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Watching Prevention Make History With the 'National Prevention Strategy'

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Five years ago, the Prevention Institute pressed for comprehensive federal policy on prevention. We said that health and well-being was everybody's business -- that every sector, every department, needed to be thinking about health. People shook their heads no, saying that people outside of health care just wouldn't be interested, that they have their own agendas, and health is just a distraction.

Last Thursday, I joined a room full of people -- including representatives from state and local governments, the Department of Housing and Urban Development, the Department of Defense and businesses like IBM -- who proved those naysayers wrong, with the release of the National Prevention Strategy.

This was a historic occasion. For the first time, the nation has delineated a broad, coherent approach to prevention -- and made it clear that prevention is critical for improving our health. For too long, when people talked about health or health care, what came to mind was illness. The Surgeon General herself said yesterday, "[As doctors] our biggest challenge is changing the way we think about health in this country." But as the prevention strategy makes clear, prevention can save lives, reduce the demand on health care services, build equity and save money.

What is impressive about the strategy is its far-reaching nature. It was shaped by seventeen different agencies, including the Department of Homeland Security, the Federal Trade commission and the Department of Agriculture. Virtually every governmental department is collaborating to focus on how best to achieve health and well-being for communities throughout the U.S.

Prevention isn't just for the "worried well." It's the science, the practice and the moral commitment to ensure that every workplace is safe and productive, every child has access to parks and safe places to play, and we all have access to healthy food for every single meal. Essentially, all of the things every sector can do collaboratively to create solutions that are safer, healthier, bigger and better than what they could have done on their own.

The strategy emphasizes that disease is not the only threat we can reduce. We must decrease injuries by making our streets and roads safe, reducing falls and preventing violence. Prevention Institute was honored that our UNITY initiative to prevent violence was highlighted during yesterday's event. Violence -- and fear of violence -- affect well-being in so many ways, from determining whether or not people are physically active, to defining whether our schools are safe and conducive places to learn, and whether we have vital neighborhoods to invest and shop in. The National Prevention Strategy should be applauded for its emphasis on equity, including "the elimination of health disparities" as one of the four pillars that should underpin every prevention effort.

The National Prevention Strategy is careful to emphasize health approaches that have been thoroughly studied and carefully documented. Neighborhoods can build on these approaches, and by trusting in the wisdom of practitioners and the wisdom of communities, prevention efforts will gain even more momentum. We get the real returns on prevention, not just by grasping for the low-hanging fruit and the winnable battles, but by using the heft of new political will to tackle the really hard issues and the places where need is greatest.

The current funding for prevention is historic, but it is still not enough to meet communities' needs. We need a game changer, where the 'dose' of prevention is great enough to reduce the demands on health services in every community. And in the midst of these most recent efforts, there have been substantive cuts to other health care initiatives and vital community services that support well-being. In locale after locale, people willing to invest in prevention and create the innovative solutions that will save lives and money down the road, are distracted by short-term decisions about cutbacks and cost-saving. As groups compete for limited prevention dollars this year, we need to make sure that a far greater proportion of prevention funding is available to communities, starting with next year's one billion dollar allocation. What community doesn't need to reduce their heart disease and cancer rates, their violence rates, and their teen pregnancy and substance abuse rates?

The blueprint is there, the ideas are there, but we must work together to make sure that the National Prevention Strategy doesn't languish on a shelf or get sliced out of future budgets. As one of the earliest implemented (and most popular) parts of the Affordable Care Act, prevention funding has already been targeted (unsuccessfully) for cuts.

Yet, we know that prevention works. We've cut smoking rates in half in California since I helped with the nation's first multi-city, no smoking ban a generation ago. We have moved from less than one in four parents buckling their kids into car seats, to nearly universal use with infants, and dramatic improvements in child safety since the passage of child passenger laws that occurred around the same time. As Lisa Jackson of the EPA reported at the strategy's release, the implementation of the Clean Air Act has saved thousands of lives and 20 trillion dollars.

The National Prevention Strategy enables us to come together as advocates, health care practitioners and community members. By doing so, we can not only ensure its implementation, but also ensure that it is strengthened as time goes on.

We now have a sense of direction. We applaud those who created it and feel encouraged that in every community there are individuals, businesses, schools, and community and religious institutions ready to step forward and put prevention to work. Dr. Benjamin said yesterday, "We must get to a place where everyone understands that everything we do -- even those things not labeled as health -- link to our health." The National Prevention Strategy is a key step to making that happen.

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