Prevention Matters

Only about 1 in 4 Americans aged 50–64 regularly take advantage of preventive services such as screenings and immunizations, according to a report from the Centers for Disease Control and Prevention in collaboration with AARP and the American Medical Association (AMA).

The report, “Promoting Preventive Services for Adults 50–64: Community and Clinical Partnerships,” focuses on opportunities to improve the health of the growing number of adults in the 50–64 age bracket to broaden the use of potentially lifesaving preventive services.

The report identifies recommended preventive services such as influenza vaccine, cholesterol screening, breast and cervical cancer screening, as well as preventive screenings for behaviors that could negatively impact health such as binge drinking.

Recent commentary in the Journal of the American Medical Association (JAMA) highlights U.S. progress on addressing the disease and death caused by tobacco products, but notes that significant unfinished business remains. The article underscores the critical and unmet need for greater availability of cessation treatments, higher cigarette taxes and expanded smoke-free policies.

While we can feel good about the decline in the prevalence of smoking and the recent congressional action to give the U.S Food and Drug Administration (FDA) authority over tobacco products (finally), complacence has no place in the tobacco control world.

As the article states, “[s]moking cessation is critical for reducing the tragic and predicable burden of disease caused by smoking.” Tragically, although cessation is a medical treatment with proven efficacy, it remains woefully underfunded and underutilized. The major problem is lack of coverage in private insurance plans and employer-provided health benefits. Barriers, like co-pays and arbitrary limits on cessation treatments, further restrict access and affect quitting success. To address these obstacles, Partnership for Prevention convened the National Working Group for ACTTION (Access to Cessation Treatment of Tobacco in Our Nation), which seeks to change this dynamic by promoting collaboration among health providers, business, insurers and the tobacco control community to implement strategies to increase access and utilization of tobacco cessation treatments.

The JAMA Commentary states the obvious…the recently-enacted law giving FDA authority over tobacco products “represents a critical step in tobacco control.” While the FDA law won’t solve all tobacco control issues, it provides a tremendous opportunity to rein in a rogue industry and to communicate more truthful information to the public about tobacco products. But FDA is not authorized to mandate an expansion in insurance coverage, develop new therapies to help youth seeking to quit or provide workplace incentives that encourage cessation. That important work requires our continue vigilance and advocacy…especially with Congress as they debate health reform.

Be warned. We advocates of tobacco control must stay on high alert for actions that would undermine current tobacco prevention and cessation efforts. There will continue to be a need to demand attention and sufficient resources from government (state and federal) to reduce further tobacco product consumption and to provide those who want to quit with real, comprehensive support and effective treatments to do so.


Diane Canova
Managing Senior Fellow

It's been a topsy-turvy day on the health reform beat. First, the American Medical Association surprised most people and endorsed the House version of the legislation. Then the head of the Congressional Budget Office delivered an assessment that many say could be a death blow for the legislation being crafted by Democrats - that it might actually hurt rather than help the economy.

The AMA sent a letter to House Ways and Means Chairman Charles Rangel, D-NY, endorsing the health reform proposal put forward by three House committees. The New Republic's Jonathan Cohn attributes the decision in part to the approach the House bill takes on the annually scheduled reduction in Medicare payments, known as the Sustainable Growth Rate (SGR) formula

The AMA's letter says the legislation "recognizes that fundamental Medicare reforms, including repeal of the sustainable growth rate formula, are essential to the success of broader health system reforms."

Under questioning by members of the Senate Budget Committee, CBO director Douglas Elmendorf said bills crafted by House leaders and the Senate health committee do not propose "the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."

"On the contrary," Elmendorf said, "the legislation significantly expands the federal responsibility for health-care costs."

The American Medical Association says it will oppose creation of a government-sponsored insurance plan. The opposition of America’s largest physician organization could be a major hurdle for advocates of a public insurance plan. President Obama is scheduled to speak to the 250,000 member group on Monday in Chicago.

People tend to associate immunizations with children, but there are a number of cost-effective immunizations that not only can help keep older Americans healthy, but can also save their lives. For example, an additional 12,000 lives could be saved each year if the adult influenza immunization rate could be increased to 90%. Dr. Litjen 'L.J.' Tan, the American Medical Association's Director of Medicine and Public Health, says the value of adult immunizations is underappreciated, and he talks with us about how policymakers can help change that. To listen to this podcast, click on the media player below. If there is not media player below, click here.

American Medical Association President Nancy H. Nielsen makes a strong case for including prevention and wellness in government-funded comparative effectiveness research (CER).

"We do not have CER findings in the area of wellness, prevention, nutrition and obesity, yet there is a wide range of available interventions," Nielsen says in National Journal's Health Care Blog. "Clarity from CER findings as to which intervention is the most effective will help physicians provide patients with the treatment most likely to have the best outcome."