Survey: Californians Concur on Need for Prevention

by David Gorn

At a joint Assembly and Senate health hearing yesterday, results of a Field Poll unveiled a few days shy of the official release indicate that an overwhelming majority of Californians (about 80% of those surveyed) believe government and schools need to pitch in to fight childhood obesity and that preventive health programs pay for themselves in reduced health care costs to the state.

That tied in nicely with the intent of the hearing, which was convened by the two legislative health committees to look at ways to focus health policy toward prevention of chronic conditions such as obesity, heart disease and diabetes.

"When we look at the fact that individual [health] behavior and people's environment contribute to about 70% of our health care costs, it should really be addressed," according to Larry Cohen, founder and executive director of the Prevention Institute and a panelist at the hearing. "But our health care investment is only about 4% in prevention."

"These are life and death decisions," according to Assembly member Bill Monning (D-Carmel), co-chair of the hearing. "When you look at the trajectories of preventable diseases such as diabetes, we really need to figure out what are the best strategies to deal with them."

The Field Poll results dovetailed with that sentiment.

"We've been looking at obesity issues in surveys over the past 10 years," Mark DiCamillo of the Field Research Corporation said, "and in each of the surveys we've done, we first ask people what they think is the single greatest health risk to California's children."

The answer to that question has changed over the years, since it was first asked in 2003, DiCamillo said.

"Back then, it was unhealthy eating habits and lack of physical activity, followed closely by drug use. And smoking was a significant answer," he said. "Now, [in the latest poll] almost half of all voters say it's predominately unhealthy eating habits and lack of physical activity."

Smoking and drug use were significantly lower responses this time, DiCamillo said.

"The broad consensus is that this subgroup is the single greatest risk to kids," DiCamillo said, "and that was across the board. White as well as ethnic voters, conservative and liberal."

To make the greatest impact on changing unhealthy lifestyles, California policy makers need to target low-income areas and communities of color, where statistical incidence of chronic conditions is much higher, Anthony Iton of the California Endowment said.

"As you move into poorer neighborhoods, life gets shorter," Iton said. "Everywhere we've looked, we see the same thing, the same relationship. The only way to fix this is to change the milieu where children are growing up."

That means building grocery stores in food deserts, Iton said. It means establishing parks, making sure neighborhoods have clean water, and other community improvements, he said.

"We need deep and authentic processes to engage the whole community," Iton said. "Health is not about health care. Health is about quality of life."

DiCamillo said the full survey results will be released next week.

Another significant result, DiCamillo said, is that a majority of polled Californians said the government should act on prevention policies, either now or when the economy recovers.

"Most people say that [implementing preventive policies] is important, and of those, most people say we should do something now."

Assembly member Richard Pan (D-Sacramento) questioned that conclusion a bit.

"If you add up the people who say, 'Yes do something, but later,' and the ones who said, 'No,' " Pan said, "then that number came to 49% ...that presents major challenges."

The major challenge in implementing prevention policies, Monning said, is funding them.

"Whenever we're looking to cut budget, prevention is often the first thing to be cannibalized," Monning said. "We need to send the message: hands off. Because really, this is the best health investment we can make in our communities."

susan smith
Ben Franklin's "An ounce of prevention is worth a pound of cure" rings true to this day. Spending money to keep people healthy - especially by helping kids form good habits - will save us all money in the future. Also, challenge medical norms. Ask for generic drugs. Get involved in your community to bring more primary care access to your neighborhood. Ask if tests - like MRIs - are really necessary for your situation.
Scott Zettlemoyer
Strong evidence we have a personal responsibility crisis in the US not a health care crisis.

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