If I had one wish for the future of health and health care, it would be a simple one. Lawmakers and agency policymakers would use evidence to develop public policy. Policy decisions and resource allocation would be driven by data and prioritized by long-term return on investment.
For one thing, that would lead to placing a higher priority on preventing, rather than treating illnesses.
Here are just a few examples of public health prevention investments that would pay dividends:
- Teen births are a primary cause of inter-generational poverty and result in higher health care costs and increased reliance on public benefits. Simple interventions to reduce teen births have a dramatic effect on reducing these bad outcomes. Colorado has invested in a Long-acting Reversible Contraception initiative (LARC) that has greatly reduced teen pregnancy and abortion rates and has a 6:1 return on investment in health care costs. Their initiative will also pay additional long-term dividends with less lifetime reliance on public benefits like Medicaid and food stamps.
- More than half of U.S. children experience adverse experiences like physical or sexual abuse, and more than 20 percent live in poverty, contributing to a range of expensive physical, mental and behavioral health issues. Supporting nurse-family home visits for high-risk families has a return on investment of 6:1 just in health care costs.
- One in three children will develop type 2 diabetes in their lifetime. The data suggest that, if we spent $10 per person on evidence-based community prevention programs to increase physical activity, improve nutrition, and reduce tobacco use, we could save the country more than $16 billion annually in health care costs, a 6:1 return on investment.
- Income is the number one determinant of overall health status and a significant driver of health care costs for chronic medical conditions and reliance on public benefits. A recent report from the Arizona Board of Regents found that persons with an undergraduate degree earn 82 percent more than those with a high-school diploma. Making college more affordable and increasing access to post-high school options is a great way to improve long-term health outcomes and reduce dependence on public benefits.
We spend a lot of time and money pulling people out at the bottom of the waterfall. Let’s focus more on things we can do to scoop them out of the water at the top – or better yet, keep them out of dangerous water all together.
— Will Humble is the executive director for the Arizona Public Health Association and former director of the Arizona Department of Health Services. Connect with him at [email protected].
The views expressed in guest commentaries are those of the author and are not the views of the Arizona Capitol Times.