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House Committee Holds Hearing on Public Health Prevention

On March 31, the House Energy and Commerce Subcommittee on Health held a hearing, “Making Health Care Work for American Families: The Role of Public Health.” This is the fourth hearing in a series exploring nationwide health care reform.

Richard Besser, acting director of the Centers for Disease Control and Prevention (CDC), said, For too long, in discussions of health reform, health care delivery and public health approaches have been treated separately, as if they were disconnected and mutually exclusive systems. With a discussion of health reform currently a focus for the nation, it is time instead to start talking about solving our national health needs through a comprehensive system that seamlessly integrates health care delivery and prevention.” Dr. Besser discussed the necessary changes to improve public health, including: increased access to evidence-based screening, such as mammography, and annual blood pressure and HDL and LDL cholesterol level measurement; minimizing the progression of existing diseases through careful, ongoing monitoring; and encouraging life and work environments that support healthy behavioral choices. He highlighted several public interventions, such as immunization, telling the committee, “For each birth cohort vaccinated with seven routinely recommended childhood vaccines, society saves approximately $9 billion in direct health care costs over a lifetime, approximately 33,000 lives are saved, and 14 million cases of disease are prevented.” Dr. Besser also emphasized the need to reduce childhood obesity, eliminate health disparities, and prevent new HIV infections.

Heather Howard, commissioner of New Jersey Health and Senior Services, discussed her state’s focus on healthy families, beginning with Women, Infant, and Children (WIC) clinics: “…I saw first hand the valuable work that peer counselors do to promote breastfeeding and provide new mothers with the support and education they need to successfully breastfeed their babies. In addition, thousands of women learn the importance of feeding their families nutritious meals.” She continued, “The Healthy Mothers Equals Healthy Babies campaign I undertook was a key recommendation of a Prenatal Care Task Force that I created last year to improve access to early prenatal care for women across New Jersey. Public health has been responsible for a 90 percent reduction in infant mortality over the last 100 years, but as a public health leader, I recognize there is more to be done until all children are born with a healthy start in life. Ms. Howard also noted her state’s newborn screening program, public health surveillance of birth defects and developmental disabilities, and testing for lead poisoning.

Also testifying were Jonathan E. Fielding, director and health officer of the Los Angeles County Department of Public Health;David Satcher, former United States surgeon general; Barbara Spivak, president of the Mount Auburn Cambridge Independent Physician Association; Devon Herrick, senior fellow at the National Center for Policy Analysis; and Jeffrey Levi, executive director of the Trust for America’s Health.

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