Report on evidence-based disease prevention programs released by TFAH and NYAM

Sep 22 2009

Trust for America's Health (TFAH) and The New York Academy of Medicine (NYAM) released a new report today featuring a range of evidence-based disease prevention programs that have shown results for improving health and reducing costs in communities.

The Compendium of Proven Community-Based Prevention Programs report includes a summary and examples from an extensive literature review that NYAM conducted of peer reviewed studies evaluating the effectiveness of community-based disease prevention programs designed to reduce tobacco use, increase physical activity, and/or improve eating habits. NYAM identified 84 articles with evidence showing how community-based prevention programs can directly reduce disease rates or disease progression. The Compendium report also includes examples of evidence-based community prevention programs that have helped reduce rates of asthma, falls among the elderly, and sexually-transmitted diseases.

"Heart disease, stroke, and diabetes account for 36.6 percent of deaths in the United States, but this could be significantly reduced by changing just three risk factors -- decreasing smoking, increasing exercise, and improving healthy eating," said Jo Ivey Boufford, MD, President of NYAM. "Despite the high rates of preventable death, investment in prevention has been historically modest in this country, accounting for only four percent of all health care expenditures. The good news is that community-based prevention programs work. Well-designed community interventions can change behavior. They help people take responsibility for their health and make healthy choices that reduce both the incidence and severity of disease."

"To really reform health in the United States, we must actively find ways to lower disease rates. The evidence is clear that prevention is the key to better health. Well-designed and well-implemented community-based disease prevention programs, like those called for in the House Tri-Committee and Senate HELP draft health reform bills, could have a major impact on improving the health of millions of Americans," said Jeff Levi, PhD, Executive Director of TFAH. "A smart National Prevention Strategy coupled with an investment fund for community-based prevention programs would allow millions of additional Americans to benefit from proven prevention programs that could spare people from needless suffering and trips to the doctor's office."

Examples of some programs featured in the report include:

• In Pawtucket, Rhode Island, the Pawtucket Heart Health Program conducted an intervention to educate 71,000 people about heart disease through a mass media campaign and community programs. Five years into the intervention, the risks for cardiovascular disease and coronary heart disease had decreased by 16 percent among members of the randomly selected intervention population.
• Researchers at Ohio State University recruited 60 women in their forties for a 12-week walking program that took place on the college's campus. At 3 months, the intervention group saw a one percent decrease in body mass index (BMI), a 3.4 percent decrease in hypertension, a 3 percent decrease in cholesterol, and a 5.5 percent decrease in glucose.
• The Rockford Coronary Health Improvement Project in Rockford, Illinois was a community-based lifestyle intervention program aimed at reducing coronary risk, especially in a high risk group. The intervention included a 40-hour educational curriculum delivered over a 30-day period with clinical and nutritional assessments before and after the educational component, in which participants were instructed to optimize their diet, quit smoking, and exercise daily (walking 30 minutes per day). At the end of the 30-day intervention period, stratified analyses of total cholesterol, LDL, triglycerides, blood glucose, blood pressure and weight showed highly significant reductions with the greatest improvements among those at highest risk.

The Compendium report follows a release this summer by the Healthy Eating Active Living (HEAL) Convergence Partnership, which consists of The California Endowment, The Kresge Foundation, Nemours, Robert Wood Johnson Foundation, W.K. Kellogg Foundation, and Kaiser Permanente, which highlighted successful community-based disease prevention programs that these major national private foundations have supported and outlined the important health impacts that community prevention efforts can provide.

"As the country is engaged in conversations about how to best structure health systems, we strongly believe that robust provisions for community health must be a centerpiece of reform efforts," said Marion Standish, MA, JD, Director, Community Health, The California Endowment, one of the groups involved in the Convergence Partnership. "As was stated in the recent announcement by the Convergence Partnership, a focus on community prevention will improve health, save money, reduce demands on our health care system, and most importantly, will lead to a nation of healthier people and healthier places to live."

In 2008, TFAH released a report that found that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use like those featured in the Compendium report could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1.