A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years

January 2013

Trust for America’s Health (TFAH) released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years, which provides high-impact recommendations to prioritize prevention and improve the health of Americans.

The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.

“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation.  “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs.  We owe it to our children to take the smarter way.”

The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective.  Some recommendations include:

• Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
• Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
• Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
• Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
• Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
• Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
• Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs.

“Prevention delivers real value as a cost-effective way to keep Americans healthy and improve their quality of life,” said Jeffrey Levi, PhD, executive director of TFAH.  “Everyone wins when we prevent disease rather than treating people after they get sick.  Health care costs go down, our local neighborhoods are healthier and provide more economic opportunity, and people live longer, healthier, happier lives.”

A Healthier America also features more than 15 case studies from across the country that show the report’s recommendations in action, such as: 

• The first-of-its-kind Accountable Care Community (ACC) launched by the Austen BioInnovation Institute in Akron, Ohio, which brings together more than 70 partners to coordinate health care inside and outside the doctor’s office for patients with type 2 diabetes.  By improving care and making healthier choices easier in people’s daily lives, the ACC reduced the average cost per month of care for individuals with type 2 diabetes by more than 10 percent per month within 18 months of starting the program – an estimated savings of $3,185 per person per year; 
• The Community Asthma Initiative (CAI), implemented by Boston Children’s Hospital, has provided support to improve the health of children with moderate to severe asthma in at-risk Boston neighborhoods.  The CAI has led to a return of $1.46 to insurers/society for every $1 invested; an 80 percent reduction in percentage of patients with one or more asthma-related hospital admission; and a 60 percent reduction in the percentage of patients with asthma-related emergency department visits; and
• The Healthy Environments Collaborate (HEC) in North Carolina is an innovative partnership across four state agencies – Health and Human Services, Transportation, Environment and Natural Resources and Commerce. The partnership focuses on creating win-win policies and programs that improve health while also meeting other priority goals, such as improved transportation, increased commerce and stable housing programs.

In addition, the report includes recommendations for a series of 10 key public health issues: reversing the obesity epidemic; preventing tobacco use and exposure; encouraging healthy aging; improving the health of low-income and minority communities; strengthening healthy women, healthy babies; reducing environmental health threats; enhancing injury prevention; preventing and controlling infectious diseases; prioritizing health emergencies and bioterrorism preparedness; and fixing food safety. 

The report was supported by grants from the Robert Wood Johnson Foundation, the W.K. Kellogg Foundation and The Kresge Foundation and is available on TFAH’s website at www.healthyamericans.org.

All of the A Healthier America case studies from across the country are in the report and here. Additional Prevention and Public Health Stories in the States, which demonstrate many of the report's recommendations are available here.