Prevention Matters

In a column in the Los Angeles Times, former Senate Republican Leader Bill Friest says true health reform has to emphasize behavior-changing wellness programs.

"The major determinants of health are not doctors, hospitals, universal insurance, public plans and expanded health services," says Frist, who is also a heart surgeon. "Much more significant is behavior -- things such as diet, exercise, smoking and drinking -- basic education and socioeconomic status. So if the goal is to make us healthier, to lower the burden and thus the societal costs of disease, policymakers in Washington must actively promote health and wellness. And the way to do that is by providing incentives for the implementation and sustained use of employer-backed wellness programs. "

Frist said prevention has been written off as costly due to reports like one that appeared recently in Health Affairs subtitled: "An Overwhelming Percentage of Preventive Interventions Add More to Medical Costs Than They Save."

"The key word is 'interventions,'" Frist says. "Think about it: Having more people getting more health screenings, mammograms, pap smears and colonoscopies has to cost more money.While we want such services to be widely available, reform that concentrates merely on offering more of those things isn't the way to fix what ails the nation.

"Instead, we need a system that concentrates on keeping us well, so we need less "healthcare" and fewer "preventive interventions" in the first place."

Living without a car in an area populated by fast food restaurants may make your weight climb, according to a study cited by the Los Angeles Times' Jeannine Stein. The study, which appears in the September issue of the Journal of Urban Health, Using information on 2,156 adults from the Los Angeles Family and Neighborhood Study database, researchers looked at connections between body mass index, the concentration of restaurants in a neighborhood, and whether or not someone owned a car.

"Car owners on average weighed 8.5 pounds more than those who didn't own cars," Stein writes. "But non-car owners who lived in neighborhoods with a high concentration of fast food restaurants weighed 12 pounds more than non-car owners in areas without fast food restaurants, and 2.7 pounds more than those who owned cars and lived in areas with many fast food restaurants.

"Those who weighed the least didn't own a car and lived in areas without any fast food restaurants," she concludes.