1. Preventing Chronic Disease: The New Public Health Jeffrey Levi, PhD Alliance for Health Reform Briefing June 10, 2011

2. Chronic Diseases Require a Look Beyond the Biomedical Model Any discussion of cost containment must focus on chronic diseases Key behaviors: physical activity, nutrition, and tobacco use Few clinical preventive interventions Emphasis on community: policy, systems, education, programs There is a growing evidence base This is prevention and treatment

3. The Economic case

4. Prevention for a Healthier America: Financial Return on Investment? INVESTMENT:$10 per person per year HEATH CARE COST NET SAVINGS: $16 Billion annually within 5 years RETURN ON INVESTMENT (ROI): $5.60 for every $1 With a Strategic Investment in Proven Community-Based Prevention Programs to Increase Physical Activity and Good Nutrition and Prevent Smoking and Other Tobacco Use

5. New federal investments Prevention and Public Health Fund ~$375 million for chronic disease prevention FY10-11 Communities Putting Prevention to Work/Community Transformation Grants Building on evidence based strategies Policy and systems change for lasting effect Center for Medicare and Medicaid Innovation Community Improvement Care Models Group Exploring steps to improve public health and make communities healthier and stronger by fighting the epidemics of obesity, smoking, and heart disease

6. National Prevention Strategy Role for prevention across the government and across sectors Co-benefits of using a health frame Emphasis on creating an environment where people can exercise their personal responsibility to make the healthy choice Thinking across silos Example: physical activity affects chronic disease, falls among elderly, depression, drug use, risk for STDs, etc.

7. Prevention Viewed As a Money-Saver; And Worth Investing in Even If It Doesnt Save Money 70 24 71 24 Prevention will save us money. Prevention will cost us money. Investing in prevention is worth it even if it doesnt save money b/c it will prevent disease and save lives. Investing in prevention is not worth it if it doesnt save money b/c reducing health care costs is most important now.