Editor's note: This piece appeared in the fall 2012 edition of Health Elevations, the Colorado Health Foundation's quarterly journal.
When I started work at the Colorado Health Foundation, I had no clue what "public health" meant. Then, a colleague informed me that public health has saved more lives than all of the drugs, surgeries and medical interventions combined. "When public health is working we take it for granted because it is almost invisible. It's when it is not working that we realize how important it is."
Indeed, public health permeates many aspects of our day-to-day routines, from the breakfast we eat in the morning to the clean water we brush our teeth with at night. Since the turn of the last century, the public health sector has come close to eliminating waterborne illnesses and to stopping contaminated food products from reaching the grocery. Thanks to prevention and public health, Americans are no longer susceptible to crippling ailments like polio, smallpox and many other deadly infectious diseases.
More recently, prevention efforts raised public awareness about the serious health implications of smoking, drunk driving and not wearing safety belts. Tobacco policies and laws have reduced incidents of heart disease and lung cancer in the United States, and strict enforcement measures have reduced traffic fatalities to their lowest rate in more than 60 years.
Colorado has its own share of public health success stories. For example, Colorado ranks No. 1 in the nation for mothers who exclusively breastfeed their babies during the first six months in life, according to a report by the Centers for Disease Control and Prevention. Breastfed babies are far less likely to develop health problems such as infections, asthma and childhood obesity. Also related to public health, regulatory compliance for hazardous material rose from 25 percent in 2008 to 65 percent in 2010 because of an innovative statewide self-certification program.
Beyond the obvious quality-of-life benefits, research shows evidence-based public health programs could substantially reduce health costs in Colorado. One study estimates that an annual investment of $10 per Coloradan in community-based prevention initiatives could generate a 500 percent return.
Yet, despite these proven benefits, prevention represents a small portion (less than 5 percent) of every dollar spent on health care in this country. Given that only 10 percent of health is influenced by actual health care, the current equation is backwards. According to the U.S. Department of Health and Human Services, 90 percent of health is influenced by factors such as income level; education; transportation; food insecurity; environment; and personal habits such smoking, drinking and obesity – a growing problem in Colorado and around the nation.
The latest edition of Health Elevations explores the challenges and opportunities of prevention in Colorado. Among our What's Working features, we highlight a dental health education initiative that helps pregnant women, an innovative employee wellness program, and a holistic approach to mental health that includes an array of fitness and emotional well-being practices.
We also look at how the small town of Leadville incented its residents to lose weight. Chris Urbina, MD, MPH, executive director and chief medical officer of the Colorado Department of Public Health and Environment, shares what he learned about prevention (and Colorado) when he took a six-day, 442-mile bike ride through the state. We also feature insights on prevention from James O. Hill, executive director of the Anschutz Health and Wellness Center.
We hope the creative thinkers featured in the latest edition will further demonstrate why – to quote Benjamin Franklin – "an ounce of prevention is worth a pound of cure."