new report that seeks to move the nation from "sick care" to
"health care" encourages all employers, including federal, state, and
local governments, to provide effective, evidence-based workplace wellness
Trust for America's Health's
(TFAH) A Healthier America 2013: Strategies to Move from Sick Care to Health
Care in Four Years outlines top policy approaches to respond to studies
that show that (1) more than half of Americans are living with 1 or more
serious, chronic diseases, a majority of which could have been prevented; and (2)
today's children could be on track to be the first in US history to live
shorter, less healthy lives than their parents.
The Healthier America report stresses the importance of taking innovative approaches and
building partnerships with a wide range of sectors in order to be
effective. Some recommendations include:
Healthier America features
more than 15 case studies from across the country that show the report's
recommendations in action. It also includes recommendations for a series of 10
key public health issues.
After the report's release, economic
experts came out against TFAH's position on preventive care's role in
reducing health care spending. (See related article posted in News Now titled "Experts Say
Preventive Care Produces Limited Savings.")
While some disease-prevention
programs do produce net savings, such as childhood immunizations and counseling
adults about using baby aspirin to prevent cardiovascular disease, most preventive
care does not save money, says an article by Reuters
Following the release yesterday of a
new report from Trust for America's Health (TFAH) that calls for putting more
resources into preventive care, economic experts challenged TFAH's position on preventive
care's role in reducing health care spending. (See related article posted in News Now tilted "TFAH Releases
Strategies to Improve Nation's Health in 4 Years.")
"Preventive care is more about
the right thing to do" because it spares people the misery of illness,
economist Austin Frakt of Boston University told Reuters. "But it's not plausible to think you can cut health care
spending through preventive care. This is widely misunderstood."
2010 study in Health Affairs, for
instance, calculated that if 90% of the US population used proven preventive
services, more than do now, it would save only 0.2% of health care spending.
One reason why preventive care does
not save money, say health economists, is that some of the best-known forms
don't actually improve someone's health. These low- or no-benefit measures
include annual physicals for healthy adults.
The second reason preventive care
brings so few cost savings is the large number of people who need to receive a
particular preventive service in order to avert a single expensive illness.
A promising approach is to target preventive care at those most likely to
develop a chronic disease, not at low-risk people. Such "smart"
prevention increases the chances of preventing expensive diseases and saving
In contrast, unthinking expansion of preventive medicine is the wrong
prescription, the article says.
American Academy of Pediatrics
(AAP) recently issued guidelines to provide
evidence-based recommendations on managing type 2 diabetes in children aged 10
to 18. The guidelines are the first of their kind for this age group.
The recommendations suggest
integrating lifestyle modifications, including diet and exercise, in concert
with medication rather than as an isolated initial treatment approach.
Specifically, clinicians should encourage patients to engage in
moderate-to-vigorous exercise for at least 60 minutes daily and to limit
nonacademic “screen time” to less than 2 hours a day. "Physical activity
is an integral part of weight management for prevention and treatment of
T2DM," write the authors. They suggest that when prescribing physical
exercise, clinicians should be sensitive to the needs of children, adolescents,
and their families. Noting that routine, organized exercise may be beyond the
family's logistical and/or financial means, it is "most helpful to
recommend an individualized approach that can be incorporated into the daily
routine, is tailored to the patients' physical abilities and preferences, and
recognizes the families' circumstance."
The guidelines also call for
additional research. In particular the authors recommend studies that delineate
whether using lifestyle options without medication is a reliable first step in
treating selected children with type 2 diabetes, explore the efficacy of school
and clinic-based diet and physical activity interventions to prevent and manage
pediatric type 2 diabetes, and investigate the association between increased
"screen time" and reduced physical activity with respect to type 2
diabetes risk factors.
guidelines were written in consultation with the American Diabetes Association,
the Pediatric Endocrine Society, the American Academy of Family Physicians, and
the Academy of Nutrition and Dietetics.
Mount, PT, a prolific member of the Ohio physical therapy community, who passed
away last August, has left a bequest of $32,000 to the Foundation for Physical
Therapy, which will be designated toward the Florence P. Kendall Doctoral
was the recipient of numerous awards and accolades for her lifelong service to
the physical therapy profession, some of which include: from the Ohio Chapter,
Physical Therapist of the Year (1997), Outstanding Service Award from the
Northeast District (2003), and Meritorious Service Award (2008); the Viking
Shield Award from Cleveland State University's Physical Therapy Program (2011);
and the Crains Cleveland Business Health Care Heroes Award for Allied Health
more about Mount in the Foundation's press release.