Authors of two new studies are urging investments in cost-effective preventive health strategies.
In a report released last week, the Washington-based Partnership for Prevention said existing research shows where policymakers can find the "best prevention buys."
For example, protection of the drinking water supply is an example of a community-based prevention strategy that is estimated to cost just $4,000 per year of life added for each individual in the community. Immunization, a clinical intervention, prevents 3.3 million cases of measles, 2.1 million cases of mumps and 1.5 million cases of rubella that otherwise would have cost $1.4 billion in medical care.
To achieve the greatest impact, policymakers must link public health services and clinical preventive services with social and economic policies designed to save lives, said Gilbert S. Omenn, M.D., dean of the University of Washington School of Public Health and Community Medicine and the report's author.
Pressures on state and local governments' budgets have severed the link between medical interventions paid for by insurance and public health initiatives left to be paid for with the meager leftovers of the public treasury, he said.
"Investment in prevention has always been low in this country and it's gotten worse," he said. "It's easier (for public officials) to say `we'll leave it until next year."'
Karen A. Bodenhorn, executive director of the Partnership for Prevention, which represents 75 organizations and associations, said the report is being distributed to policymakers to drive home the three-pronged prevention approach.
Separately, a recent report by the Harvard School of Public Health's Center for Risk Analysis shows a wide variation in the costs and benefits of various preventive health strategies. But researchers concluded that the nation should invest in certain cost-effective interventions.
Researchers involved in the project scoured existing literature to identify health prevention initiatives that saved money and averted deaths. They found 587 life-saving interventions and calculated cost-effectiveness ratios for each. The ratio considers all the costs to society, except indirect costs, and the years of life saved.
For example, the median cost of a medical intervention is $19,000 per year of life saved. When the medical intervention is a primary-care service, the median cost is just $5,000 per year of life saved. By comparison, the median cost of a toxin control intervention (such as asbestos and radiation protections) is $2.78 million per year of life saved.
"It's a myth that all preventative measures save money," said Tammy O. Tengs, assistant research professor at Duke University's Center for Health Policy, Research and education and director of the Harvard research project.