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The Enemy We Know

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Healthcare’s best spent dollars are in prevention and interven­tion, according to Dr. Thomas R. Frieden, director of the Centers for Dis­ease Control.

“The biggest challenge for health research, for public health and for clinical medicine moving forward is how to be as one program, focused on improving health status,” he said, “from the public health department, from the university, from the clinical provider, from the com­munity health center, from the pharmacy, from the school, from the workplace.”

Employers can play an important role with wellness programs connected to their health insurance plans.

Improving health is the biggest chal­lenge facing the nation, Frieden empha­sized during his “Saving Lives and Saving Money: Best Buys in Health” pre­sentation to several hundred healthcare providers from around the nation who gathered at April’s Keeneland Confer­ence at the Lexington Convention Cen­ter. The annual conference is billed as a premier national meeting focused on advancing the science, policies and delivery of programs and services to protect and improve Americans’ health.

It is sponsored by the National Coor­dinating Center for Public Health Services and Systems Research, which is housed at the Uni­versity of Kentucky College of Public Health and funded by the Robert Wood Johnson Foundation.

Chronic diseases are the leading cause of death in the United States, but much of that loss of life is preventable with current technologies, Frieden said.

More than 700,000 deaths in 2010 were caused by heart disease and stroke. Cancer killed 574,000 Americans, and uninten­tional injuries claimed 118,000 victims, according to preliminary data from the National Vital Statistics Report that Frie­den presented.

Americans are more likely to die before age 75 from conditions that are prevent­able by healthcare, and the United States is making slower progress in preventing these conditions than other countries.

“Over the past 15 years, the world has left us in the dust,” Frieden said. Other countries “have significantly reduced conditions that are preventable through healthcare, (and reduced) deaths due to conditions preventable through healthcare, and we have not.”

The result, he said, is that chronic dis­eases are the leading cause of U.S. death and disability, with 1.7 million people dying of chronic diseases each year.

Half of all Americans – about 133 million people – have one or more chronic condition, accounting for three-quarters of healthcare costs.

“This is not sustainable in our soci­ety,” Frieden said.

The CDC has identified seven areas where improvements can be made:

• Tobacco use

• Nutrition, obesity, food safety and physical activity

• Healthcare-associated infections

• Teen pregnancy


• Motor vehicle injuries and

• Heart disease and stroke.

Employers can play a significant role in prevention and save a lot of money, the CDC chief said.

“Businesses have a real stake in pre­vention,” Frieden said. “If you just look at how much someone with obesity, smok­ing and diabetes costs per year, businesses can play a big role in how they design health benefits – if they pay for health benefits. They can say, ‘Alright, we’re going to make sure that prevention is no cost-sharing, because it’s going to save us money in the long run.’ ”

Employers also can make sure onsite food is healthy and safe, preventing food-borne illnesses. They also should make their workplaces tobacco free.

“And they can do a lot to help smok­ers quit because that’s going to save them money. Plus, people not going out for a smoking break is going to increase their productivity as well,” Frieden said.

Businesses have been slow to imple­ment such suggestions because the investment return is not immediate and obvious, he said.

“Prevention is kind of like the dog not barking in the night: When it doesn’t happen, you don’t see it,” Frie­den said. “That’s why monitoring is so important, so we can identify what’s working and do more of it.”

Lorie Hailey is associate editor of The Lane Report. She can be reached at [email protected].