Public health message still falling on deaf ears

A special July/August issue of the Journal of Public Health Management and Practice, dedicated to public health financing, suggests that a rebalancing of the US healthcare investment in clinical care and public health initiatives is needed to improve the health of the population and reduce overall costs.

"If we fail to strengthen our public health system now, we can look forward to falling further behind other developed nations and it will become more and more difficult to restore our health and competitiveness," according to Steven M. Teutsch, MD, MPH, of the Los Angeles County Department of Public Health and colleagues.

The lack of attention to public health and prevention has serious consequences not only for the nation's health but also the economy. A healthy workforce is essential to "sustain economic growth and continued gains in labor force participation and longevity," Teutsch and colleagues believe. Coverage for medical treatment is essential -- but the dollars invested in clinical care far exceed its contributions to the nation's health. Medical care accounts for only 10 to 20 percent of the factors that shape health, but accounts for about 97 percent of all health spending, according to Teutsch and coauthors.

While total annual U.S. health spending is approximately $2.5 trillion, or about $8,100 per person, only $250 is related to public health. And while the U.S. spends twice as much per year as any other industrialized country, Andrew S. Rein, MS, and Lydia L. Ogden, PhD, MPP, of the Centers for Disease Control and Prevention state that that its health system ranks 37th in the world -- just behind Costa Rica.

Bonnie: I have a master's degree in public health. I heard the same message when I was in school in the late 1980's. It is impossible to improve our nation's health because we are not a preventive health care society. If we can alter the "treating the symptoms" model we are stuck in, our place in the world as a healthy nation will improve.