Building Advocacy for Policy Change to Improve the Nation's Health

Dates of Program: December 2002 through July 2016

Field of Work: Public health advocacy

Problem Synopsis: Modernizing the chronically underfunded and outdated public health infrastructure is essential to protect the public and control skyrocketing health care costs.

Synopsis of the Work: TFAH built a coalition of partners to advocate for a revitalized public health system and make recommendations on how it should be structured, funded, staffed and held accountable. Project staff convened consensus-building forums, provided information and technical assistance, crafted recommendations for prevention-related policies, and produced and disseminated strategic policy reports to federal, state, and local policy-makers, the media, and the general public.

The advocacy efforts of TFAH and its partners helped inform the health care reform debate. The 2008 consensus document, Blueprint for a Healthier America, recommended a stable and reliable funding stream for public health, community-based prevention activities, a national prevention strategy, and other policy approaches that were incorporated into the 2010 Patient Protection and Affordable Care Act (ACA). Following passage of the ACA, TFAH advocated to ensure its effective implementation and to protect key provisions, including the Prevention and Public Health Fund.

Its work in these areas continues through July 2016.

A small strategic investment in disease prevention can result in significant savings in U.S. health care costs. Implementing community-based interventions, which do not require medical care, could yield net savings of more than $2.8 billion in one to two years—meaning that the country could recoup nearly $1 over the cost of the program for every $1 invested.

Key Results

  • In 2006 and 2007, TFAH built consensus around an agenda for modernizing the public health system and created a framework for subsequent improvements. Over 140 organizations endorsed Our Vision for a Healthier America, which called for transforming the U.S. health care system from a “sick care” system to one focused on prevention and wellness.
  • In October 2008, TFAH released Blueprint for a Healthier America with specific recommendations for improving the public health infrastructure.
  • TFAH documented the business case for prevention in the 2008 report, Prevention for a Healthier America and communicated that message to policy-makers. The report, which was widely cited by policy-makers, showed that a small strategic investment in disease prevention can result in significant savings in U.S. health care costs.
  • TFAH reports and associated advocacy efforts helped inform health care reform legislation. Recommendations from the Blueprint and other reports were ultimately incorporated into the 2010 Affordable Care Act, including creation of the Prevention and Public Health Fund. Since the fund was created, $2.25 billion has been appropriated for prevention-related programs over three years.
  • Following passage of the Affordable Care Act, TFAH and a diverse coalition of some 770 partners from public health, philanthropy, business, faith-based organizations, education, and other sectors have advocated for its effective implementation and the protection of key provisions, including the Prevention and Public Health Fund.
  • TFAH published and disseminated reports to educate policy-makers, the media, and the public about key public health issues such as emergency preparedness, injury prevention, obesity, and the flu endemic. Every TFAH report is delivered to all members of Congress and follow-up one-on-one meetings are held to discuss policy recommendations.
  • In 2013, TFAH worked with a range of partners to reorient its existing series of reports on emergency preparedness. The new report, Outbreaks: Protecting Americans from Infectious Diseases, addresses antibiotic resistance and health care-associated infections, as well as the ongoing threats of food safety, immunization-preventable diseases, and emerging diseases.
  • Under the two-year renewal grant RWJF awarded TFAH in August 2014, TFAH is using its policy and advocacy skills to help achieve the Foundation’s goal of building a national Culture of Health.

"The Affordable Care Act includes the ingredients needed to ensure we get the returns that prevention offers, including a focused national prevention strategy, a reliable public health funding stream, and evidence-based programs that will be held accountable for improving health outcomes."—Jeffrey Levi, TFAH


Investing $10 per person per year in programs could save billions in health care costs over 20 years