Last week, a commentary in the New England Journal of Medicine explored what different 2012 election scenarios could mean for the Affordable Care Act (ACA). In short, an uphill battle lies ahead. Even if Obama wins re-election, his health-care overhaul is likely to languish if Republicans win control of the Senate while keeping the House.
While the ACA is aimed largely at reforming health insurance, it includes significant investments in public health—including the creation of the Public Health and Prevention Fund which commits $15 billion over 10 years. Research indicates that such an investment would yield substantial improvements to the public's health, gains which will be lost if funding is cut.
A recent policy brief synthesized evidence on the return on investment for public health spending. Going beyond estimates that the U.S. spends 4¢ on public health and prevention for every $1 it spends on medical care, the policy brief highlights some compelling statistics that show why investing in public health pays off. How much difference does it make? A study of public health spending and health data looked at that question.
It found that a 10% increase in public health spending was associated with a:
6.9% decrease in infant mortality;
3.2% decrease in deaths from cardiovascular disease;
1.4% decrease in deaths from diabetes; and
1.1% decrease in deaths from cancer.
Let's do a little math to see what these figures could mean for Philadelphians' health.
In 2009, for example, the Philadelphia Department of Public Health's budget was just over $202 million. Pretend, for the sake of illustration, that the ACA's Public Health and Prevention Fund enables the city to increase spending on public health by 30%. What would this extra $60.6 million translate to in Philadelphian lives saved?
The most recent Philadelphia Vital Statistics Report tells us that there were 248 infant deaths, 775 deaths attributable to cardiovascular disease, 369 to diabetes, and 3,409 to cancer in 2007. If we extrapolate the research presented above to Philadelphia, a 30% increase in public health spending would mean saving the lives of roughly:
51 Philadelphia babies;
74 Philadelphians who would have died of cardiovascular disease;
13 Philadelphians who would have died of diabetes; and
112 Philadelphians who would have died of cancer.
These 250 lives saved in a single year don't even include all the deaths that could be prevented for other fatal conditions through additional evidence-based public health programs.
If you agree that public health and prevention are smart investments, let your representative in Congress know by sending a message.
Read more about The Public's Health.