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The Role of Prevention in Health Care Reform

This blog was written by Laura Aiken, community health specialist with WakeMed and director of Advocates for Health in Action (AHA).  Learn more about AHA by visiting their website.

Like the majority of the issues related to health care reform, there is a great deal of debate about the importance of prevention in the final bill.  A draft Senate bill includes $10 billion in prevention funding each year for projects that increase access to healthful eating and physical activity through projects like the construction of greenways and farmers markets.

Creating Access to Healthier Food

This is music to the ears of advocacy groups like Advocates for Health in Action (AHA), a 40 member community collaborative in Wake County that is working to make the healthy choice the easy choice for everyone who lives here.  AHA is in the process of creating a community assets map and is finding a lack of access to healthful foods and physical activity to be widespread across the community. There is no doubt that this is leading to increased rates of obesity and projects like those suggested in the bill will help.

A High Rate of Obesity

According to the CDC, the United States spends $147 billion each year on obesity related diseases. This is nearly three times more than the cost of all cancers combined. In North Carolina, 66% of adults are overweight or obese and we have the 14th highest rate of childhood obesity in the country. Although many in Congress agree that prevention will reduce health care costs, they are extremely reluctant to spend money on programs that some classify as wasteful spending.  Many people struggle to connect providing resources for Americans to lead healthy, active lifestyles as an investment in health care.

Advocates for Health in Action sees it otherwise. Through projects such as the “Sports Snack Game Plan,” which encourages youth sport organizations to provide healthy snacks instead of junk food, AHA has witnessed an outpouring of support from parents and others who are looking for ways to make the environment healthier. People are seeking solutions and they are ready for change.

Creating a Healthier Lifestyle

There is no doubt that creating a healthy lifestyle is a hot topic right now. According to a recent New York Times article, the Department of Agriculture is welcoming ideas from community groups on how to make school food healthier and more appealing to the children who eat it. There are signs that funding for school cafeterias is being increased from Washington and private providers. President Obama added an additional $1 billion for child nutrition programs in his 2010 budget proposal, and he is even pushing to host a farmer’s market outside the White House with produce from his family’s garden.

Now is the time to make changes that will improve the health of our children. Our nation needs health care reform and prevention is the key to cutting costs and improving the quality of American’s health.


10 thoughts on “The Role of Prevention in Health Care Reform

  1. Respectfully, Dr. Atkinson, I must again point out that it is not my responsibility – financially or otherwise – to increase healthy lifestyles in anyone except me and mine.

    You say, though, that the public is ready for these health overhauls. It’s too important for them… but not important enough to turn off the television and computers and go to a park with their kids.

    If we want to turn around the trends in obesity, it starts at home.

    The argument is that obesity is on the rise, thus we must spend tax dollars to fix it. My question is, on the rise from what? When was this time when government intervention kept America trim and healthy that we need to move back to?

    Or, is it possible, that outsourcing these concerns away from the home and into the government – thus decreasing personal responsibility – can only lead to an increase in obesity?

    How, exactly, would an increased spending from the Fed get more kids running and playing outdoors? Forcing people to work longer hours to pay for it certainly isn’t going to get them into the gym more often. How would the fed decrease the number of stops at McDonald’s for a good ol’ heart attack in a box?

    Our personal health starts with us. If there’s such a public outcry to increase personal fitness then it would seem a very short trip to get the public practicing healthy living of their own accord.

    I do have to agree with you though, on the matter of public school food. Heaven knows I was scared out of my high school cafeteria by their “meat by the scoop.” Uggg…

    A great place to start may be to overhaul the free lunch program. Estimates are that roughly 50% of the money we spend on the free lunch program goes to children who’s parents would have absolutely no problem paying for their own kid’s meals. And, honestly, if you’re not willing to pay for your kid’s food… come on… that’s pretty messed up.

    What if we start this discussion on school food where it belongs? Not at the Federal level, but with the Wake County School Board and NC State government? Why not start by overhauling the free lunch program to help ensure that it’s not exploited by people who can pay for their own meals? Use the money saved there to strike deals with in-state farmers and ranchers to provide fresh food to our children?

    It may not be the end all solution. But hey, if we’re going to start tackling this problem, we ought to start it where it belongs – at home.

  2. I agree with “Jeff”. I am a Mom who feeds my children the healthiest of foods because like Jeff, I believe that it is my responsibility as a parent to do so. I do not believe that my 30 year old single neighbor should be footing the bill to promote a program that would encourage me, a parent, to make better lifestyle choices for me and my children.

    Our society is becoming so hung up on the government being our saviour for all that is wrong in our lives and we are dismissing our own accountability for our actions. WE have to empower ourselves to make better choices, WE have to be sure that our plates are filled with healthy options, and when we do not know what a ‘healthy option’ is, WE have to find out what those healthy options are.

    Why is a whopping $1Bil being requested to an already beaten budget for a child nutrition program? Individual states should have requested that funding for the program in that fabulous stimulus package that we, and our great-grandchildren, will be paying for. If North Carolina, Texas, Nebraska, etc. all feel that they are lacking in the nutrition programs, then they should have thought about that when all that money was being printed for their use.

    I’d like to find out how many salad’s and sides of apples are ordered at McDonald’s in comparison to the amount of French Fries and Cheese Burgers ordered. You can lead a horse to water………… but should I pay for it???

  3. MOM
    Your 30 year old neighbor is footing a bigger bill because we don’t have programs to cover the kids whos parents are not doing the job. I am not happy about government getting involved but someone has to. we as parents sure have not. There is no argument, just look around. We should nor be here. Parents should solve this problem but they are not. Not the best way is better than no way.

    AHA you keep up the good work and don’t let anyone discourage you. When the kids are adults they will thank you.

    some of what you say makes sense this is just the wrong place. These people are not creating or asking the govt to spend this money they are only trying to put that is going to be spent any way in a better place. Your comments should be directed to Congres and yes I mean that you should.

    Last comment. I can’t spell and I know it so no use in going dow that road.

  4. While I completely understand what you are saying, “Mom,” I cannot even count how many times my child has been served foods that I would never want her to eat because that is what is acceptable in our culture. A bag of Oreos and a Gatorade is a typical snack after a softball game. Children are consuming more calories than they burn in snacks after sports! Without policy changes, do you think parents are going to suddenly decide they should bring healthy foods as snacks when they have been providing junk all of this time? Yes, I break the mold and bring the healthy choices, but I am the exception, not the norm.
    I will also inform you that North Carolina has requested funds for Child Nutrition Programs from our state for several years. The State of North Carolina has nutrition standards for all foods sold in schools, but unfortunately, our state has not allocated the funding for the schools to buy and prepare foods that meet these standards. Just another unfunded mandate. Unfortunately, there has not been any stimulus funding available for the use of child nutrition programs. Each school in North Carolina must run their cafeteria as a stand alone business, and they are responsible for making a profit to keep their business alive. Unfortunately, our culture has created children who will only buy junk food, so the child nutrition programs feel that they have to sell unhealthy items a la carte to keep their programs alive. We are working with local, state, and federal decision makers on the school lunch program. I promise you, this is not an easy problem to fix, but we will do it!
    When it comes to our children, we are responsible for protecting their health. I sincerely wish that all mothers were like you and provided healthy meals for their children on a regular basis. Unfortunately, that is not the case, and we are currently paying for that in our health insurance premiums.
    If we want to see the cost of healthcare decrease, we must find ways to help people succeed at making the healthy choice. Dumping them in an environment where they are set up to fail is not the answer.

  5. You must also remember that the environment that your child is in will grow to a point that they are away from you more than they are with you. If they don’t have those healthy choices what do they do then? We need to change things for all kids if we are to make progress.

    Thank god we have people like AHA who care enough to fight the fight. Not Democrats, not Republicans, just Americans.

    Last of all to all the kids who I coached over a 20 year span, I am sorry I let those treats and drinks into the picture after games. I wish AHA had been around to set me straight.

  6. As an oldtimer, I can tell you there was a time when the government was involved in fitness. I cannot recall the name of the program, but President Kennedy mandated Physical Education in High School, and it was a requirement to pass for graduation.

  7. This is somewhat off the topic, but wanted to express my thoughts on one particular aspect of health care.

    I would like to first of all preface my comments with this background information. My parents and my wife’s parents both immigrated to this country – so this is not an issue with immigrants. We were both born and raised in the US. But we are “minorities” in all sense of the word, so I do not want my comments to be misconstrued. It is an issue with the way health care is distributed to those who are here illegally and who abuse of the system, with no desire or motivation to become citizens of this country.

    I pay over $400 a month for my daughter and I to receive health care coverage with BCBS. This amounts to approximately $5000 a year. We are both healthy, and generally only go to the doctor once a year for a physical. Nothing more, nothing less. Yet, we have illegal families here who have 4 or 5 children, with no signs of letting up, because of the beautiful provision that WE pay for called Medicaid. It is mind-boggling to me that we as citizens of this country, who strive to do things the right way, must pay such extreme prices for health care that is deemed a “fundamental right” while those who CHOOSE to break the law and be here illegally, are given the same if not better care than I am, free of charge. My wife and I are STILL paying off the $1500 hospital bill for the birth of my daughter, and that is WITH insurance, yet others have many as they want, on my tab. Talk about a crooked system. Again, I have nothing at all against those who have immigrated to this country in search of a better life for their family. But take accountability for being here – show pride in being here. If I have to work hard and pay for healthcare for myself and my family, why can’t they? Oh wait, I forgot, because I also pay tax that they don’t – so I guess that’s where my tax dollars go.

    I’m not arguing that health care shouldn’t be provided to those that are here illegally. I AM saying that if a person chooses to break the law to be in this country, and are going to be ALLOWED to stay – then they too should act like proud citizens and take accountability for receiving health care like we do. If you’re want to live here, act like it.

    I have a family member who works in the school system. Classrooms are now overrun with illegal immigrant children who are given education as a “fundamental right.” However, this fundamental right now affects the level of education my child receives, as classrooms are larger, not enough teachers, etc. Then, the parents make NO effort to learn English so as to have a part in their child’s health and education. Yet, they call their relatives in their countries, and tell them, “You have to get over here by any means necessary, they give us free education and health care.”

    Sorry for the rant, but when we talk about “fundamental rights” this always irks me. I sincerely believe that those who abuse of the “free” services that this country provides (i.e. medicaid, foodstamps, wic)at the expense of those who are here legally and struggling to make ends meet, should also be held accountable in some way. They are making a mockery of our already broken system.

  8. Ed-
    I could not have said it better. This is really a root cause to the health care issue. My wife works in the Childrens ER at big Wake. So we know first hand how the illegal population has learned to work our system to the fullest. Not only do they get free care but meals, snacks and car seats as well. Not to mention the 15 y/o who wants a pregnancy test but complains of stomach pains and must go through 1000.00 of test to CYA so Wake does not get sued. All of which no one is paying for. I beleive in care for everyone on team USA. If you are here illegally you are a criminal and should be sent back to where you came from. You can only become a citizen when you come through the front door not over the fence in the middle of the night.

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