A 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 programs.

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:

• Advance the nation's public health system by adopting a set of foundational capabilities, restructuring federal public health programs, and ensuring sufficient funding to meet these defined foundational capabilities;
• Ensure insurance payment for effective prevention approaches both inside and outside the physician's office;
• Integrate community-based strategies into new health care models, such as by expanding accountable care organizations into accountable care communities; and
• Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs.

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 News.

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."

A 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 money.

In contrast, unthinking expansion of preventive medicine is the wrong prescription, the article says.

The 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.

The 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.

Marilyn 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 Scholarship Fund.

Mount 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 (2012).

Read more about Mount in the Foundation's press release.