Robert Wood Johnson Foundation President on Public Health’s “A-Ha” Moment
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NWHF Staff
| Posted on: October 13th, 2008
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Disparities •
Education •
Policies & Laws •
Public Health
Evidently, there’s been some buzz in the public health world about a recent talk by Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, that she delivered to the National Association of County and City Health Officials this past September.
She titled it “Public Health’s A-Ha Moment and What it Means for the American People,” but she might have called it “Public Health’s Wake-up Moment,” because her message was that public health needs to make some bold changes in order for it to fulfill its promise of dramatically improving the health of everyone.
She began the speech with a group hug: “My mother always told me that we are known by the company we keep—so today I am looking really good.”
But then she told a story about a recent tirade lobbed at public health folks by an anonymous collection of high-powered Washington insiders. The criticisms included accusations that public health is dysfunctional and disconnected, and frequently complains about inadequate public funding: “What a bunch of whiners!” one of them said. “All they want is more money, but they never explain what they really do with it.”
So with that, Dr. Lavizzo-Mourey went into her vision, which included the following directives to public health professionals:
1.“Improve how you do what you do.”
2. “Influence decisions affecting you by demonstrating the value of what you do.”
In order to accomplish the second point, she says public health people must begin communicating to politicians, and the media, about the benefits, and especially the cost-effectiveness, of public health programs.
“You are the only ones who can make public health’s case in the political arena,” she says, adding that “you need to leverage your stature as leaders to get the political system working for public health—and not against it.”
“This is finally your time, the time, to change the discussion, to rebalance the equation, to establish a new public health.”
Public health also needs to continue building partnerships, and creating collaborative relationships that reach far into every corner of the community. After all, she said “the new public health does not for a minute presume that government can do it all on its own. The new public health taps into the very best leadership the larger community has to offer.”
As she makes clear, the data’s already there:
The University of California, San Francisco Medical School recently reported that by 2004 California’s tobacco-control program had saved the state $86 billion in personal health care costs. That is a 50-to-1 return on a total program investment of only $1.8 billion.
In Genesee County, Mich., and the city of Flint, public health departments partnered with local hospitals and community organizations to enhance baby care, educate the community and providers, and lower the level of racism as much as possible. The results were that between 2002 and 2005, the African-American infant mortality rate dropped from 22 per 1,000 live births to 15. For white infants, it dropped from 9.9 to 6.3. The black–white disparity ratio also dropped from 3.6 to 2.4.
The University of Arkansas used data from 2,900 local public health agencies and showed that for each 10 percent increase in public health spending, mortality rates fell by as much as 6.9 percent.
This same study found that increasing public health spending in a mid-sized community by roughly $300,000 can achieve a 3.2 percent reduction in cardiovascular mortality. Without public health, those same results would require 14 new primary care physicians for every 10,000 in population. The estimated difference was $2.5 million using doctors versus $300,000 using public health.
So, with data like this readily available, now’s the time for public health to make its case.
What do you think?
Are we ready to go?
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