Increasing the use of just five preventative services would save more than 100,000 lives each year in the U.S., health experts said in a report released last week by Partnership for Prevention (Washington), a non-profit health policy group.
Of the five prevention tips, the U.S. would see the biggest impact if adults took a low dose of aspirin every day to prevent heart disease, a step that could save 45,000 lives a year, according to the organization.
The report, titled "Preventive Care: A National Profile on Use, Disparities, and Health Benefits," also calls for renewed efforts to help smokers quit, more colorectal cancer and breast cancer screening and annual flu shots for people over 50.
The study found serious deficiencies in the use of preventive care for the nation as a whole — and particularly troubling shortfalls among racial and ethnic populations.
"One of the reasons we did the study is to bring attention back to the preventative services that mean the most … prevention pays and we can get a really good value for a relatively modest investment," Ashley Coffield, a senior fellow with Partnership for Prevention, told Diagnostics & Imaging Week. "We could pay now [for preventive services], or we can pay a lot more later [for treatment]."
The report found that fewer than half of American adults take aspirin preventively, though boosting aspirin use to 90% could save 45,000 additional lives each year.
The report also found that only 28% of smokers who are advised by a health professional to quit are offered medication or other assistance. Increasing the number of smokers who receive such services to 90% would save an additional 42,000 lives each year.
Meanwhile, 14,000 additional lives would be saved each year if the portion of adults over 50 who are up-to-date with any recommended screening for colorectal cancer was increased to 90%, according to the report. Today, fewer than 50% of adults are up-to-date with such screening, the report says.
If 90% of adults over 50 received annual flu shots —instead of just 37% — 12,000 additional lives would be saved each year, the report noted.
Nearly 4,000 additional lives would be saved each year if 90% of women over 40 have been screened for breast cancer in the past two years, compared to 67%.
The report also calls for more screening for chlamydia infection among sexually active young women, noting that 30,000 cases of pelvic inflammatory disease would be prevented each year if 90%, compared to 40%, of young women were screened annually.
Despite the study findings, Coffield said Partnership for Prevention does not expect improved use of preventative services to happen quickly or easily.
"We often take for granted [the fact] that most children get vaccinated, but this didn't happen overnight," Coffield told D&IW, noting that it took a significant amount of time and attention by public policy makers and government bodies to ensure that most children get vaccinated regularly. "If we gave the same kind of attention to preventative services we could save so many lives and we could prevent so much disease."
It is a follow-up study to a 2006 report by the organization, which ranked 25 evidence-based clinical preventive services recommended by the U.S. Preventive Services Task Force and Advisory Committee on Immunization Practices based on service's health impact and economic value.
"A lot of Americans are not getting [life-saving] preventive services, particularly racial and ethnic minorities. As a result, too many people are dying prematurely or living with diseases that could have been prevented," said Eduardo Sanchez, MD, chair of the National Commission on Prevention Priorities, a blue-ribbon panel convened by Partnership for Prevention to guide the study. "We could get much better value for our healthcare dollar by focusing upstream on prevention."
The report underlines the tendency of Americans to focus on disease treatment, rather than prevention.
"This report illustrates that the health benefits would be great if more people took preventive actions," said Julie Gerberding, director of the CDC. "More illnesses would be avoided, fewer lives would be lost, and there would be more efficient use of our limited healthcare resources. It's important that all of us make a concerted attempt to focus our energies and efforts on preventing disease, not just treating it."
Gerberding's comment underlines the CDC's recent shift from focus on disaster response to every day, chronic, preventable diseases.
The report also uncovers racial disparities in the use of preventative care.
For example, Hispanic smokers are 55% less likely to get help to quit smoking from a health professional than white smokers and Asian Americans are less likely to take aspirin or get screened for breast, cervical and colorectal cancer.
"Those disparities have got to be eliminated," Coffield said.
And despite higher screening rates among African Americans for colorectal and breast cancer compared to Hispanic and Asian Americans, increasing screening in African Americans would have a bigger impact on their health because they have higher mortality for those conditions, the report says. If the 42% of African Americans over 50 who are up-to-date with any recommended screening for colorectal cancer increased to 90%, 1,800 more lives would be saved each year, according to the report.
Partnership for Prevention worked on the report in collaboration with HealthPartners Research Foundation (Minneapolis), a clinical and health services research organization. It was funded by the Centers for Disease Control and Prevention (Atlanta), the Robert Wood Johnson Foundation (Princeton, New Jersey) and WellPoint Foundation (Thousand Oaks, California).
"The bottom line is that we need to strengthen the U.S. health system by investing more in preventing disease," said John Clymer, president of Partnership for Prevention, adding that the report "makes it clear that following a few preventive steps may end up saving your life."
The report is available on Partnership for Prevention's web site at www.prevent.org/NCPP.