An Integrated Framework for Assessing the Value of Community-Based Prevention

Over the last century, the major causes of disease and death among Americans have changed, shifting from predominantly communicable diseases spread by germs to chronic ailments. This shift has been accompanied by a deeper understanding about what keeps people healthy or leaves them vulnerable to becoming ill. To get at the heart of the challenges to living a healthy life, we must increasingly emphasize factors that affect today’s causes of morbidity and mortality.

Despite their importance to preventing illness, determining the value of community-based interventions has proven difficult. Preventing illness requires immediate investments with benefits that might not be realized for many years.

Four foundations—the California Endowment, the de Beaumont Foundation, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation—asked the Institute of Medicine to convene an expert committee to develop a framework for assessing the value of community-based, non-clinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases. This report is the result of the work performed by that committee and represents a valuable step toward realizing the elusive goal of appropriately and comprehensively valuing community-based prevention.