The Institute on Urban Health Research and Practice is a public health research institute within the Bouvé College of Health Sciences at Northeastern University. The IUHRP uses research and its practical applications to improve the health and well-being of the residents of Boston and other urban communities, by addressing the social determinants of health in urban settings in order to promote health equity and eliminate health disparities, and by examining the efficacy of programs and interventions to inform health care practices, policies, and training.
These are challenging times for public health. Funding at the Centers for Disease Control is being dramatically cut. The Prevention and Public Health Fund of the Affordable Care Act has been cut almost in half. Around the nation, state and local public health department budgets are significantly smaller than they were before the recession, and additional cuts are likely. There is no escaping it. The traditional approach to supporting public health activities – namely, with government funds for disease-specific programs – is not doing well, and is unlikely to improve any time soon.
Fortunately, several innovative experiments around the country are under way to determine whether alternative approaches can support public health activities. Some involve moving from the prevailing fee-for-service reimbursement system to one that gives financial incentives to providers to keep patients healthy by a wide variety of means, including changing the conditions at the community, school, and workplace.
This White Paper focuses on one alternative approach: the Prevention and Wellness Trust in Massachusetts, whose purpose is to gather evidence of the cost-saving power of disease prevention. Passed in 2012, this first-in-the-nation trust is a four-year, $60 million commitment to population-based health promotion efforts. Its goals are ambitious, and other states might well regard them as breathtaking: nothing less than ensuring that all residents live in communities that promote health and have seamless access to community and clinical services.
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