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This week, Secretary Thompson is launching his Prevention Initiative with a week of activities focusing on disease prevention and health promotion activities. New steps will continue to be taken throughout the year.

Background

The greatest advances in America's health have come from preventive and public health measures. And the opportunity remains vast for further gains through disease prevention and health promotion.

Over the last century, life expectancy in the U.S. increased by about 30 years. About five of those years were due to improvements in curative medicine and health care. The remaining 25 years were due to improvements in public health and preventive medicine.

A recent study has estimated causes of premature deaths in America (deaths before age 65). According to this estimate, the largest determinant is our own behavior choices:

1. Unhealthy behavior patterns, 40 percent.
2. Genetic predisposition, 30 percent
3. Social circumstances, 15 percent
4. Shortcomings in medical care, including access to care, 10 percent
5. Environmental causes, 5 percent

A few highlights demonstrate the scope of the problem and the opportunities:

• The largest single preventable cause of premature death is tobacco use, causing almost a fifth of all deaths (19 percent) in the U.S., or some 440,000 premature deaths each year. Its cost to America is over $70 billion per year in health care spending alone, plus another $25 billion in lost productivity.

• Overweight, poor dietary habits and lack of physical activity account for at least 14 percent of deaths in the U.S., or some 300,000 premature deaths each year. Total direct and indirect costs attributed to overweight and obesity were estimated at $117 billion in 2000.

• Among American adults, 70 percent do not get enough physical activity to provide health benefits. And 40 percent are not active at all in their leisure time. More than a third of young people in grades 9 to 12 do not engage regularly in vigorous physical activity. And a fourth of children in America spend four hours or more per day watching TV.

• In 1999, an estimated 61 percent of American adults were overweight or obese, along with 13 percent of children and adolescents. Obesity among adults has doubled since 1980, while overweight among adolescents has tripled.

• Each year in America, three health conditions -- smoking, obesity and diabetes -- are associated with almost a million deaths, costing our economy some $270 billion.

HHS Agencies and Disease Prevention

Office of Public Health and Science -- The Office of Disease Prevention and Health Promotion leads the "Healthy People" program, establishing prevention goals through a national partnership of public, professional and volunteer groups. "Healthy People 2010" identifies 467 prevention goals and measures progress. The President's Council on Physical Fitness and Sports leads efforts to improve fitness of young people.

Centers for Disease Control and Prevention -- Leads community prevention efforts including immunization; monitoring and control of infectious diseases, including sexually transmitted diseases; health and behavioral information to reduce chronic disease, including smoking prevention; and injury prevention. Leads the effort to identify successful practices in the Guide to Community Preventive Services.

Agency for Healthcare Research and Quality -- Provides guidance on effective clinical preventive services. Supports the U.S. Preventive Services Task Force and its Guide to Clinical Preventive Services.

National Institutes of Health -- Supports research in areas including prevention of heart disease and stroke, prevention and control of diabetes, and prevention and detection of cancer. Supports research in health education, vaccines and other basic research underlying preventive medicine, including genetic research.

Health Resources and Services Administration -- Provides access to preventive services and information through community health centers and rural health centers; leads maternal and infant health efforts.

Food and Drug Administration -- Ensures food safety to prevent foodborne disease; prevents illness through regulation of medical and other products.

Substance Abuse and Mental Health Services Administration -- Supports services and information to prevent alcohol and drug abuse and to promote mental health and reduce the effects of mental illness.

Indian Health Service -- Working with tribal governments, provides preventive services and information for Native American populations.

Centers for Medicare & Medicaid Services -- Covers certain preventive services for beneficiaries and provides information on health choices for beneficiary populations.

Administration for Children and Families -- Provides early childhood preventive services delivered through Head Start.

Administration on Aging -- Supports state and community efforts in health promotion and disease prevention for older Americans.

Next Steps

Public health efforts to reduce smoking over the past 35 years have shown that unhealthy behaviors are not easy to change, but with a combination of education, healthy public policies and community-wide initiatives, improvements can be achieved. Some new steps to expand disease prevention and health promotion efforts include:

• Healthy Communities Initiative -- The President's fiscal year 2003 budget includes $20 million for a new interdisciplinary services demonstration program that will focus on preventing diabetes, asthma and obesity through community systems of services. The initiative will encourage innovative efforts in five communities to enhance access to services and health information, and change health outcomes. Funds will be matched by communities to enable development of coalitions to provide better opportunities for Americans to choose healthy lifestyles, with special attention to eliminating racial and ethnic disparities in health.

• Leading Health Indicators -- A new annual report on the nation's progress in disease prevention and health promotion, as measured by 10 leading health indicators, will be released this year. The 10 leading health indicators were identified as part of the "Healthy People 2010" process. They represent the major public health concerns in the U.S. where individuals and communities can take action to realize significant health improvements.

• Youth Media Campaign -- A major media campaign directed by the CDC will be launched this summer. The campaign will use the kinds of sophisticated advertising used to market to kids, but instead of selling products it will pitch healthy choices including physical activity, sports and community service.

• Challenge to Employers and Families -- Prevention can be an effective tool for lowering long-term health care costs. Secretary Thompson will challenge employers to help employees live healthier. He'll also challenge family members to support one another in changing old habits and benefiting from the savings and better health of a disease prevention lifestyle.

• Micro-Grants for Communities -- Last September, HHS launched a new program to award hundreds of "micro-grants" to community organizations for activities that support disease prevention and health promotion. Worth up to $2,010 each, the micro-grants will represent a new, low-cost approach to foster effective prevention efforts at the community level. Each grant will support efforts by local groups to promote health education, quality care, access to care and other projects that support the national health goals of "Healthy People 2010." This is a new way to leverage very small grants into widespread action.

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