The Users' Guide to the Health Reform Galaxy

Recess for better health

Jim Marks, senior vice president and director of the Health Group, encourages us to turn to the playgrounds to build prevention efforts and reclaim recess to help improve children’s learning and well-being. This post first appeared on The Huffington Post. As another way to improve children’s health, read Jim Marks’ thoughts about the importance of attacking “cereal killers” in the grocery store to help reverse childhood obesity here.
 
When it comes to improving the health of Americans, we normally talk about what happens in a doctor's office.

And when it comes to improving education, we usually focus on what happens in the classroom.

But what if we looked outside of the classroom and the doctor's office? In fact, what if we just looked outside?

It turns out that there's one place you can go to improve learning and health at the same time: the elementary school playground. A growing body of research suggests that playing games like kickball or four square at recess may be the secret to a successful school day and building a lifetime of health.

Kids today are getting fewer and fewer minutes on the playground for recess -- the average is now down to about 22 minutes each day. Facing pressure to meet academic and other requirements, many schools have cut back on recess and some have eliminated it entirely, thinking that this can help them with their academic mission.

However, this trend toward sacrificing recess may produce the exact opposite result and hurt academic performance. In fact, according to a new Gallup poll of elementary school principals, the vast majority surveyed linked having recess to academic achievement, and two-thirds reported that students listen better and are more focused in the classroom after they have had recess. Principals also overwhelmingly saw recess as key to their students' social development.

What breakfast cereal has to do with health reform

Jim Marks writes about why the decisions we make in the cereal aisle of the grocery store are as important those Congress will make when it comes to health reform.

One of the greatest challenges we face in reforming our nation’s health system is reducing costs. We will never be able to afford a health system that provides all Americans with access to affordable, quality care unless we do all we can to prevent or greatly delay the onset of illness and their associated costs.

Reversing the epidemic of childhood obesity should be right at the heart of that effort, and addressing this crisis would avert untold suffering and enormous expense related to chronic conditions like hypertension and type 2 diabetes. (Don’t just take my word for it—check out this commentary in the New England Journal of Medicine). 

No single piece of legislation is going to cure all of the ills of our nation’s health system, which is why we need to look past the bills wending their way through Congress for solutions that are beyond medical care. True health reform will require action on Capitol Hill, in the White House, in doctors’ offices, in schools and communities throughout the nation—and in the cereal aisle.  Seriously.

$650M for community prevention is milestone on road to reform

Jeff Levi, executive director of Trust for America's Health, writes about how stimulus funds  for community prevention will create a laboratory for what might be achieved with health reform.

The Administration’s announcement Thursday that $650 million in stimulus money will be made available for community prevention and wellness programs is a defining moment for public health in America. It is also an important down payment on the road toward real health reform that will help make Americans healthier.

With two-thirds of Americans overweight or obese and one in five Americans still smoking, this initiative, called Communities Putting Prevention to Work, is tackling two of the biggest health crises in the United States head on.  It will help reduce rates of preventable diseases and give millions of Americans the opportunity to live healthier, higher quality lives. Evidence-based community prevention programs have shown success in improving nutrition, increasing physical activity, and preventing tobacco use by making healthy choices easier choices forAmericans.

What is unique about this initiative is its scale. The program, funded through the American Recovery and Reinvestment Act, will earmark funds for approximately 30 to 40 communities around the country and to states to build or expand upon programs that prevent chronic disease and obesity by addressing physical activity, nutrition and tobacco use. Potentially, it will direct as much as $10 to $20 million to larger cities, representing one of the great advances for prevention programs that this country has seen in decades.

The program will give strong priority to communities that suffer a disproportionate share of preventable chronic diseases and where leaders are able to assemble a communitywide consortium of partners, including the local and state health departments, schools, businesses, community and faith-based organizations, health plans and health centers. At the end of the day, these programs will be the laboratory for showing what results we can have if we invest more heavily in wellness and prevention.

At the end of the day, these investments will be the laboratory for showing what results we might achieve if we invest more heavily in wellness and prevention.

We are convinced they will have a big payoff. In 2008, Trust for America released a study, Prevention for a Healthier America, which found that for every $1 spent on proven community-based disease prevention programs, the county could net a return of $5.60 in health care costs within five years.   On Monday, we’ll release a Compendium of Proven Community-Based Prevention Programs report, along with the New York Academy of Medicine, featuring a range of evidence-based, disease prevention programs that have shown results for improving health and reducing costs.

Finally, this initiative through the American Recovery and Reinvestment Act is a milestone towards the recognition that health reform must start with prevention in order to be successful.   We must take this as a down payment towards the creation of a dependable annual funding stream to allow hundreds of additional communities around the country to benefit from these programs. The future health and wealth of our country demands we improve the health of Americans, not just how we pay for our care.

At yesterday’s briefing, I asked HHS Secretary Kathleen Sebelius where prevention programs ranked on her priority list for health reform legislation.  She replied that it was at the very top – as it was for both the First Lady and President Obama.  Between now and the end of the year when legislation lands on the President’s desk to be signed, I believe it’s the role of the public health community to cement that support, from Congress as well as from the Administration.

To learn more about the Communities Putting Prevention to Work initiative, visit http://www.hhs.gov/recovery/programs/cdc/chronicdisease.html

 

The costs of rising obesity

Risa Lavizzo-Mourey, President and CEO of RWJF, cites the high cost of the obesity epidemic in America as she argues for investing in building healthier communities.

A new study released yesterday that demonstrates the clear link between rising rates of obesity and increasing medical costs is alarming, but not unexpected.  Right now, America's health care system is set up to focus on treating people after they already have a health problem, and that’s a sure way to drive expenditures up.  We must shift our focus to preventing people from getting sick in the first place, which will save us money in the long run.

Obesity is the driver of so many chronic conditions—heart disease, diabetes, cancer—that generate the exorbitant costs that are crushing our health care system. What’s worse is the quality of life for people living with these illnesses.

The obesity epidemic isn’t just an adult epidemic, it’s booming among our kids. Today, more than 23 million children and adolescents in the United States—nearly one in three young people—are either obese or overweight, putting them at higher risk for serious, even life-threatening health problems.  The costs are only going to continue to rise.

Reform in our health financing and delivery systems is not the only answer to rising health care costs, we must have prevention.  We must change public policy and local environments in ways that make all communities healthier—especially those that have the highest rates of obesity and the fewest resources.  All Americans deserve to enjoy the benefits of good health.

In the coming months, as Congress works to enact meaningful health reform legislation, I strongly encourage comprehensive reform that addresses the delivery of care, but also makes wholesale changes to how we address wellness and prevention in this country.

 

Healthier ingredients for health reform

By Jim Marks

Yesterday, I was involved in the RWJF and Trust for America's Health release of our annual F as in Fat report on obesity in the United States.  This year's findings were particularly interesting.

In addition to going over the usual things about which states were the fattest for adults and children, for the first time it showed how much more obesity there is among 55- to 64-year-olds versus those already eligible for Medicare.  The wave of disease and costs to come dwarf what we're spending now, and some researchers, like Ken Thorpe, have already been finding that obesity and chronic conditions were major drivers of Medicare spending increases during the 1990s. 

America is being weighed down by the obesity epidemic.