Andrew Rein: NewPublicHealth Q&A
Andrew Rein, MS, is the Associate Director for Policy for the U.S. Centers for Disease Control and Prevention, and the HHS designee on the National Prevention Council. NewPublicHealth spoke with him about the National Prevention Strategy Action Plan released earlier this week.
NewPublicHealth: What are the overarching goals of the National Prevention Strategy?
Andrew Rein: We not only want people to live longer, we want them to live healthier, too. And the way to get there is really to become a nation that focuses on wellness and prevention, not just sickness and disease. We want to prevent disease from happening in the first place. To do that, we work across sectors because that’s the best way to have a prevention-oriented society where people work, live, learn and play and prevention is “baked in.” So, working with non-profit, private, state, and other sectors, such as transportation, education, housing, we can really make our communities safe, our communities healthy, and focus on prevention.
NPH: What movement have you seen on prevention in the last year, and how does the Action Plan move that forward?
Andrew Rein: The Action Plan really brings the National Prevention Strategy to life. It presents federal actions that not only will make progress in their own right but also serve as examples to others who want to focus on prevention. In the last year, there’s already been some of that mobilization across the country as a result of the release of the strategy. San Diego and Chicago used the strategy when designing their prevention plans; a few state legislatures are considering legislation to create multi-sector prevention councils. So there really is support to move prevention forward in all sectors and the Action Plan tries to catapult that to the next level.
NPH: The strategy talks about the 17 agencies and offices that have a role in the National Prevention Council. What is the niche of the Department of Health and Human Services?
Andrew Rein: That’s a great question. First off, I just have to say how significant and wonderful it is that we can be asking that question. We can only ask that question because there are so many departments involved. Prevention, of course, is the core business for HHS, whether it is community prevention at the Centers for Disease Control or clinical prevention being supported by Health Resource Services Administration and the Center for Medicare and Medicaid Services, or the basic research at the National Institutes of Health and the Food and Drug Administration in terms of safety. There’s so much that we do. On the National Prevention Council, we know the data on health, so that we can target our activities for leading causes of death, disease and disability, and share the evidence base and examples of what works to effectively address these problems.
NPH: What are some things that might have informed the Department of Health and Human Services in the last year from engagement with the other agencies?
Andrew Rein: I think the most significant piece for me has been to learn how much is already going on and what kind of commitment and expertise there is out there to improve the health of the American people. What the National Prevention Council has been able to do is share that expertise and align our activities. One of the most significant pieces has been to bring together a community of people within the federal government who want to work on these activities, have the charge of their leadership to move forward and just have been waiting for ways to do this in a more effective manner.
For example, the Department of Defense is very focused on prevention in terms of physical activity, obesity and tobacco control as just a few examples.
NPH: What are some of the critical prevention goals that all departments are focusing on? Some examples from the 2012 report were access to healthy foods and tobacco free environments.
Andrew Rein: There are over 200 council actions aligned with the strategic directives and priorities and much more is going on. The National Prevention Council came together and selected three common areas of commitment. One is to increase tobacco-free environments in their own facilities and voluntarily with their partners as appropriate. We know that tobacco still kills 440,000 people a year. So that’s a great shared commitment. We know tobacco-free environments work and help reduce tobacco-related illness and death. The council members also committed to increase access to healthy and affordable food in their own facilities and with their partners voluntarily as appropriate.
And third, they are continuing to consider additional opportunities for prevention and health within each department, and that means training their own staff, whether those staff are transportation planners or people in housing, for example, and saying well, how does prevention and health relate to the work I do?
So these three areas are ones that all 17 National Prevention Council departments have come together and committed to moving those forward, committed to assessing their current environment, making a plan for improvement, committing to leadership, communication on what that plan will be and the importance of these issues, and then moving forward in future years.
NPH: For many initiatives, many people might be surprised that departments other than HHS would be involved such as the Housing and Urban Development on Housing and Health. Are you seeing more examples of actions other sectors are taking to advance prevention?
Andrew Rein: We’ve seen many more examples of activity across sectors. The Department of Housing and Urban Development is a great example. Its work on smoke-free housing is wonderful. It has a great voluntary approach that’s had real impact. There are now 230 public housing authorities that have voluntarily adopted such policies for some or all of their buildings. And the Department of Defense and the Veterans Administration are working on transforming their food environments, increasing access to healthy foods, sharing the information. The VA is even developing teaching kitchens for veterans in an effort to support healthy eating.
The Office of National Drug Control Policy (ONDCP) has a very prevention-oriented approach along with traditional interdiction measures, supporting measures such as screening, brief intervention, referral and treatment to curtail alcohol abuse.
>>Listen to our interview with ONDCP director, R. Gil Kerlikowse.
It has really been amazing to see fantastic examples across the 17 departments, and these are just some of the examples where all sectors are coming together. But we also see at the community level, people understanding that their health is not just in the doctor’s office; it’s when they walk outside and is it easy and safe to play? Do they have access to healthy foods? Are they focusing on prevention rather than treatment both in their clinical systems and in their communities? In their schools, how can they improve health? There is more awareness throughout communities in the country, not just in the public health community. We need to make healthy choices the easy choices, the default choices, and the National Prevention Strategy Action Plan is the way to do it, to bring everyone in.