The old adage “an apple a day keeps the doctor away” has increasing resonance as the nation starts to grapple with the “how” of health care reform. At the recent White House Forum on Health Care Reform, which brought together representatives of organizations and interests from across the health care spectrum, President Obama renewed his call for urgent action. Along with the focus on expanding health insurance coverage and reducing costs, part of the President’s health reform platform includes an important overarching issue—the need for increased emphasis on disease prevention and health promotion. With wellness firmly fixed in the Administration’s health agenda, now is the time for corporations, nonprofit organizations, government agencies and others with a vested interest in American’s health to consider what taking a bite out of the prevention apple can mean to them.
Investing in Prevention
The Administration’s platform recognizes that covering the uninsured and improving the nation’s health care system are urgent needs, but aren’t enough to make America the picture of health. Just five chronic conditions—heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes—cause more than two-thirds of all deaths in the U.S. each year. One recent report estimated that the total cost to the nation for managing chronic diseases is $1.3 trillion annually, with $1.1 trillion attributed to lost productivity and another $277 billion spent on treatment. But many of these diseases can be delayed or substantially prevented. Investing in prevention can reduce illness in the first place and keep people out of a health care system that many experts say is more of a “sickcare” system. National and local programs to encourage healthy lifestyles, clinical preventive services such as blood pressure, cholesterol, and colorectal cancer screenings, mammograms, and related measures can all contribute to building a healthier nation. The good news is that many promising and successful initiatives are already being implemented at the national level and in schools, worksites, churches and other settings in communities across the country. Employers, for example, are increasingly taking action to prevent and control chronic diseases, thereby helping to cut their health care costs and improve the health of employees and their families. A recently published survey by Hewitt Associates found that the number of companies with employee health programs grew nearly 30 percent in the past year. A renewed interest in health promotion—whether at work or where people live, learn, play, or pray—means there is tremendous opportunity to expand and enhance existing programs and invest in new approaches. Working together, government agencies, foundations, nonprofits and corporations can play a key role in the nationwide effort to help prevent disease and promote health.
Focusing on Women’s Health
As part of his agenda to improve the nation’s health, President Obama also focuses on specific populations. In women’s health, critical issues include expanding health insurance coverage to the more than 19 million American women who are currently uninsured, as well as a focus on preventing disease and encouraging women’s health research. Heart disease is singled out as women’s leading cause of death. One in four women dies of heart disease although the condition is highly preventable. In fact, by following a healthy lifestyle—eating right, staying physically active, not smoking and keeping a healthy weight—heart disease risk can be lowered by as much as 82 percent. A focus on prevention is also important in other women’s health issues, ranging from giving women in underserved areas better access to preventive services to increasing awareness of gynecologic cancers to combating HIV/AIDS. In addition, the Administration’s women’s health platform mentions the importance of research into specific conditions more likely to strike women than men—arthritis, asthma, autoimmune diseases and depression. As women’s access to health care expands and new research begins to yield results, it will be increasingly important to reach out to women through targeted communications and community outreach. Women’s power in the marketplace is considerable—they make approximately 80 percent of the health care-related purchases for their families. With a strong marketplace incentive and a renewed women’s health agenda, corporations and public sector organizations have ample reason to develop new partnerships and cause-marketing initiatives that speak directly to millions of women. Doing so in a strategic way has been shown to make good business sense—and good health sense.
Reducing Health Disparities
Although measures to promote healthy lifestyles and improve access to care could enhance health outcomes for all Americans, these approaches are especially critical for vulnerable populations who are more likely to suffer from chronic diseases, but less likely to receive quality care. Heart disease, for example, is more serious among populations of color, based on just about any type of indicator—from lack of awareness of risk, to prevalence of risk factors, to numbers of deaths. The Administration’s platform seeks to reduce health disparities through measures such as improving access to health insurance coverage and reporting health care quality for disparity populations, as well as promoting healthy behavior and providing health services aimed at preventing disease. The Institute of Medicine reports that without health insurance, adults and children are much less likely to receive clinical preventive services such as immunizations and health screenings that can reduce avoidable illness and premature death. And beyond health insurance, the Robert Wood Johnson Foundation cites the need for promoting health in vulnerable populations where “health really happens”—at home, at work, in the grocery store, at school and on the playground. The Administration’s health agenda acknowledges the serious disparities in Americans’ health and health care, and seeks to tackle the issue through broad changes in health delivery systems and in the community. The community focus, especially, has led to a wide range of efforts already underway in schools, neighborhoods and workplaces. For corporations and nonprofit groups with relevant products and services, the expanded health agenda in the community, and at the national level, offers a host of opportunities for becoming engaged in the movement to improve the health of the nation’s most vulnerable populations.
Using the Power of Social Marketing
Improving health and preventing disease in America will require substantial change at multiple levels—in individuals, families, communities, institutions and society in general. What few Washington policy makers realize is that an effective method for bringing about positive social change is alive and well and ready to be applied to today’s problems. The discipline, known as social marketing, is being practiced at their very doorstep, across the country and all over the world. Simply put, social marketing seeks to apply the principles and practices of commercial marketing to social problems and issues. At its best, social marketing provides a framework for integrated action that encompasses not only communications strategies and education campaigns, but systems change and policy interventions such as healthier school lunches and workplace non-smoking regulations. For the past three decades, social marketing has had many successes in the health arena, including helping to reduce the prevalence of hypertension and high cholesterol, reducing teenage smoking rates, promoting cancer screenings and preventing childhood diseases and deaths in developing nations. These efforts take considerable time and resources to plan, implement and evaluate. But, with the integrated efforts of traditional sponsors such as government agencies and nonprofit organizations, as well as the involvement of corporations and other private sector groups, more programs—including HIV/AIDS and obesity prevention—have been initiated, more will begin, and many successes can be anticipated.
Biting the Apple
The new health reform agenda, with its focus on a host of issues critical to improving the health of all Americans, presents myriad opportunities for corporations, government agencies, and nonprofits to become involved in a transformational issue. Putting the spotlight on specific health conditions and audiences will mean greater attention at the policy and program levels across the health care delivery system and government health agencies. The Administration’s emphasis on wellness and disease prevention opens up a world of possibilities to create messages, products, campaigns, and programs both nationally and where “health really happens” in the community. The Administration’s focus on populations such as women and those with health disparities also presents a substantial opportunity to align products and services with precisely-targeted audiences. Across the board, private and public sector initiatives—perhaps a line of healthy food products for Latinos, or an innovative, objective-based cause marketing program to combat heart disease in women, or a national grant program for community walking trails—can all take new energy and relevance from the health reform agenda. And in carrying out prevention efforts, there is a rare chance to apply social marketing approaches on a significant scale and forge strong collaborations to bring new solutions to old problems. In short, when it comes to helping people build healthier lives, there perhaps has never been a better time to take a big bite of the prevention apple.