State and Territorial Health Officials to follow state public health agendas for 2013.
Three years after a devastating earthquake took the lives of 200,000 Haitians, displaced millions more and disrupted the public health infrastructure of the country, two new public health buildings opened yesterday in the country’s capital city of Port-Au-Prince with funding by the CDC Foundation and several partners including the Robert Wood Johnson Foundation, the GE Foundation and Kaiser Permanente. The CDC Foundation was established by Congress to forge partnerships between the Centers for Disease Control and Prevention (CDC) and corporations, foundations and individuals to support CDC's work in the U.S. and abroad.
“‘Building back better’ isn't just a slogan, it's a reality in public health. These buildings represent an important step forward to save lives in Haiti,” said CDC director Thomas Frieden, MD, MPH, at the opening in Port-Au-Prince. "These new buildings have an importance far beyond their physical presence—they will serve as a basis and catalyst for programs that will save literally tens of thousands of lives,” Frieden said.
One building replaces the Haiti Health Ministry, which was destroyed in the earthquake. The second building will house some of the ministry’s surveillance, epidemiology and laboratory staff as well as Haiti-based CDC staff, who are now working side-by-side in the country.
Representatives of the partners critical to the funding of the new buildings were on hand in Port-Au-Prince for the buildings’ ribbon cutting ceremony, including Susan Mende, senior program officer at the Robert Wood Johnson Foundation. “The earthquake in Haiti wrought great destruction and suffering to some of the most vulnerable in society as well as to the health and public health infrastructure so critical to the nation’s health,” said Mende. “The Robert Wood Johnson Foundation made a $500,000 grant to help build a public health laboratory research center to be used by Haiti’s Ministry of Public Health and Population. The Foundation recognizes that a stronger public health system is the network that protects communities, saves lives and directly improves people’s health and well being.”
To learn about the significance of the new buildings and the continuing efforts to improve public health in Haiti, NewPublicHealth spoke with Charles Stokes, president of the CDC Foundation, and Justin Tappero, MD, MPH, Director for the Health Systems Reconstruction Office in the Center for Global Health at CDC. Both were on hand for the ceremonies this week.
The Public Health Quality Improvement Exchange (PHQIX) is a brand new online community designed to be a communication hub for public health professionals interested in learning and sharing information about quality improvement (QI) in public health. PHQIX was created by RTI International and funded by the Robert Wood Johnson Foundation. The key goal of the site is to share national QI efforts by health departments of all sizes so that public health experts can learn from the experience of their colleagues across the country. NewPublicHealth recently spoke with Jamie Pina, PhD, MSPH, PHQIX project director, and Pamela Russo, senior program director at the Robert Wood Johnson Foundation about the new resource and its promise for helping health departments continuously improve their performance and achieve the national standards set forth by the Public Health Accreditation Board.
NewPublicHealth: What’s the vision of PHQIX, and how did it come about?
Pamela Russo: Public health departments are looking for ways to be more and more efficient and to eliminate waste and to make their limited budgets have the maximum possible impact. That’s the major value of QI, to show what works and where you can improve.
The new issue of Frontiers in Public Health Services and Systems Research (PHSSR), an online journal that looks at early research on issues related to public health services and delivery, focuses on quality improvement in practice-based research networks.
This issue’s commentary, from the journal’s editor, Glen Mays, PhD, MPH, is about a series of studies sponsored by the Robert Wood Johnson Foundation that look at how public health decision-makers are responding to accreditation, quality improvement, and public reporting initiatives during ongoing fiscal problems. Mays is co-principal Investigator of the National Coordinating Center on PHSSR, Director of the Public Health Practice-Based Research Networks and the F. Douglas Scutchfield Endowed Professor at the University of Kentucky College of Public Health. Mays says that, overall, the current evidence shows that “these initiatives represent promising strategies for strengthening evidence-based decision-making and expanding the delivery of evidence-tested programs and policies in local public health settings.”
Mays adds that continued comparative research and evaluation activities are needed to provide more definitive evidence about which combination of strategies work best, for which population groups, in which community and organizational settings, and why.
A new commentary by Dr. Georges Benjamin, president of the American Public Health Association, looks at how the Affordable Care Act (ACA) is impacting public health and how it will create new opportunities for better health for more people across the nation.
The Affordable Care Act affects all 10 essential public health services, writes Dr. Benjamin in the commentary published by the Institute of Medicine. Dr. Benjamin says the ACA will influence the public health system in three major ways:
- Expanded insurance coverage will impact how public health departments offer clinical services: Governmental public health agencies currently providing clinical services may transfer cases to the private sector, such as routine childhood vaccinations.
- New care delivery models offer opportunities to integrate public health principles and enhance requirement for hospitals to define and utilize beneficial community efforts: Public health practitioners will have the opportunity to share their expertise on assessing the health of populations, implementing community and broad-based solutions, and evaluating the outcomes of these solutions.
- Public health services can reach more people: Programs and services such as, home visiting and other maternal child health programs and specialized behavioral health services will be made available to the general population, in addition to programs on prevention and protection.
“There is a lot to learn as we make this transformation to achieve better health and better value for our health investment. A transformed public health system is an essential element of that change,” Dr. Benjamin comments in the report.
>>Read the commentary.
There is great promise in leveraging the strengths and resources of both the health care and public health systems to create healthier communities. Hospital community benefit is one critical area of opportunity for greater collaboration. Historically, nonprofit hospitals, as a condition of their tax-exempt status, have been required to enhance the health and welfare of their communities. Through the Affordable Care Act, nonprofit hospitals will have the opportunity to direct their community benefit efforts toward public health interventions and collaborate more effectively with local health departments.
Paul Kuehnert, MS, RN, senior program officer and director of the Public Health Team at the Robert Wood Johnson Foundation (RWJF), shared his insights on the opportunities and challenges that lie in integrating health and health care. Prior to joining the Foundation, he was county health officer and executive director for health for Kane County, Ill., where he led a partnership between the health department, hospitals and other partners to assess and address the community’s health needs. Paul is a Pediatric Nurse Practitioner and worked as a primary care provider in schools and other community settings in Missouri and Illinois.
NewPublicHealth: There has been lots of conversation across the public health field about the need for more strategic coordination or integration with health care. Why is there so much focus on this now?
Paul Kuehnert: There are a couple of reasons for that. One of the primary reasons is that we know that there are increasingly limited dollars for public health. We really have to be as efficient and effective as we can be in trying to improve health in our communities. There’s a common interest between public health and health care around controlling the overall cost of health care. At the same time, we’re not getting the kinds of health outcomes we need. There’s this dynamic of mutual interest in controlling cost and finding ways to improve health and get to the best health outcomes for the community.
Inspired by the 2012 American Public Health Association (APHA) Annual Meeting, the Robert Wood Johnson Foundation recently talked with a range of national thought leaders to discuss what’s needed—and what works—to achieve better health.
Today, we're featuring video interviews Alex Briscoe, director of the Alameda County Health Care Services Agency.
In the first video, Briscoe talks about the connection between health, wealth, race and class. Briscoe says, "it's now harder to get out of poverty than in the history of our civilization." Watch the video:
Briscoe also talked about how we can shift the power dynamic that exists between consumer and physician. How can we empower patients to realize that they are their own best clinician? Briscoe shares his ideas:
Finally, Briscoe talks about "the trump card" in achieving better health outcomes: the resilience of communities and individuals. Watch the video: