'Time To Get Serious About Health Promotion' by Wendy Everett

Call it what you will – health promotion, wellness, prevention….it’s all of a piece. The idea is to avoid getting sick by staying healthy – and it’s an idea whose time has come.

Massachusetts already leads the nation in envisioning and delivering near-universal health insurance coverage. Now we need to expand the vision more broadly – by embracing health promotion and prevention.

Why? First of all, it’s only common sense that staying healthy is better for us than receiving medical care after we get sick.

Secondly, we’ve simply got to get beyond the distracting debate over whether prevention actually pays. Considerable research already exists on which prevention measures are effective – and we need to start promoting them. Health care costs nationally are nearly 18% of GDP and rising, and anything we can do that might rein them in is worth trying.

Thirdly, preventable chronic illnesses like obesity, diabetes and asthma cost $34 billion annually in Massachusetts alone

- a drain that is crowding out investment in priorities like education, public safety and environmental protection that are also keys to good health. So it’s time to prevent the preventable.

And finally, the recession is only accelerating the trends driving chronic illness as people lose jobs and health insurance, delay medical care, stop exercising and revert to unhealthy diets.

Massachusetts can ill afford to continue down this path. Our population is comparatively old, with significant health disparities and weak income growth, and with more than half of all residents either overweight or obese. Moreover, our workforce is overly reliant on older workers, who are more susceptible to chronic illness.

But this is much bigger than a medical issue, it is a societal and cultural issue as well. In order to help people avoid disease and the need for costly health care services, prevention initiatives will need to take place outside the doctor’s office and beyond the confines of the health care system.

Beating back the trend in poor diet, fitness and unhealthy weight will mean changing policy and creating a new, supportive, behavior-changing environment in many venues throughout the state: in our homes and within our families, in schools, at the workplace, in transportation systems, in development practices, in food policy, and in our communities. That is what is spelled out in a new report, Healthy People in a Healthy Economy: A Blueprint for Action in Massachusetts, by the New England Healthcare Institute and the Boston Foundation.

The Blueprint lays out dozens of specific action items, including closing the excise tax loophole for snack foods and soft drinks, bringing healthy foods and more physical activity into the schools, supporting incentives for worksite wellness programs, and reimbursing physicians for promoting healthy behaviors.

Everyone has a stake in the prevention game. Leaders across the board, from government to business to education, need to ask themselves, from year to year, not only what they have done to maintain health care coverage, but what they have done to measurably improve health as reflected in our rates of overweight and obesity, smoking, hypertension, and other critical indicators.

And average citizens need to ask themselves, day in and day out, whether they are doing what they can to eat healthy, exercise healthy and stay healthy.

Major leaders in Washington, including President Obama and Senator Kennedy, get it. They are laying out a vision of national health care reform in which prevention, health promotion and wellness are viewed as part of the fundamental infrastructure for sustainable health care spending.

Massachusetts should follow suit. If the first phase of health care reform in the Commonwealth has been about access, and the second phase is about payment reform and cost control, the third phase must be about a comprehensive attack on the drivers of unhealthy behaviors and preventable chronic disease.

Thanks to health care reform to date, any future backsliding in our rates of health insurance will be viewed as a significant black mark on the Commonwealth. It’s time we started viewing the state of our collective health in the same way.

Wendy Everett is president of the New England Healthcare Institute.