{"subscriber":false,"subscribedOffers":{}} Why Behavioral And Environmental Interventions Are Needed To Improve Health At Lower Cost | Health Affairs

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Research Article

Why Behavioral And Environmental Interventions Are Needed To Improve Health At Lower Cost

Affiliations
  1. Bobby Milstein ( [email protected] ) is the coordinator for the Syndemics Prevention Network at the Centers for Disease Control and Prevention, in Atlanta, Georgia.
  2. Jack Homer is president of Homer Consulting, in Voorhees, New Jersey.
  3. Peter Briss is the medical director of the National Center for Chronic Disease Prevention and Health Promotion, at the Centers for Disease Control and Prevention.
  4. Deron Burton is a Commissioned Corps officer at the Center for Global Health, at the Centers for Disease Control and Prevention.
  5. Terry Pechacek is the associate director for science of the Office on Smoking and Health, at the Centers for Disease Control and Prevention.

We used a dynamic simulation model of the US health system to test three proposed strategies to reduce deaths and improve the cost-effectiveness of interventions: expanding health insurance coverage, delivering better preventive and chronic care, and protecting health by enabling healthier behavior and improving environmental conditions. We found that each alone could save lives and provide good economic value, but they are likely to be more effective in combination. Although coverage and care save lives quickly, they tend to increase costs. The impact of protection grows more gradually, but it is a critical ingredient over time for lowering both the number of deaths and reducing costs. Only protection slows the growth in the prevalence of disease and injury and thereby alleviates rather than exacerbates demand on limited primary care capacity. When added to a simulated scenario with coverage and care, protection could save 90 percent more lives and reduce costs by 30 percent in year 10; by year 25, that same investment in protection could save about 140 percent more lives and reduce costs by 62 percent.

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