Cardiovascular disease (CVD) is the leading cause of death and disability in the nation. In 2010 direct medical costs and indirect costs of CVD were $450 billion. If the current rate of growth in costs persists, that figure is expected to more than double by 2030. The federal Congressional Budget Office (CBO) analyses conducted prior to the passage of the Affordable Care Act did not give high marks to the value of prevention. However, more recently there is evidence that prevention provisions of health reform legislation can make a hefty contribution to deficit reduction. The CBO estimate of HR 1217, the bill that would repeal the Prevention and Public Health Fund, presents a more promising scenario.
Given the desire to repeal health reform, the AHA's policy statement is a valuable source of information for prevention advocates. The policy statement, released July 25, 2011, states the following: "Although it is clear and accepted from clinical trial data that prevention is efficacious (ie, that prevention works within the scope of the trial), it is less well accepted that preventive community interventions are effective and provide value (ie, that prevention will work in the community and is worth what we will pay for it). This statement summarizes the rationale and available evidence that support a life-course approach to primordial and primary prevention, as well as the cost-effectiveness (ie, value) of, multilevel policy implications for, and fertile areas for future research of preventive intervention."
The policy statements frames prevention from the life course perspective that forces examination of health status in five life stages. The power of the life course framework is its emphasis on the cumulative impact of health care and lifestyle practices on health status in each life stage.