Hala Moddelmog,
President and CEO, Susan G. Komen for the Cure
Moderator:
Ross DeVol, Executive Director, Economic Research, Milken Institute
Hala Moddelmog of Susan G. Komen for the Cure says that “60 percent to 70 percent of all chronic diseases are preventable through behavioral changes.”
Chronic diseases in the United States have an enormous impact on health. This year alone, approximately 5 million Americans will be diagnosed with cancer, heart disease, stroke or diabetes; and 1.5 million will die from one of these conditions.
All these diseases are highly preventable. The fact that they share some of the same risk factors makes a strong argument that coordinated prevention programs have the potential to make great strides in controlling these diseases.
Chronic diseases cause an economic burden as well. Approximately $277.5 billion will be spent on just seven chronic diseases in 2007 in the United States. It's safe to assume that allocating resources toward prevention would be a cost-effective alternative to medical treatments.
When asked to discuss recent trends in chronic disease among insured individuals, Jay Gellert of Health Net Inc. discussed prenatal outcomes, smoking and obesity in California. Although more than 45 percent of births are from Medicaid-eligible mothers, he said, California rates 43rd in the nation for preterm labor/low-birth-weight children, and is in the top 10 for first trimester prenatal care. California also ranks 50th in the nation in smoking.
Tragically, the war on obesity has not been so successful. Comparing the obesity and smoking campaigns, Gellert noted several differences: ads for poor food choices are not as effective as anti-smoking ads; the differential tax for smoking is nonexistent for foods leading to obesity; there was no single massive campaign targeting obesity; campaigns do not address issues like increased access to processed foods for poor populations; and obesity prevention is largely geared toward adults rather than young people.
As a result, Gellert said, California is in the bottom 10 nationally for diabetes prevention. "We have a long way to go in talking about prevention," he concluded.
Much of the debate surrounding prevention has focused on personal responsibility versus societal responsibility. Hala Moddelmog of Susan G. Komen for the Cure stated that "60 to 70 percent of all chronic diseases are preventable through behavioral changes." So why haven't we made further progress? "We get what we pay for and pay attention to," replied Valerie Fleishman of the New England Healthcare Institute. Ironically, less than 5 percent of spending in this country has been allocated for healthy behavior, while health-care spending has increased annually.
The 2008 presidential candidates have focused on universal health care, but the panelists suggested that a broader approach to health care is imperative. Interestingly enough, Fleishman said, residents in Massachusetts were not necessarily any healthier since the state implemented health-care reform. Other determinants must be considered. A conversation on poverty, racism, lack of transportation and unequal access to care must be included in discussions about prevention, as these factors affect behavioral changes in certain populations.
As a possible solution to disease prevention, Wayne Gattinella of WebMD suggested that better information leads to better health. Since 80 percent of U.S. households have Internet access and eight out 10 use the Internet for health information, he suggested using computer-based approaches to aid in preventive health initiatives. He also recommended the adoption of electronic medical records to reduce errors, increase efficiency and increase quality of life.
Gellert mentioned incentives to encourage people to adopt healthier behaviors but cautioned that "incentives in the absence of tools don't work. Tools with community involvement work." Data was presented that showed financial incentives beginning at $100 will interest people in changing their behavior.
The session concluded with moderator Ross DeVol of the Milken Institute asking the panelists to note one aspect of the health-care system they would change. Responses included: using the Internet for health as commonly as it's used for music or checking stocks; increasing the intensity of the war on obesity; changing patent laws so that prevention drugs can be tested; and encouraging scientists and researchers to share data.
Global Conference 2013
Former Prime Minister Tony Blair, philanthropist Bill Gates and Strive Masiyiwa of Econet Wireless discuss advancing prosperity in Africa.
