Prevention and wellness: Treating the causes
“Prevention and Wellness: The Keys to a Healthier, More Prosperous Society” was the first health panel at the Milken Institute Global Conference. Moderator Michael Milken, chairman of the Institute, opened by noting that 50 percent of economic growth over the past century can be attributed to improvements in public health and medical research. But currently, 70 percent of health-care spending is aimed at preventable lifestyle diseases.
Virtually all of the panelists related stories of their frustrations as medical professionals treating the complications of chronic diseases like diabetes, without being able to remedy the underlying causes. “I felt like I was putting Band-Aids on things,” said Peter Attia, president and cofounder of the Nutrition Science Initiative. Attia abandoned a promising career as a surgeon to focus on bringing more rigorous science to the public’s understanding of prevention and wellness. He declared that “unambiguous scientific evidence, combined with policy initiatives and market forces,” will ultimately result in success in the battle against chronic disease.
Dean Ornish, president and founder of the Preventive Medicine Research Institute, presented compelling evidence of his own on the impact of “lifestyle medicine” on health, including even potentially reversing the effects of aging. “It’s not only medically effective, it’s cost-effective.” He emphasized, however, the importance of ensuring that these approaches are paid for in the health-care system. “If it’s not reimbursable, it’s not sustainable,” he said.
Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, says the business case for prevention and wellness is clear. “The costs of illness are enormous, and the return on investment on prevention is substantial.” Implementation of what is known to work, however, is critical. “We need to implement what works first. We know what to do, but we’re not doing it.” He offered the example of high blood pressure, which now kills more people globally every year than lung cancer, and the low percentage of people who are keeping it under control.
Troyen Brennan, executive vice president and chief medical officer at CVS Caremark, discussed the company’s recent decision to stop selling cigarettes in its stores – welcomed by applause from the audience – and his vision for all retail pharmacies to do the same. “Private-sector leadership could have a real impact on public health.”
Lynn Goldman, dean of public health at George Washington University, focused on the enormous impact our environment has on behavior. “We think this is about personal choice, but when things that are bad for us are available, we make bad choices.” She remains optimistic, however, about the power of partnerships to address the challenges of creating healthier environments and motivating better choices. “We need to involve employers, schools, and the medical profession. This is a complicated issue, but it’s tractable. We can do this.”