Longtime readers of MH Blog are likely familiar with my vexation regarding the typical features of the debate over prevention in context of health. Namely, the kind of prevention that interests me -- and, I believe, that is most firmly rooted in a compelling evidence base -- is generally not the kind of prevention that is wrangled over in the current "discourse" over health care reform. The kind of prevention that interests me relates to social policy, and involves creating or remediating existing conditions in ways thatwe have reason to believe will facilitate health over the lifespan. These kinds of social policies suggest intensive investment of resources extremely early in the lifespan, and therefore operate on a paradigm that is entirely different from the preventive services that occupy virtually all of the political discussion on the topic.
Thus, I am pleased to recommend a short article on the topic by Erika Blacksher* (The Hastings Center) entitled Health Reform: What's Prevention Got to Do With It? Succinct and eloquent, Dr. Blacksher adduces similar points. Here is an excerpt:
A recent poll found that an overwhelming majority of Americans from across the political spectrum think prevention should be given priority in health reform. Given its intuitive appeal, that result is not surprising. Who could be against the idea of investing in keeping people healthy? But as it turns out, prevention has its detractors. The debate turns on questions about its exact meaning, whether it is cost-effective, and the complexity of the enterprise.
Like most Americans, I am a fan of prevention. My view of what prevention is, however, may not be widely shared. Prevention to my mind means assuring that all persons are able to live in safe, clean houses and neighborhoods; eat healthy foods; socialize with family and friends; get exercise; rest and manage stress.
Highly recommended.
*Disclosure: Dr. Blacksher is a colleague of mine, and we have tentative plans to collaborate in the near future.
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