Affordable Care Act: Prevention and Public Health Fund
Dani Cuddeback, Vanika Jethwa, Hannah Pratt, Bennington Wentworth KSC Dietetic Interns
Background Information:
The Affordable Care Act’s Prevention and Public Health fund was
established in 2010 and represents a critical investment in our
nation's health. The Affordable Care Act established the Prevention
and Public Health Fund to provide expanded and sustained national
investments in prevention and public health, to improve health
outcomes, and to enhance health care quality.
The United States currently spends too much money on healthcare
without adequate results and achieves too little. The per capita
health spending in the US is nearly double the average spent by other
industrialized nations, yet our life expectancy is 26th out of these
same 36 nations. Only 3% of our health care spending is focused on
prevention and public health, when 75% of our health care costs are
related to preventable conditions.
The ACA Prevention and Public Health Fund is mainly used to
support and fund programs for the CDC and HRSA. These include
community prevention programs, which are used for programs such
as obesity prevention, tobacco usage, and other chronic diseases.
Funds can also be used in a clinical setting in order to help spread
awareness of preventive services and their benefits. Training
involved with public health is also funded under the bill. These funds
are used at the state and local levels in order to increase the
healthcare workforce and allow them to better prevent and respond
to outbreaks within their community. Finally, funds can also be used
in research in order to increase and expand the collection of public
health data around the nation.
References: American Diabetes Association Statement on
Cuts to the 2018 Budget:
‘The ADA has expressed disappointment at the
ADHC as the new legislation repeals the
Prevention and Public Health Fund after 2018,
eliminating almost 40 percent of the CDCs
chronic disease prevention and health
promotion budget—a drastic step backwards
for diabetes prevention’ - ADA 2018
APHA Statement on Cuts to the 2018 Budget:
“The American Public Health Association (APHA) is
deeply disappointed that the spending deal will cut $1.35
billion from the Prevention and Public Health Fund over
the next 10 years. This funding is a critical component of
CDC’s budget, supporting programs in childhood lead
poisoning prevention, vaccinations and other important
public health activities. Congress should repeal these cuts
and restore the Prevention Fund to prior funding levels” -
Statement from Georges C. Benjamin, MD, executive
director, American Public Health Association Feb 09 2018
Impact on RDNs:
Future RD’s can promote, enhance and/or run
community-based preventive health programs. They can
be part of the disruption of funds process by determining
what their program needs and voting for the allocations
of funds. Dietitians can assist policy makers on the best
ways to spend the allocated funds by keeping them up-
to-date on current issues in the community. This role
entails informing and being able to back up claims to
support the funding of individual programs with science
based evidence information.
Programs Funded Through the ACA: PPHF
There are multiple programs funded through the PPHF, for
example,The National Public Health Improvement Initiative:
In Virginia alone, they saved $1.2 million and saw a 32%
increase in enrollment in Medicaid Family Planning
Program. The Community Transformation Grant Program is
another great example of funding. In Iowa, dental patients
were screened for high blood pressure as well as tobacco
use. Over 300,000 patients were involved and the state saw
an increase in referrals to tobacco usage and heart related
programs due to funding.
Finally the CDC’s Chronic Disease Self Management
Program (CDSMP) had a positive effect on the incidence of
myocardial infarction among US adults 65 and older, since
the Acts establishment in 2010. Data for the trendline
shown on this poster was taken from the CDC database. As
we can see, before the ACA was put into place, the
prevalence of myocardial infarctions was as high as 12.1% in
2001. This indicates that the prevalence of myocardial
infarctions were higher before there was funding for public
health organizations and prevention programs became
available. The trendline also shows a continual decrease in
the incidence of MI with continued finding. Without this
funding we have predicted that there will be no change.