Principles for Prevention (Draft): For Discussion & Input

[Matthew Marsom]

Following on from today's D4H Web Forum "Implementing the Affordable Care Act: Principles for Prevention” we want to have your input and comments on the draft Principles for Prevention.  In the coming days and weeks we’ll be outlining a strategy for how these principles will be used to influence policy and funding decisions at a national level and how we can call use them as part of a larger organizing strategy to support prevention.

Please review the draft principles below and provide us with your comments and feedback.  These are just the first draft; we know there is room for improvement; this is the opportunity for your voice to be heard.

Thank you,

Matthew Marsom

Director of Public Policy

Public Health Institute

DRAFT PRINCIPLES FOR PREVENTION:

1. Invest in strategies that will both address multiple health and safety outcomes and substantively reduce the burden on the health care system.
2. Emphasize communities with the greatest gaps in health status and the greatest disease and injury burden.
3. Focus on environments (communities, schools, workplaces).
4. Directly engage and fund communities.
5. Reflect a comprehensive health system by linking to and complementing health care activities.
6. Encourage multisectoral partnerships and collaboration.
7. Change policy, organizational practice, and norms.
8. Build on existing evidence and experience.
9. Create sustainable change.

[Beatrice Yearwood]

A few ideas/suggestions that may help draw non-health sectors to sign on to prevention. Note: The national public transportation association has an old report that specifies how public transportation benefits prevention & access to care. I think I have seen that report on this network sometime ago?
1. If you want to involve clinical providers, consider using terms that directly speak to them. For example, in Item #5 mention that you support strategies that prevent chronic conditions and reduce likelihood of developing complications associated with chronic conditions.
2. Make some mention of giving greater weight to (supporting) interventions that keep the population healthy across the lifespan. Signal an interest in healthy aging.
3. Consider specifically mentioning sectors that play a role in prevention & clinical prevention. Avoid jargon (multisectoral) and clarify collaboration and its purpose.
4. Clarify what is meant by sustainable change.

[Margaret Casey]

Where do the state health departments fall in these principles? They seem to be completely left out and yet all are already working in most of these areas, on these issues.

[Ray R. Lewis]

I think the key will be broadening the public's definition of health and their view of how to maintain and improve it separately from, or along with, the health care systems. However, groups with an economic interest will continue to push back to define the problem and solution. Finding reliable health information in an understandable format from a trusted source and continued nudges will be important.

Changing the definition of health from an individual to a "public" perspective via policy changes clearly linked to population based interventions will be a major paradigm shift. Interdisciplinary work outside disease specific funding silos, and in sectors that usually do not consider their impact on health, may require additional training for the current workforce, as well as systems and organizational change.

Will the slides, questions and responses from last Fridays web forum available soon? Where will the July 1, 2010 report from the National Prevention, Health Promotion and Public Health Council be available? Where could I get more information on the formation of the 25 member Advisory Group for the Council?

[Ray R. Lewis]

The July 1, 2010 report is available at:
http://www.hhs.gov/news/reports/nationalprevention2010report.pdf

[Deb Spicer]

We will never have enough money to directly fund all communities in this work, especially not at the levels that were distributed in the recent CPPW Communities Initiative. Work in and with communities is critical, but the community work should serve as a laboratory for developing and testing policies that then can be implemented at higher levels, and to build support for higher level policies. This is certainly what has happened in the tobacco control movement. The eventual goal needs to be enactment of policies at the state and federal level that cover people living in all communities, not just those communities that happen to be lucky enough to have good grant writers. I suggest adding a principle about investing in state and national government agencies and partners who can work on implementation of policies at these higher, more inclusive, levels.

[Linda Kreeger]

I am not so sure funding State governments to do Prevention is a workable idea when money States are so financially burdened in providing for their Constitutionally mandated responsibilities. I think Prevention is a grassroots, community based function. If prevention is happening at the local level it can influence the State and Federal policies since their lawmakers are in fact community members.