An Ounce of Prevention is Worth a Pound of Cure
A banner with this quote on it is the first thing you see when you enter the Center for Humanistic Change (CHC) office in Bethlehem. I spent a year after college working for CHC full-time before going back to school. I continue to facilitate part-time, as my schedule allows.
In my time at CHC, I believe that I learned a lot about prevention. I learned that prevention is a very broad concept covering all sorts of things. It’s not just brushing your teeth, staying physically fit, or consuming your daily dose of Echinacea. In fact, at CHC, we did not deal with any of those things. If I had to define it, I would say that prevention is about the ability to make healthy decisions, and the development of resiliency—both physically and mentally.
As an employee, I was responsible for facilitating programs to youth throughout the Lehigh Valley in schools and community centers. The programs include topics ranging from conflict resolution and communication skills, to drug and alcohol prevention and ranged from 4-6 weeks in length(meeting once a week).
CHC’s philosophy is that people learn best by doing and that learning is most effective when it engages the whole person. So, our programs always include components that facilitate interaction and critical thinking, while promoting empathy.
Because many of the programs use games, activities, role plays and more to engage the students, the students responded very well. They looked forward to sessions, engaged in the conversations, and had noticeably different outlooks on the topic from the beginning of the program to the end.
However, the dilemma, one that is often discussed when it comes to prevention is, how do we measure it? Prevention is, as it says, an attempt to prevent something from taking place. So, how do we measure the effects of a program that aims to deter youth from doing something or acting in a way that they may or may not have acted in the first place? This question is important because to ask how results are measured is to ask how the cost is justified. If people are going to fund prevention, or anything for that matter, they want to know that their funding is justified.
Of course we had our approved methods. Pre/Post tests, teacher evaluations, student evaluations, etc. But we were always looking for ways to get a better read on the effects of our programs. As facilitators, face to face with the youth, we knew we saw changes… big changes. Unfortunately, qualitative data, in the form of personal accounts, only takes you so far.
Today, people want results. They want quantitative feedback and reports that prove that money is not being wasted– thereby justifying their commitment of resources to the program.
This dilemma is one that has been and continues to be dealt with on a national level with the allocation of health care dollars. If you are a politician, I can understand the motivation behind funding treatment… you see clear, immediate results and people like results. Results=Votes. However, times appear to be changing. People realize that we have been investing in treatment with little focus given to prevention and while we see results, we are not addressing the root of the problem. Voters seem to be realizing that we can’t afford to ignore prevention anymore.
The Robert Wood Johnson Foundation and the Trust for America’s Health released a public opinion survey in November that found that Americans view prevention as a top priority in health care reform. The majority of those polled, Democrats, Republicans, and Independents alike, support increased investment in prevention funding.
By a nearly three-to-one margin (70-24 percent), people think prevention will save us money rather than cost us money.
People want health care costs down and what better way to do that then to decrease the need for treatment, doctor visits, and trips to the hospital. If we act in a proactive way and do what we must to deal with the problem before it begins, we’ll save money in the long term and more importantly, save lives.
The debate surrounding the Lehigh Valley Health Department is a debate about preventative approaches to health. Public health is about the health and safety of the public. As such, it is an essential function of local government. It is not a luxury or an elective service. Yet, while there are several agencies providing a number of prevention/public health services intended for Lehigh Valley residents, we lack one entity, able to coordinate services, educate LV residents about those services, and promote their use.
The survey shows that voters place a significant emphasis on the importance of prevention. These same voters seem more willing to accept the logical effectiveness of prevention even if it means we don’t have the same quantitative measurement tools. Further, I think people are realizing that the quantitative results of prevention will be noticeable in the long term when health statistics before a reallocation of funding to prevention are compared with health statistics after.
Do you think Lehigh Valley residents feel similarly about prevention? Are Valley residents going to demand that elected officials promote prevention funding? Please share any thoughts below.