Prevention: An Apple-a-Day Isn't Gonna Cut It
by Naomi Freundlich
December 11, 2009
There is much to be hammered out before a final health reform bill emerges from Congress. Disputes over the public plan, abortion, financing and when reforms will actually take effect continue to delay progress. But on one thing, apparently, there is broad consensus: Nearly everyone supports prevention. In fact, a recent poll found that 71% of Americans favor increased investment in disease prevention and believe it will save money in the long run.
Prevention is a broad concept, encompassing everything from flu shots to prostate screening to smoking bans to confronting racism...
...Because the truth is, prevention does not always pay off—both in terms of health consequences and in economic terms. You can invest in community health centers and send out a legion of health educators to tell folks about diet, exercise, quitting smoking and having safe sex—but you might only have a minor impact on preventing disease. If there is nowhere to exercise safely in the community, if fresh produce is expensive and hard to find, if people are unemployed, suffering mental distress, facing the threat of losing their homes, confronting language barriers or cultural incompetence from providers, these interventions will have limited effect...
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