Issue Category: Public Health Preparedness

Washington, D.C., December 7, 2016 – The below is a statement from Rich Hamburg, interim president and CEO, of Trust for America’s Health (TFAH) on the 21^st Century Cures legislative package.

“TFAH is deeply disappointed Congress will utilize the Prevention and Public Health Fund as an offset for the legislative package known as 21^st Century Cures. Cutting the Prevention Fund will limit the nation’s ability to improve health and quality of life and prevent disease.

While TFAH supports aspects of this legislative package, including the much-needed funds to address the opioid epidemic, we remain opposed to using the Prevention Fund to offset the cost of this legislation.

The Prevention Fund is inextricably tied to the nation’s future ability to reign in healthcare costs. This is the nation’s first and only substantial investment in moving from our current “sick care” system to a true preventive health system. The Prevention Fund should be dedicated to its intended purpose: helping all Americans stay healthy.

Despite the exponentially growing burden of largely preventable diseases, federal disease prevention and public health programs remain critically underfunded. Public health spending is still below pre-recession levels, having remained relatively flat for years. Today, more than 12 percent of the CDC budget is supplied through Prevention Fund investments, including the 317 immunization program, epidemiology and laboratory capacity grants and the entire Preventive Health and Health Services Block Grant program—all critical to preparing for and responding to public health emergencies.

The United States spends $3 trillion annually on healthcare without much to show for it: Millions of Americans suffer from chronic diseases, which are responsible for seven out of 10 deaths and $1.3 trillion in treatment costs and lost productivity every year.

And, two-thirds of Americans are overweight or obese and nearly 20 percent of Americans smoke. Obesity costs the country $147 billion and tobacco use leads to another $130 billion in healthcare spending each year.

Time and again research shows that the vast majority of these chronic diseases can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.”

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Washington, D.C., October 19, 2016 – Today, the Trust for America’s Health (TFAH) released Blueprint for a Healthier America 2016: Policy Priorities for the Next Administration and Congress which calls for a new approach to health – prioritizing improving health and addressing major epidemics in the United States.

“It’s time for a sea change from our current sick care system to a true health system, where we focus on preventing disease and improving quality of life,” said Richard Hamburg, Interim CEO and President of TFAH.  “In the Blueprint, we highlight high-impact policies that could help spare millions of Americans from preventable health problems and save billions in avoidable healthcare costs – if we make them a priority.” 

The report highlights pressing crises and how investments could yield positive returns on investment by adopting proven health strategies.  For instance:

• Investing $1 in substance use prevention to realize as much as $34 in return.  Deaths from prescription painkiller use have more than quadrupled in the last 15 years and deaths from heroin have tripled since 2010, contributing to higher death rates among middle-aged Whites.  Five of the strongest school-based substance use prevention strategies have returns on investment ranging from $3.8:1 to $34:1.
• Saving more than $16 billion through a more active and healthy population. One in three children will develop type 2 diabetes in their lifetime and one in four young adults are not healthy enough to join the military.  An investment of $10 per person in proven, evidence-based community prevention programs to increase physical activity, improve nutrition and reduce tobacco use could save the country more than $16 billion annually – a $5.60:1 return.
• Connecting health and social services to cut billions in costs.  Health and social service coordinating systems that address gaps between medical care and effective social service programs – by connecting patients in need with programs ranging from supportive housing to food assistance – could yield between $15 billion and $72 billion in healthcare savings a year within 10 years, according to a new analysis by TFAH and Healthsperien.
• Reducing the $120 billion spent annually on preventable infectious diseases.  Fifteen years after 9/11 and 11 years after Hurricane Katrina, when health crises such as new infectious diseases arise, the country still scrambles to implement emergency plans and secure funding.  Preventable infectious diseases cost the country more than $120 billion annually – and that cost is exponentially compounded when new diseases emerge.
• Realizing a 7-10 percent annual return by investing in early childhood education. More than half of U.S. children – across the economic spectrum – experience adverse experiences, such as physical or sexual abuse, and more than 20 percent live below the poverty line, which increases their risk for “toxic stress” – living under a constant state of stressful conditions – that can contribute to a range of physical, mental and behavioral health issues.  Investments in early childhood education can help mitigate against impact of these risks and increase resilience, while also providing an annual return of 7 to 10 percent per year, and supportive nurse-family home visits for high-risk families show a return of $5.70:1. 

The Blueprint highlights leading evidence-based strategies for improving health and policy – and models to help bring them to scale across the country. These include:

• Supporting Better Health in Every Community:  Federal, state and local public health programs and policies should support place-based health improvement partnerships. Doing so will help identify and elevate a local community’s top priorities and bring key partners and assets together – from public health, healthcare, social services, philanthropies, education, businesses and faith and community groups – for a greater collective impact.  A network of expert institutes in each state should provide technical assistance to these multisector collaborative partnerships.  In addition, the Prevention and Public Health Fund and other community-based health improvement programs should be protected and fully funded.
• Modernizing the Public Health System to Be Prepared for Emergencies:  The public health system must be modernized – and sufficiently funded – so that it can handle ongoing threats and new emergencies. Too often the country has been caught off guard when a new crisis emerges, diverting attention and resources.  There should be 1) greater investment to improve baseline foundational capabilities in communities around the country; 2) a standing Public Health Emergency Fund to provide additional surge funds when needed; 3) improved federal leadership, such as through a Special Assistant to the President for Health Security; and 4) upgrades to out-of-date technology and surveillance systems.
• Incentivizing Health Care vs. Sick Care:  There should be increased incentives and mechanisms for healthcare insurers, nonprofit hospital community benefit programs and social investment funds to support health improvement strategies.  Efforts such as healthcare investment in community-wide health improvement programs, “navigator plus support” health and social service integration (such as Accountable Health Communities), Community Development Financial Institutions for Health (strategic planning and financing intermediaries) and pay-for-outcome approaches should be expanded.

The report also includes a set of policy recommendations to address priority health problems that require urgent action, some highlight areas include:

• Stopping the Prescription Painkiller and Heroin Epidemics
• Renewing Efforts to Prevent Obesity, Diabetes and Tobacco Use
• Highlighting Prevention in the National Cancer Moonshot Initiative
• Ending the HIV/AIDS Epidemic
• Stopping Superbugs and Antibiotic Resistance
• Lowering the Rising Death Rates Among Middle-Aged Whites
• Achieving Health Equity

The Blueprint was supported by grants from the Robert Wood Johnson Foundation, the W.K. Kellogg Foundation, The California Endowment and The Kresge Foundation.

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

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