Federal strategy to put wellness, prevention on front burner: Reform progressing
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* Teddi Dineley Johnson

Promising to shift the nation from its present sick-care system to one focused on prevention and wellness, the federal government in June unveiled a groundbreaking national strategy that aims to increase the number of Americans who are healthy at every stage of life.

With the release of the National Prevention Strategy in June, federal health officials are taking what public health leaders see as an unprecedented and historic step toward putting prevention at the forefront of the nation’s efforts to improve health. The strategy focuses on both increasing the length of people’s lives and ensuring that people’s lives are healthy and productive.

“As a family physician, I understand the importance of stopping disease before it starts,” said U.S. Surgeon General Regina Benjamin, MD, MBA, at the June 16 event releasing the National Prevention Strategy.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/41/6/1.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/41/6/1.2/F1)

Speakers introduce the Prevention Strategy in June. From left, Howard Koh, MD, MPH, U.S. assistant secretary for health; R. Gil Kerlikowske, MA, director of the Office of National Drug Control Policy; and Robert Velasco II, acting chief executive officer of the Corporation for National and Community Service.

Photo by Teddi Dineley Johnson

“The leadership of this council and the strategy will help us create a healthy and fit nation by making prevention a part of our lives.”

The strategy equips public, private and nonprofit agencies, organizations and individuals with a roadmap for reducing preventable death, disease and disability in America. Developed by the National Prevention, Health Promotion and Public Health Council — created under last year’s health reform law — the strategy places a new focus on prevention, health promotion and wellness through federal policies and programs. To ensure that all Americans share in the benefits of prevention, the plan includes an important focus on Americans who are disproportionately burdened by poor health.

“The National Prevention Strategy is a major milestone in our effort to improve the health and wellness of all Americans,” said Georges C. Benjamin, MD, FACP, FACEP (E), executive director of APHA. “We applaud the National Prevention Council for its leadership and commitment to what will serve as a vital tool to preventing disease and keeping people healthy.”

With an overarching goal of increasing the number of Americans who are healthy at every stage of life, the National Prevention Strategy provides evidence-based recommendations that are aimed at improving the nation’s health through the active engagement of all sectors of society. Weaving prevention into every facet of Americans’ lives, the plan outlines four strategic directions that are fundamental to improving the nation’s health: building healthy and safe community environments, expanding quality preventive services in both clinical and community settings, empowering people to make healthy choices, and eliminating health disparities.

To help achieve its goals, the strategy identifies evidence-based recommendations that are most likely to reduce the burden of the leading causes of preventable death and illness. The strategy’s priority areas include tobacco-free living, healthy eating, active living, preventing drug abuse and excessive alcohol use, injury and violence-free living, reproductive and sexual health, and mental and emotional well-being.

Recognizing that it will also take the leadership of states, local communities, businesses and nonprofit groups to achieve its goals, the strategy calls on federal agencies and private and public partners to work together to help implement the recommendations at the national, state, tribal and local levels. The federal government alone cannot create healthier communities, U.S. Department of Health and Human Services Secretary Kathleen Sebelius said at the release of the strategy at HHS’ Washington, D.C., headquarters.

“If we want to achieve our goals and make a real change in the health of our nation, it can’t just be one department doing the work,” Sebelius said. “If we are going to serve healthier school lunches, we need to work with the departments of agriculture and education. If we want to design neighborhoods where it’s easier to walk or bike, we need to work with the Department of Transportation. If we want to work to create healthier homes, we need to work with the Department of Housing and Urban Development. We know that health is affected by the air we breathe and the water we drink, so our partners at the Environmental Protection Agency are essential.”

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/41/6/1.2/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/41/6/1.2/F2)

The release of the strategy and its comprehensive approach drew praise from public health leaders, organizations and advocates across the nation.

“By cutting across many federal agencies, the National Prevention Strategy will, for the first time ever, ensure we’re leveraging policies so they are win-wins to improve health, while at the same time improving housing, education, the economy, productivity, military readiness and the environment,” said Jeff Levi, PhD, executive director of Trust for America’s Health, which joined APHA and 78 other organizations in signing a letter commending the National Prevention Council on the strategy release.

An APHA member, Levi is chair of the Advisory Group on Prevention, Health Promotion and Integrative and Public Health. The advisory group, also created by the Affordable Care Act, brings a nonfederal perspective to the strategy’s policy and program recommendations and to its implementation.

Calling the National Prevention Strategy a “much-anticipated roadmap for public health and wellness,” APHA member Robert Pestronk, MPH, executive director of the National Association of County and City Health Officials, said the strategy is a “significant step toward engaging a broad spectrum of partners from diverse sectors in a national effort to build an integrated health system — one that is focused on preventing diseases, rather than just treating them.”

The National Prevention, Health Promotion and Public Health Council, which released the strategy, brings together the cabinet secretaries and top directors of 17 federal departments and agencies. Chaired by the surgeon general, the council developed the strategy with input from stakeholders, the public and the 13-member Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.

“One of its most key areas is the fact that we now have 17 unique departments coming together to focus the assistance of a wide variety of sectors on health,” Janet Collins, PhD, associate director for program at the Centers for Disease Control and Prevention, told *The Nation’s Health*.

Collins, who is co-leader of CDC’s effort to assist the National Prevention, Health Promotion and Public Health Council, said the council, with its 17 department heads, will remain in place for at least the next five years, “planning what each of them can do as unique departments, but also, together as a council, plotting a path for implementation.”

For more on the new strategy, visit [www.healthcare.gov/center/councils/nphpphc](http://www.healthcare.gov/center/councils/nphpphc).

*   Copyright The Nation’s Health, American Public Health Association