Friday, April 3, 2009

Anyone familiar with Partnership for Prevention’s work and activities knows that “real health reform starts with prevention.” Implicit within this assertion is the conviction that the issue is health reform, not just health care reform. Partnership has always promoted this idea-it is the central premise of our Principles for Prevention-Centered Health Reform and all of our health reform recommendations.

Robert Wood Johnson Foundation’s Commission to Build a Healthier America further developed this theme with the release April 2 of its 10 recommendations for improving the nation’s health. By concentrating on evidence-based interventions and programs that are outside the health care system, the Commission emphasizes the need to have a broader view of health to generate a healthier nation.

Three aspects of the recommendations are particularly worth noting:


  • The Commission addresses the main causes of poor health. Half of the recommendations deal directly with the three primary actual causes of death in the United States-smoking, poor diet, and physical inactivity;
  • The Commission focuses on working as “upstream” as possible in the age continuum. Determinants of health and health behavior habits start early in life, therefore any policy or program implementation must begin with our children; and
  • The Commission recognizes the role that non-health factors play in the health of the country. Policies related to transportation, housing, infrastructure, agriculture, and the environment all have a “health impact,” and developing healthy communities requires measuring that impact.

Finally, these recommendations are consistent with Partnership’s emphasis on the significance that community prevention plays in health reform, and we look forward to collaborating with the Commission and other partners to advance interventions that will have a greater impact on health than increased access to medical care, improved health insurance coverage, less medical errors, or health IT. As we say in our principles, “The nation will get a much greater return on investment by focusing on health improvements in communities, schools, and worksites rather than focusing solely on what occurs in traditional healthcare settings, such as doctors’ offices and hospitals.”

Read more on Partnership’s health reform efforts at www.prevent.org/healthreform. The Commission to Build a Healthier America’s recommendations can be found on its website at http://www.commissiononhealth.org/.

- Jason Spangler, MD, MPH

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