Even though America spends more than $2 trillion annually on health care -- more than any other nation in the world -- tens of millions of Americans suffer every day from preventable diseases like type 2 diabetes, heart disease, and some forms of cancer that rob them of their health and quality of life. Keeping people healthier is one of the most effective ways to reduce health care costs. This study, which was developed through a partnership of the Trust for America's Health (TFAH), The Urban Institute, The New York Academy of Medicine (NYAM), the Robert Wood Johnson Foundation (RWJF), The California Endowment (TCE), and Prevention Institute, examines how much the country could save in health care costs if we invested more in disease prevention, specifically by funding proven community-based programs that result in increased levels of physical activity, improved nutrition (both quality and quantity of food), and a reduction in smoking and other tobacco use rates. The researchers found that if the country reduced type 2 diabetes and high blood pressure rates by 5 percent the country could save more than $5 billion in health care costs; also reducing heart disease, kidney disease, and stroke prevalence by 5 percent could raise the savings to more than $19 billion; and with additional 2.5 percent reductions in the prevalence of some forms of cancer, chronic obstructive pulmonary disease (COPD) and arthritis savings could increase to more than $21 billion. A review of a range of evidence-based studies shows that proven community-based disease prevention programs can lead to improvements in physical activity, nutrition, and preventing smoking and other tobacco use can lead to reductions of type 2 diabetes and high blood pressure by 5 percent in one to 2 years; heart disease, kidney disease, and stroke by 5 percent in 5 years; and some forms of cancer, COPD, and arthritis by 2.5 percent in 10 to 20 years. According to the literature, the per capita cost of many effective community-based programs is under $10 per person per year. Therefore, TFAH concludes that an investment of $10 per person per year in proven community-based disease prevention programs could yield net savings of more than $2.8 billion annually in health care costs in one to 2 years, more than $16 billion annually within 5 years, and nearly $18 billion annually in 10 to 20 years (in 2004 dollars). With this level of investment, the country could recoup nearly $1 over and above the cost of the program for every $1 invested in the first one to 2 years of these programs, a return on investment (ROI) of 0.96. Within 5 years, the ROI could rise to 5.6 for every $1 invested and rise to 6.2 within 10 to 20 years. This return on investment represents medical cost savings only and does not include the significant gains that could be achieved in worker productivity, reduced absenteeism at work and school, and enhanced quality of life.
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