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Prevention and public health funding: A move in the right direction

(This guest column was submitted by public health officers from throughout Montana.)

It is well known that the United States spends a lot of money on medical care, more than $8,000 for each man, woman and child or about $2.6 trillion in 2010.

What do we have to show for our investment?

Because we spend twice as much on medical care than what the 14 wealthiest nations in the world spend, does that mean we are healthier? No.

The U.S. did not even make the top 20 on Bloomberg's recent "Healthiest Countries" ranking.

How do we become a healthier nation? Investing in public health is part of the answer. Of the more than $8,000 health expenditure for every American, only $250 is spent on public health.

This is alarming when we consider how many medical care expenditures can be prevented through primary prevention activities. Primary prevention is public health.

Established through the Affordable Care Act, the Prevention and Public Health Fund expands and sustains efforts to prevent disease, detect it early, manage conditions before they become severe and provides states and communities with needed resources to promote healthy living. The fund is a substantial investment that moves our country from a "sick care" system that manages illness to "well care" system that promotes maintenance of health and prevention of disease.

The services offered through the Prevention and Public Health Fund are many and include newborn health screenings, cancer screenings, HIV screenings, as well as programs to reduce tobacco use and increase healthy eating and physical activity. The fund also makes investments in programs that help ensure that our food is safe to eat and that our communities can respond to disease outbreaks and disasters. These programs save both lives and money by preventing illness or detecting it early.

All Montanans benefit from these public health programs and services. However, despite the success stories, federal funding for these programs is in jeopardy.

The fiscal year 2013 health and human services appropriation's bill under consideration in the U.S. House of Representatives contains significant cuts to public health funding and eliminates the Prevention and Public Health Fund. In addition to proposed cuts in the annual spending bill, public health programs face across-the-board cuts of roughly eight percent if the pending "sequester" takes effect in January 2013. The sequester is the result of Congress' failure to pass a balanced deficit reduction plan to cut $1.2 trillion over the next decade. According to a U.S. Senate Appropriations Committee report, in Montana the sequester could result in:

  • 13,530 fewer women, children and families served through Maternal and Child Health programs;
  • 655 fewer children receiving immunizations;
  • 671 fewer women being screened for cancer;
  • nearly 2,000 fewer people being screened for HIV.

Reduced public health funding through the sequester would also limit our ability to respond to disease outbreaks like pertussis and disasters such as flooding.

Montanans need an unwavering investment in public health funding that supports life-saving programs and services that have long been underfunded. Building a sustainable public health infrastructure means improving community-based health programs and strengthening the capacity of public health departments.

If you knew that for every $1 you invested you would get a $5.60 return, you would most likely make that investment. Research from the Trust for America's Health shows this return for investing in proven community-based public health programs.

Please encourage our Montana Congressional Delegation to make the investment in public health. Reducing or eliminating public health funding is a step in the wrong direction, another step in the direction of high health care costs and unacceptable health outcomes.

(John Felton, president and CEO, RiverStone Health, Yellowstone County health officer; Ellen Leahy, health officer, Missoula City-County Health Department; and Joe Russell, health officer, Flathead City-County Health Department.)


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