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An Open Letter to President Obama About the Importance of the Prevention and Public Health Fund

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Dear Mr. President:

I write to strongly urge you to stand firm in the face of attempts to eliminate or reduce the Prevention and Public Health Fund created by the Affordable Care Act. I share your commitment to improving health care for all Americans and I concur with your belief that prevention is how we can best accomplish that.

At The California Endowment, we know something about this issue. Not long ago, we commenced a 10-year program to build healthy communities all across our state. And one of the foundational pieces of our strategy is to promote community-based prevention.

Thanks to your leadership, the Affordable Care Act took a similar approach. This was most clearly demonstrated in the creation of the Prevention and Public Health Fund. This vital investment of $15 billion "to provide for expanded and sustained national investment in prevention and public health programs" represents a game-changing strategy in health care. States are already using money from this fund to train public health workers, prevent HIV and AIDS, reduce tobacco use, beef up laboratories to track disease outbreaks, and promote wellness and safety in the places where people live, work, plan and learn.

At The California Endowment, we recognize that improving health care in this country will require the efforts of both the public and the private sector. Philanthropy, in particular, can and has played an important role in both improving the quality and availability of health care and promoting community-based prevention. Businesses spend $73 billion dollars a year on chronic diseases that community prevention efforts can prevent. But, both private and public sector support are needed if we expect to improve access to quality health care for all, prevent unnecessary disease and illness and save costs over the long term. The issue of our nation's health needs a combined focus on care and prevention.

Health care is a national priority; therefore it requires a national approach. For decades, our health care system has been designed to treat patients once they are sick; now, thanks to the Prevention and Public Health Fund, we are finally beginning to shift to a health care system that will simultaneously prevent and treat sickness. Not only is this approach more affordable, it's more effective. But it will take everyone working together to make it successful.

As Secretary Kathleen Sebelius put it,

Prevention is something that can't just happen in a doctor's office. If we are to address the big health issues of our time, from physical inactivity to poor nutrition to tobacco use, it needs to happen in local communities. This investment is going to build on the prevention work already under way to help make sure that we are working effectively across the federal government as well as with private groups and state and local governments to help Americans live longer, healthier lives.

Mr. President, you and I know prevention works. It has worked in stopping countless Americans from a cancer diagnosis through comprehensive smoke-free policies. It has saved lives through mandatory requirements for seat belt installation and uses. And it has worked in our neighborhoods where children are safer because they wear bicycle helmets.

Here in California, we don't just talk about preventive health care, we're doing it. Let me give you three specific examples of how preventive health is already beginning to work in California:

  • Students in six California communities are eating healthier due to The California Endowment's Healthy Eating, Active Communities program. Since 2005, program leaders worked to improve school food and beverage environments and prevent childhood obesity in diverse communities throughout the state. Participating sites dramatically increased adherence with California's school nutrition standards during the program's life, and student participation in school meal programs also increased significantly (breakfast enrollment increased 32 percent and lunch participation jumped 16 percent). Most important, four years after the program start, students reported healthier eating habits in school, and they didn't compensate with more unhealthy foods at home. Students in these communities simply ate and drank better, showing particularly strong declines in consumption of soda, french fries, and sports drinks.
  • Currently more than 72,000 students and teachers in the San Diego Unified School District are served local, farm-fresh produce daily for lunch. In 2010, with the objective of improving student nutrition (preventing malnutrition) by providing a produce rich diet, the San Diego Unified School District changed its food procurement policy. The district launched the Farm to School lunch program to directly connect the public school food service program to hundreds of San Diego's local farms.
  • The 112,247 residents of the City of Inglewood, California now enjoy smoke-free parks, recreational facilities, walking paths, and hiking trails. In order to increase the quality of life for residents of the City of Inglewood by reducing their exposure to secondhand smoke that has been determined to cause cancer, heart disease, asthma and other health problems, on October 5, 2010, the Inglewood City Council unanimously passed an ordinance prohibiting smoking in Inglewood parks.

These are just a sampling of the kind of change we need to improve our nation's health and to complement our new health care system. At The California Endowment, we are doing our part to promote healthy lives by preventing illness. And we believe the Prevention and Public Health Fund is an essential tool that we will need to succeed in improving the health of all Californians.

Mr. President, you were right to push for the creation of this fund. And Congressional opponents are wrong to try and defund it. We will stand with you again as you fight to preserve it.