Despite some major victories in support of prevention, the nation’s commitment to preventing illness has long taken a back seat to treating it. To clarify the relationship between prevention and treatment, a new book explores why the U.S. health system puts prevention activities second to treatment.
When prevention and treatment are equally effective and likely to produce the same benefits given the risk, western society more readily chooses “alleviating harm over preventing it,” according to “Prevention vs. Treatment: What’s the Right Balance?” Released in October by APHA Press and Oxford University Press, the book presents a wide range of perspectives to explain why the U.S. health system prioritizes treatment over prevention.
Preventive measures such as diet and nutrition can lead to better health, but the U.S. health system remains focused on treatment, a new book says.
Photo courtesy Aldo Murillo, iStockphoto
“Why will we marshal all available resources to save a little girl who’s fallen into the well, while we either procrastinate or avoid putting a protective barrier up around the well long before she would have fallen in?” co-editors Halley Faust, MD, MPH, MA, and Paul Menzel, PhD, ask in the book’s introduction.
Treatment bias is often driven by compassion, Faust said.
“Our values drive our priorities, and our values are clearly wired to alleviate suffering over preventing suffering,” said Faust, who is an APHA member. “There is a vividness of suffering that overwhelms our rational, logical side, so while logically it may make more sense to do more prevention, once someone is in front of us with suffering, it clicks in our compassion, which is a driving force,” said Faust, president-elect of the American College of Preventive Medicine and a clinical associate professor of family and community medicine at the University of New Mexico.
The book’s 16 chapters — authored by economists, public health scholars, preventive medicine physicians, philosophers, lawyers and religious ethicists — examine the amount of money spent on prevention, the history of health policies that have contributed to a lack of emphasis on prevention, the values that may justify treatment over prevention and the religious and cultural traditions that have shaped the moral relationship between the two types of care. With its broad range of perspectives, the book features frank discussions of the prevention versus treatment debate, including several essays that examine the reasons for prioritizing treatment.
Though the nation is moving toward striking a greater balance between prevention and treatment — such as the prevention provisions contained in the 2010 health reform law — the U.S. health system remains predisposed toward treatment.
“Every decade that goes by without us seeing how important prevention is, if in fact we are giving prevention short shrift in many areas, the costs are huge — the cost of lives,” said Menzel, who is a professor of philosophy at Pacific Lutheran University in Tacoma, Wash. “We are spending ridiculously much on treatment. If we use our heads, we will still end up putting some priority on treatment, but we will do it more knowledgeably and we will do it much less than we are now.”
APHA Annual Meeting-goers can attend a book signing with Faust from 4 p.m. to 5 p.m. on Sunday, Oct. 30, in the Everything APHA section of the meeting’s Public Health Expo.
For more information or to order a copy of the book, visit www.aphabookstore.org or email apha{at}pbd.com.
- Copyright The Nation’s Health, American Public Health Association
