“An ounce of prevention is worth a pound of cure.” Yes, it’s so cliché, but it intuitively makes sense for health care; if we take care of ourselves today, we’ll save big by avoiding huge medical bills tomorrow. This is the basic premise of public health, whereby investing in widespread prevention efforts will prevent sickness in thousands of people, and save millions of dollars in future medical expenses.
Yet our health care system highly rewards the life-saving medical services that treat people once they’re already sick, and invests little in cost-effective public health programs. Consequently, while state spending on health care services continues to grow, public health has endured significant budget cuts in recent years. The Mass Budget and Policy Center’s Budget Browser, shows that since 2008, public health spending in Massachusetts has decreased around 20%.
But the cliché is true. A new article published in the journal Health Affairs demonstrates that a greater investment in public health produces substantial health gains in communities. The thirteen year (1993-2005) study examined spending changes in 3,000 local public health agencies across the nation, and their impact on community health in terms of preventable causes of death, such as infant mortality and deaths due to heart disease, diabetes, and cancer. The most striking results: for each 10% increase in public health spending, researchers observed statistically significant decreases for infant mortality (6.9% decrease), cardiovascular disease mortality (3.2%), diabetes mortality (1.4%) and cancer mortality (1.1%).
The authors conclude “additional spending, such as the $15 billion in new federal funds authorized under the Affordable Care Act’s Prevention and Public Health Fund, would be expected to generate substantial improvements in population health over time. At the same time, our results suggest that the recent recession-driven reductions in state and local support for public health activities are likely to have adverse health consequences over time unless they are offset with new spending.”
Before these spending cuts impact the health of the Commonwealth, we should urge legislators to increase our investment in public health. Increased funding can allow local public health agencies to tailor health programs that will best suit the unique problems facing individual communities. The Prevention and Cost Control Trust (H. 1498), sponsored by Representative Lewis and Senator Chandler, would allocate funds directly to local projects for cost-saving community prevention programs that will bring about sustainable health improvements.
The Health Affairs article provides strong evidence that investing in our community health will yield huge payoffs in the future. Not only do public health initiatives benefit a greater number of people, they are also less costly than comparable health care services that target the same diseases. In an economic downturn, policy-makers must confront difficult choices regarding program funding cuts. While public health has consistently made it to the chopping block, we hope this study will encourage policy-makers to reverse this trend, and increase funding to public health programs.