Surgeon general previews preventive health strategy

Washington -- The U.S. surgeon general and a council focused on preventive health care have drafted a strategy to keep Americans healthy in anticipation of tens of millions of uninsured people gaining health care insurance starting in 2014.

"Giving Americans health care coverage is only the first step to truly reducing the health disparities that plague our country," said Regina Benjamin, MD. "We know reducing and ultimately eliminating health disparities will require more than just giving them a health insurance card."

Dr. Benjamin

The surgeon general delivered the keynote address to the National Quality Forum's annual education conference in Washington, D.C., on Feb. 24. The event focused on ways to improve the general population's health and wellness.

The National Prevention, Health Promotion and Public Health Council is set to formally unveil a national prevention strategy on March 23, which will be the one-year anniversary of President Obama signing the national health system reform act into law.

The strategy will set goals, recommend improvements, identify actions for federal efforts, and prioritize policies for wellness and prevention programs. Dr. Benjamin spoke about the strategy during her remarks and in an interview with American Medical News.

"This is our vision," Dr. Benjamin said. "And that is working together to improve the health and quality of life for individuals, families and communities by moving the nation from a focus on sickness and disease to one based on wellness and prevention."

Dr. Benjamin, a family physician, wants physicians to be leaders in implementing this vision. She urged doctors who have been active in their communities to continue and those on the sidelines to play an active role.

The Agency for Healthcare Research and Quality also has prevention advice for physicians. It has established an "innovations exchange" to showcase more than 2,000 quality tools used by clinicians and public health officials to reduce health disparities, said Carolyn Clancy, MD, the agency's director, who also spoke at the NQF conference.

For instance, the Barbershop Quartet, a church-based group in the Harlem neighborhood of New York, provided free health education and screenings for African-American men by using a mobile unit parked in front of barbershops. Local hospitals helped establish the program, which has provided more than 2,700 screening services since 2007, according to AHRQ.

The draft copy of the council's plan contains 10 strategic directions and several recommendations. Four are "cross-cutting" strategic directions, such as eliminating health disparities. The other six target more specific issues, such as mental health, well-being and tobacco-free living.

One cross-cutting strategic direction is titled "quality clinical preventive services." This would call for the increased use of "effective and highest impact/priority" preventive services and medications. They include screening and treatment for hypertension and cholesterol, cancer screening, and screening and treatment for HIV, chronic viral hepatitis and sexually transmitted diseases. Recommendations associated with the strategy include lowering cultural and market barriers to patient access.

Under the healthy eating target, the council would support policies improving nutrition choices for people at all stages of life. This includes recommendations to increase access to healthy foods, eliminate so-called food deserts, and establish nutritional guidelines in schools and other settings that serve children.

Dr. Benjamin also said she is working on a paper discussing children's misuse of prescription drugs.

She cited a troubling trend of youths gaining access to their parents' or grandparents' medicine cabinets and sharing the medications with their friends.

"It's dangerous, and parents don't know about it," she said.

The surgeon general's paper would address responsible use and disposal of prescription drugs to keep them out of the hands of minors.