PROMOTING PREVENTION & STRENGTHENING

Covering the uninsured and modernizing America's health care system are urgent priorities, but they are not

enough. This nation is facing a true epidemic of chronic disease. An increasing number of Americans are

suffering and dying needlessly from diseases such as obesity, diabetes, heart disease, asthma and HIV/AIDS, all

of which can be delayed in onset if not prevented entirely. One in 3 Americans—133 million—have a chronic

condition, and children are increasingly being affected.38 Five chronic diseases—heart disease, cancer, stroke,

chronic obstructive pulmonary disease, and diabetes—cause over two-thirds of all deaths each year.39

In addition to the tremendous human cost, chronic diseases exact a tremendous financial toll on our health care

resources. Care for patients with diabetes costs $130 billion each year alone, and this amount is growing.40

Tackling chronic diseases is also straining our public health departments and finances, which are already

stretched too thin carrying out traditional public health functions, which include ensuring our water is safe to

drink, the air is safe to breathe, and our food is safe to eat.

Barack Obama and Joe Biden believe that protecting and promoting health and wellness in this nation is a

shared responsibility among individuals and families, school systems, employers, the medical and public health

workforce, and federal and state and local governments. All parties must do their part, as well as collaborate

with one another, to create the conditions and opportunities that will allow and encourage Americans to adopt

healthy lifestyles.

(1) EMPLOYERS. Reduced workforce productivity from illness and disability represents an additional drain on

business. To address employee health, an increasing number of employers are offering worksite health

promotion programs, onsite clinical preventive services such as flu vaccinations, nutritious foods in cafeterias

and vending machines, and exercise facilities. Equally important, many employers choose insurance plans that

cover preventive services for their employees. Barack Obama and Joe Biden believe that worksite interventions

hold tremendous potential to influence health and they will expand and reward these efforts.

(2) SCHOOL SYSTEMS. Childhood obesity is nearly epidemic,41 particularly among minority populations,42 and

school systems can play an important role in tackling this issue. For example, only about a quarter of schools

adhere to nutritional standards for fat content in school lunches.43 Barack Obama and Joe Biden will work with

schools to create more healthful environments for children, including assistance with contract policy

development for local vendors, grant support for school-based health screening programs and clinical services,

increased financial support for physical education, and educational programs for students.

(3) WORKFORCE. Primary care providers and public health practitioners have and will continue to lead efforts

to protect and promote the nation's health. Yet, the numbers of both are dwindling,44 and the existing

workforce is further challenged by inadequate training for new health threats such as bioterrorism and avian flu,

antiquated funding and reimbursement mechanisms, and limited access to real-time information and technical

support. Barack Obama and Joe Biden will expand funding—including loan repayment, adequate

reimbursement, grants for training curricula, and infrastructure support to improve working conditions— to

ensure a strong workforce that will champion prevention and public health activities.

PROMOTING PREVENTION & STRENGTHENING

PUBLIC HEALTH

(4) INDIVIDUALS AND FAMILIES. Preventive care only works if Americans take personal responsibility for their

health and make the right decisions in their own lives – if they eat the right foods, stay active, and stop smoking.

Barack Obama and Joe Biden will ensure that all Americans are empowered to monitor their health by ensuring

coverage of essential clinical services in all federally supported health plans, including Medicare, Medicaid,

SCHIP and the new public plan. Americans also benefit from healthy environments that allow them to pursue

healthy choices and behaviors that can help ward off chronic and preventable diseases. Healthy environments

include sidewalks, biking paths and walking trails; local grocery stores with fruits and vegetables; restricted

advertising for tobacco and alcohol to children; and wellness and educational campaigns. In addition, Barack

Obama and Joe Biden will increase funding to expand community based preventive interventions to help

Americans make better choices to improve their health.

(5) FEDERAL, STATE, AND LOCAL GOVERNMENTS. The federal government and state and local governments

play critical roles across the full range of disease prevention and health promotion activities. First, working

together, governments at all levels should lead the effort to develop a national and regional strategy for public

health and align funding mechanisms to support its implementation. Second, the field of public health would

benefit from greater research to optimize organization of the 3,000 health departments in this nation,45

collaborative arrangements between levels of government and its private partners, performance and

accountability indicators, integrated and interoperable communication networks, and disaster preparedness and

response. Third, the government must invest in workforce recruitment as well as modernizing our physical

structures, particularly our public health laboratories. And finally, the government must examine its own

policies, including agricultural, educational, environmental and health policies, to assess and improve their

effect on public health in this nation. Barack Obama and Joe Biden will prioritize all of these activities, to

ensure a 21st century public health system and healthy America.