Thank you for joining us today to mark the anniversary of the Affordable Care Act. The Affordable Care Act, is, as we all know, landmark and visionary in its aspirations, in its efforts to promote wellness for everyone who calls America home, and in its early achievements—particularly here in California. We here at Prevention Institute are proud of the Affordable Care Act's early success—and we are most proud of its commitment to focusing on health for all, rather than just health care for some, through an investment in prevention.
We are honored to have Dr. Howard Koh, one of the nation's highest ranking and prominent prevention and public health officials here in California and at this special event at Prevention Institute's offices. We are also happy to be joined by Herb Schultz, Regional Director of HHS Region 9. I've known Herb for a long time now and firmly believe that he is not only an advocate of prevention but a "collaboration magician" who always knows how to get the right people together to advance an issue.
Remarks:
California is a state renowned for its innovation. We proposed health reform long before discussions of reform ever entered the national stage. And, particularly relevant for this audience and this event, California's innovation is marked by its contribution to the growing awareness and the growing number of efforts focused on community prevention, that is, efforts to keep people healthy in the first place. Research increasingly shows that the places where people live, work, learn, and play, influence and shape the health and safety of residents. For example, we've been facilitating the Strategic Alliance coalition, focused on healthy eating and physical activity. We've emphasized that if people can't find fresh, affordable food in their neighborhood, they can't eat healthily. Strategic Alliance's work with the governor revealed that half the kids in California don't have access to fresh water during lunchtime. We then worked with the governor who passed legislation providing California's students to fresh, free drinking water at all California schools.
Our work connecting safety to physical activity found that if neighborhoods aren't safe, parents aren't going to send their children out to the local park; they'll park the kids in front of the television. Safety is an important part of prevention because violence affects where we live, where we work, where we go to school, even if there are workplaces and shops in our communities and whether it's safe to walk around. Fortunately, we are starting to understand what to do in our communities to support health. We have literally seen a movement in the last generation toward greater understanding about what quality prevention looks like and commitment to expanding health efforts from being exclusively focused on medical care and other after-the-fact type of measures, to prevention. Underpinning all of our prevention work is a focus on equity: community prevention efforts make sure a young man growing up here in the Oakland flatlands lives in a neighborhood that gives him the same opportunities to access healthy foods, safe places to play, and a supportive community environment as someone growing up in the Oakland hills.
In many ways, prevention has been the essence of 'bootstrap' innovation. When I began working in prevention, the prevailing thinking was that prevention was solely about education and placing the responsibility for change on individuals. With very little funding and with very little health system attention, a 'field' of quality prevention has emerged over the past few years. There is much greater understanding today that prevention means an emphasis on comprehensive approaches and that behaviors and environments are interrelated determinants of health. Communities across California, from Humboldt County in the north, to the Central Valley, and Southern California have been blazing the way with promising models for community change that have improved population-wide health and safety outcomes, and saved lives and money. As a result of the Communities Putting Prevention to Work funds from the 2009 stimulus, San Diego kids are eating San Diego food. Where there were no connections between local farmers and schools, the San Diego CPPW initiative came in and helped facilitate meaningful relationships such that we now have 8000 pounds of broccoli reaching San Diego school children from local farmers every month. In San Jose, kids will grow-up in smoke free apartments, thanks to new zoning laws designed to protect their health. This is another example of CPPW funds at work. Health, and health care costs, play one of the most important roles in the functioning of our local, state and national economies—so it's just as important to recognize that these quality prevention efforts save us money, showing a 5-to-1 Return on Investment in just five years. We simply can't fix our economy without reigning in preventable chronic diseases. Prevention is the way to do that.
Today is a particularly remarkable day for prevention because we have the opportunity to gather together as prevention supporters and acknowledge the hard work of these communities and signal support for ongoing local innovation through the many investments of the Affordable Care Act. I founded Prevention Institute nearly 13 years ago with a glimmer of hope that we might find ourselves in the situation we find ourselves in today. On this first anniversary of the Affordable Care Act, we are marking the most significant federal investment in prevention and wellness that our country has seen. And in the spirit of innovation I want to highlight one major opportunity to better align the efforts of health care institutions and community prevention activities. In South Los Angeles, a community marked by health inequities, clinicians at St. John's Well Child and Family Center noticed a preponderance of patients with cockroaches in their ears. These clinicians understood that this wasn't just a medical issue but a community issue. To be specific, they understood that the conditions they were witnessing were the direct result of slum housing and negligent landlords. St. John's clinic partnered with a local housing agency, a human rights organizing agency, and a tenant rights organization to form a collaborative and their collective efforts led to local administrative policies and secured agreements from high level leadership that led to improved landlord compliance with standard housing requirements.
Today Prevention Institute is releasing a new report, Community Centered Health Homes: Bridging the gap between health services and community prevention, focuses on exactly this type of innovation and the notion that health care institutions can take an active role in supporting community change. Integrating clinical service delivery with community prevention will reduce demand for resources and services; improve health, safety, and equity outcomes; and provide medical providers with skills and strategies to change the social circumstances that shape the health of their patients. In Community Centered Health Homes, Prevention Institute outlines an approach that community health centers can take to promote community health even as they deliver high quality medical services to individuals. For, perhaps, the first time, we are proposing a set of recommendations which will turn the innovation of a few clinics and health care institutions around the country into systematic practice. This paper asserts that health care professionals and institutions have a powerful role to play in community prevention, and is founded on the notion that we all have a role to play in promoting health.
While prevention has strong, bi-partisan support among the public, and there is unprecedented support from professionals, including all of you here, I know the work is far from done. We've made great strides over the past few decades—with virtually every infant in a car seat and dramatically reduced smoking rates, nationally—but we must keep the drumbeat for prevention strong. Health matters. The people in this room today are changing the way our communities think about health, and we're beginning to change the ways our delivery system and our leadership thinks about health. In California, that's been because we have innovative funders, innovative approaches, and leaders who are willing to put into action a common sense solution like community prevention. We have that kind of leadership here, with Herb Schultz and Dr. Koh, now we need to make sure they have our strong support, so we can take the next steps in bettering the health of all of our people, in all our communities across the country. Political will is particularly important at this time. And this will literally take a collective commitment from us all to move it forward.
