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December, 2011 Strategic Directions: Practicing in the Age of Health Care ReformBy James Lehman, DC, MBA, DIANM Chiropractors should be pleased to learn that President Obama agrees with our desire to promote wellness rather than disease management or sick care. The President's Affordable Care Act (ACA) passed in 2010, created the National Prevention Council and calls for the development of The National Prevention Strategy to realize the benefits of prevention for all Americans' health. The National Prevention Strategy is critical to the preventative focus of the Affordable Care Act and builds upon the law's efforts to lower health care costs, improve the quality of care, and provide coverage options for the uninsured. According to Surgeon General Regina M. Benjamin, MD, The National Prevention Strategy will move us from a system of sick care to one based on wellness and prevention. It builds upon the state-of-the-art clinical services we have in this country and the remarkable progress that has been made toward understanding how to improve the health of individuals, families, and communities through prevention. She claims the council knows preventing disease before it starts is critical to helping people live longer, healthier lives and keeping health care costs down. Poor diet, physical inactivity, tobacco use, and alcohol misuse are just some of the challenges addressed with The National Prevention Strategy. Chiropractors interested in learning more about The National Prevention Strategy, America's Plan for Better Health and Wellness should read the document. It identifies four Strategic Directions and seven targeted Priorities. The Strategic Directions provide a strong foundation for all of our nation's prevention efforts and include core recommendations necessary to build a prevention-oriented society. Directions and Priorities The four Strategic Directions address community environments and quality of life issues:
The Priorities provide evidence-based recommendations that are most likely to reduce the burden of the leading causes of preventable death and major illness. The seven Priorities are: I. Tobacco Free Living Tobacco use is the leading cause of premature and preventable death in the United States. Living tobacco free reduces a person's risk of developing heart disease, various cancers, chronic obstructive pulmonary disease, periodontal disease, asthma and other diseases, and of dying prematurely.Tobacco free living means avoiding use of all types of tobacco products—such as cigarettes, cigars, smokeless tobacco, pipes and hookahs—and also living free from secondhand smoke exposure. Recommendations include:
II. Preventing Drug Abuse and Excessive Alcohol Use Preventing drug abuse and excessive alcohol use increases people's chances of living long, healthy, and productive lives. Excessive alcohol use includes binge drinking (i.e., five or more drinks during a single occasion for men, four or more drinks during a single occasion for women), underage drinking, drinking while pregnant, and alcohol impaired driving. Drug abuse includes any inappropriate use of pharmaceuticals (both prescription and over-the counter drugs) and any use of illicit drugs. Preventing drug abuse and excessive alcohol use improves quality of life, academic performance, workplace productivity, and military preparedness; reduces crime and criminal justice expenses; reduces motor vehicle crashes and fatalities; and lowers health care costs for acute and chronic conditions. Recommendations include:
III. Healthy Eating Eating healthy can help reduce people's risk for heart disease, high blood pressure, diabetes, osteoporosis, and several types of cancer, as well as help them maintain a healthy body weight. As described in the Dietary Guidelines for Americans, eating healthy means consuming a variety of nutritious foods and beverages, especially vegetables, fruits, low and fat-free dairy products, and whole grains; limiting intake of saturated fats, added sugars, and sodium; keeping trans fat intake as low as possible; and balancing caloric intake with calories, burned to manage body weight. Safe eating means ensuring that food is free from harmful contaminants, such as bacteria and viruses. Recommendations include:
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