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Tuesday, July 22, 2008

Better Health for $10 a Person

Writing for Time magazine, Lauran Neergaard suggests that investing $10 a year or leading a healthy lifestyle could cut health care costs by more than $16 billion annually.  Neergaard writes,

Ten_dollarsInvesting just $10 per person — roughly the price of a six-pack of beer and some chips — could greatly fuel community programs that get couch potatoes moving, prevent smoking and improve nutrition, researchers say.

How much health does $10 a person buy? Invest that every year, and within five years the nation could cut health care costs by more than $16 billion annually, concludes a new analysis by the nonprofit Trust for America's Health and a team of public-health research groups.

If the big dollars have your eyes glazing, the overall point is simple: Obesity — from poor nutrition and inactivity — and smoking are blamed for much of the heart disease, cancer, diabetes and lung diseases that are the nation's leading public health problems, fueling the $2 trillion annually spent on health care.

Yet small improvements can add up. Research suggests, for example, that walking 30 minutes a day and dropping just 15 pounds can cut in half the risk that someone with pre-diabetes will get the full-blown disease. The question is how to educate and persuade people to take such steps.

"This is pennies when you look at the long-term cost of treating diabetes or high cholesterol," said Audry Tayse Haynes of the YMCA, which runs programs in more than 64 communities that are the type the report aims to emulate — programs typically begun with one-time government grants of about $40,000.

For example, the YMCA runs various after-school care programs. Rather than just supervise students playing and doing homework, some sites added a program that teaches healthy snacking and physical activity, with games to help kids exercise. Tracking 3,100 children in Texas, the YMCA found the program helped youngsters eat more fruit and less candy, exercise a little more each week and watch less TV.

The California Endowment has started a Healthy Eating, Active Communities program that partners with local government and private businesses to build parks, provide more fresh fruits and vegetables and other healthy foods for area markets, and increase physical activity in schools. Estimated cost: about $7 per person, Thursday's report found.

In Somerville, Mass., federal health officials funded a "Shape Up Somerville" program that slowed weight gain among first- to third-graders and may have had some citywide impact: Steps that started with better school food and a push for safe walking and biking paths to school wound up also touting restaurants that made their menus healthier. Estimated cost: $3 to $4 a person.

As for tobacco, when New Yorkers started paying the nation's highest cigarette taxes this month, officials estimated that 140,000 eventually would stop smoking.

U.S. spending on prevention programs has been stagnant for about four years.

Programs that help people slim down and stop smoking clearly make for a healthier population, but whether they save governments money is controversial. A Dutch study published last winter, for instance, found that the obese and smokers die sooner, which makes them cheaper for health systems than thin nonsmokers who live longer.

But other research suggests the obese may actually live as long but with more diseases.

"You're prolonging the period of healthy life," said Jeff Levi, executive director of the Trust for America's Health. "Whether I need a knee replacement is not a life-and-death question. ... If I'm not obese and more mobile and don't kill my knees and therefore don't need that knee replacement, I'm not living longer, but I'm a lot cheaper."

For the report, the New York Academy of Medicine reviewed research on community-based disease prevention programs to find what works, and how well. Then the Urban Institute developed a model to estimate the savings in health care costs that would accrue if the country achieved various levels of health improvements — such as a 5% drop in diabetes and high blood pressure rates.

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