By David A. Kindig, MD, PhD
Last Friday, a draft framework of the National Prevention Strategy was posted on healthcare.gov. The draft strategy, required by the Patient Protection and Affordable Care Act, has been developed through the National Prevention, Health Promotion, and Public Health Council, in conjunction with the Department of Health and Human Services, the Centers for Disease Control and Prevention, and other federal departments. Surgeon General Dr. Regina Benjamin chairs the council and on October 1st she hosted a conference call to overview the draft strategy and invite questions and comments from stakeholders.
The draft framework has the following vision, goals, and strategic directions, excerpted below from the full document:
Draft Vision: Working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on wellness and prevention.
Draft Goals: In order to achieve the vision for the National Prevention Strategy, efforts will be targeted toward the following goals. Each goal can be applicable to every member of the Council and to many public and private partners.
- Create community environments that make the healthy choice the easy and affordable choice
- Implement effective preventive practices
Draft Strategic Directions: The intent is to use the Strategic Directions a) to frame specific actionable proposals to meet the goals and achieve the vision for the Strategy, and b) as a lens through which to view federal and non‐federal activities in order to identify how they can best promote wellness and effective prevention. In large part, the Strategic Directions are designed to address ways to prevent significant causes of death and disability by focusing action on the factors that underlie these causes.
The Draft Strategic Directions are:
- Active Lifestyles
- Address Specific Populations’ Needs to Eliminate Health Disparities
- Counter Alcohol/Substance Misuse
- Healthy Eating
- Healthy Physical and Social Environment
- High Impact, Quality Clinical Preventive Services
- Injury‐Free Living
- Mental and Emotional Wellbeing
- Strong Public Health Infrastructure
- Tobacco‐Free Living
The development of this National Prevention Strategy is a welcome opportunity to ensure that health reform is not limited to health insurance reform, as important as that goal is. Population health advocates have a responsibility to help shape this effort, ensuring that it reflects the broad population health perspective which underpins this blog and the County Health Rankings. For example, as important as lifestyle and individual behavior changes are, we know that these are significantly influenced by upstream determinants in the social and physical environments. Their status as the first Strategic Goal is therefore appropriate and appreciated. Care will have to be taken that they are not lost as only one factor in the longer list of Strategic Directions. This is particularly important given the membership on the Council of many Cabinet Secretaries such as Education, Housing, Labor, Transportation and Energy -- a “health in all” policies perspective will be important for this work.
In addition, the draft doesn’t specifically mention early childhood and prenatal environments, but given their long term health impacts, these deserve significant attention. Finally, health care cost containment should be viewed as a community prevention opportunity strategy, as these growing expenditures necessarily limit broad population health investment opportunities.
During last Friday’s call, Surgeon General Benjamin responded to a very wide range of concerns, and invited additional stakeholder comments on the draft strategy. She should be commended for taking on this critical and challenging task. It is our responsibility to help her and her colleagues by submitting comments on this strategy (send to [email protected]). I invite you to share your comments on the blog as well.
David A. Kindig, MD, PhD is Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin School of Medicine and Public Health.
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