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Durkin: 'Primary Prevention' Two Important Words for Policymakers

Noteworthy is its panoramic worldview of health care ó that is, that preventive care can, and should, be provided in places outside the clinical setting. The report points out as an example community-based smoking-cessation support groups and diabetes prevention programs that help promote physical activity and good nutrition. And it calls on public health officials to work with other sectors ó such as education, transportation and housing ó to capitalize on the many opportunities to promote health and wellness where Americans live, learn, work and play.

Sen. Tom Harkin, D-Iowa, a longtime advocate of healthy lifestyles, recently introduced a bill calling for the very cultural shift toward wellness and prevention that America so desperately needs. While the Healthy Lifestyles and Prevention America Act (HeLP America Act) is extensive and will likely be difficult to move forward in its entirety, the spirit of the legislation is on target.

In fact, there are a number of must-pass elements of the bill that directly address the need for increased physical activity in our society ó a linchpin of primary prevention. For example, one component of the bill calls for indicators describing the physical activity environment in schools (e.g., time, quality, teachers and facilities devoted to physical education) to be included in annual state report cards. It also adds PE to the existing set of core subjects, according to the Harkin press release.

Another worthwhile bill component allows employers to deduct the cost of athletic facility memberships for their employees and exempt this benefit as taxable income for these workers. Still another provides tax credits to businesses that offer comprehensive workplace wellness programs to help their employees improve their health and well-being.

Others are recognizing the value of primary prevention. In fact, Kaiser Permanente, one of Americaís leading health care delivery entities, has created an electronic Exercise Vital Sign initiative that systematically records patientsí physical activity in their electronic health records. Not only will this help improve treatment and guide providers in counseling patients on healthy lifestyle practices, but it also opens a window for examining the relationship between exercise, chronic disease and health care consumption and cost.

Itís time for policymakers to expand their vocabulary. If we are to stop the tide of chronic diseases that are eroding our health care budgets and economy, then we need to widen the lens and take a long-term view. Fixation on short-term ROI in the doctorís office isnít going to fix the problem. We need health policies and legislation that support primary prevention and healthy lifestyle choices because we need to change the way America lives and functions.

Primary prevention. Itís a catchy little term. I urge all policymakers to learn it, practice it and promote it. Itís the very best shot weíve got.

Helen Durkin is the executive vice president of public policy for the International Health, Racquet and Sportsclub Association.

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