Lynn R. Goldman and Paul H. Irving: Prevention is investment in nation's health (and wealth)
Paul Irving and Lynn Goldman
In his 2014 State of the Union address last month, President Barack Obama praised the bipartisan effort to pass a recent budget bill and renewed his commitment to the Affordable Care Act, a law that puts public health and prevention front and center.
Now lawmakers from both parties have the opportunity to put aside the fractious debates of last year and come together in a “year of action” to improve the nation’s well-being. By fully funding programs to prevent chronic diseases, lawmakers can keep Americans of all ages healthier, bolstering our national productivity and improving America’s global competitiveness.
Right now, our system waits until someone gets sick before costly treatment kicks in for an established disease. But the current system has it all wrong. To keep our nation strong, lawmakers simply must start directing more resources toward programs that make it easier for people to avoid getting sick in the first place.
Earlier this year, a bipartisan group of lawmakers signaled a readiness to adopt this shift toward health by signing off on a spending bill that will fund many parts of the ACA, including the Prevention and Public Health Fund. This landmark fund will help communities in all 50 states support initiatives aimed at keeping people healthy.
Diseases caused by smoking or related to obesity already represent a huge drain on the economy. In mid-January, the surgeon general issued a new report that says smoking not only causes lung cancer, but also Type 2 diabetes and many other serious ailments.
The surgeon general’s report goes on to say that the direct medical and economic cost of smoking in this country adds up to nearly $290 billion a year.
And we now know that adult obesity rates could exceed 60 percent in 13 states by 2030, according to a report released in 2012. Mississippi, South Carolina, Kansas, Missouri, Kentucky and the other states in the top 13 will be battling a surge of obesity cases and rising costs in the coming years. Obesity puts people at risk of developing more than 20 potentially life-threatening medical conditions. That report says the loss in U.S. economic productivity due to obesity could add up to $580 billion annually.
If anything, such numbers may underestimate the real costs related to obesity and tobacco use. Both lead to poor health, absenteeism, a wide range of caregiving expenses and other costly problems that are hard to forecast.
The United States now spends just 3 percent of its health care dollars on preventing chronic conditions. In 2012, the Institute of Medicine recommended that we increase federal funding for public health and prevention by $12 billion annually — a doubling of what was spent on such programs in 2009.
But states also must do their part when it comes to prevention.
A 2011 study conducted by California researchers says that if states fully funded anti-tobacco programs, they could save an estimated 14 to 20 times their investment. In California alone, the savings resulting from such an investment comes to about $6 billion.
According to a report released in December, only two states — Alaska and North Dakota — are currently funding smoking-cessation programs at the recommended levels. Alaska’s investment is already paying off: The state has cut its smoking rate among high school students by 40 percent since 2007, to just 10.6 percent in 2013.
The bottom line is prevention just makes good economic sense: Nationally, an investment of just $10 per person per year in programs aimed at better nutrition, physical activity and the prevention of tobacco use could save the nation more than $16 billion within five years, according to a 2008 report. The return on that investment comes to more than five dollars for every dollar spent.
That’s a healthy return and one that would help push us toward the “rising America” that Obama referred to in his State of the Union address. After all, disease prevention through innovative solutions and smart policy change would not only improve the lives of individuals and families, but would also help build a stronger, more resilient and more economically powerful nation.
These are goals we can all agree on and work toward together.
Lynn R. Goldman is dean of the George Washington University School of Public Health and Health Services in Washington, D.C. Paul H. Irving is president of the Milken Institute in Santa Monica, Calif., and a member of the George Washington University School of Public Health and Health Services Dean’s Council. They wrote this column for McClatchy-Tribune News Service.