Public Health is ROI: Saves Lives, Saves Money

Since 1995, when the first full week of April was
declared National Public Health Week, communities
across the United States have observed NPHW as a
time to recognize the contributions of public health and
highlight issues that are important to improving the
public’s health.
The American Public Health Association serves as the
organizer of NPHW and develops a national campaign
to educate the public, policymakers and practitioners
about issues related to that year’s theme. APHA creates
comprehensive planning, organizing and outreach
materials that can be used during and after the week to
raise awareness.
It’s hard to picture our lives without a strong public health
system. From the time we wake up until we tuck ourselves
in at night, the benefits of public health make all of our lives
healthier, safer and better. Whether it’s the drinkable water
that flows from our kitchen sinks, the safe food we buy at
the local grocery or the clean air we breathe on an afternoon
walk, the benefits of public health are — quite literally — all
around us.
hundreds of thousands of lives. Most states and hundreds of cities and
counties have adopted smoking bans in bars and restaurants. And less
than 1 percent of young children go without any vaccinations, resulting in
historically low rates of vaccine-preventable disease.
These investments not only improve our health and save health care
dollars; they’ve changed how we think about health. Today, it seems
entirely out of place to walk into a public establishment that allows
indoor smoking. Today, seeing someone not fasten a seat belt attracts
disapproving looks and reminders to buckle up. Today, an outbreak of
measles — a common disease before the discovery of a vaccine — is
startling, front-page news.
However, these successes cannot sustain and grow on their own. It
takes a robust public health system to protect the gains we’ve made and
ensure that all future generations have opportunities for good health and
well-being. Plus, confronting today’s big health threats, such as obesity
and chronic disease, will require a public health approach if we’re to
truly turn around these alarming trends.
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In the business world, a return on investment (ROI) refers to the amount
of profit made in relationship to the dollars invested. In the world of
public health, ROI is measured by the amount of health impact when
compared to resources invested, which may include direct funds,
infrastructure or personnel. The public health ROI can be measured
in lives saved, diseases and injuries mitigated or prevented and cost
avoided. Public health cost avoidance or savings may impact other
sectors of the economy and improve the quality of life for our nation.
There’s no doubt that investing in a resilient public health system is
smart in terms of dollars and cents. But the real value of public health
goes beyond numbers on a spreadsheet. It’s the baby girl who lives to
celebrate her first birthday thanks to the newborn screening program
that detected a genetic disorder early enough to treat it. It’s the teenager
who avoided a lifetime of disability because he knew to fasten his seat
belt. It’s the new mom who learned that breastfeeding will protect her
child’s health now and far into the future. And it’s the flu shot that kept
an aging parent out of the hospital and healthy at home.
This is the value of public health. There are few investments that reap
the far-reaching and life-changing results that investments in evidencebased public health do.
Consider this small handful of public health successes: Seat belt use
has gone from 11 percent in 1981 to about 85 percent in 2010 and saved
WE NEED YOUR VOICE. Current declines in public health funding are
threatening the health of our families, our communities and our country.
Help us spread the word that supporting public health is an investment
in the future prosperity of our nation. This National Public Health Week,
stand up for the value of public health.
• U.S. health care costs rose tenfold from 1980 to 2010 and are
expected to rise faster than national income during the foreseeable
future. However, investing just $10 per person each year in proven,
community-based public health efforts could save the nation more
than $16 billion within five years. That’s a $5.60 return for every $1
• Routine childhood immunizations save $9.9 million in health care
costs, save 33,000 lives and prevent 14 million cases of disease.
• A $52 investment in a child safety seat prevents $2,200 in medical
costs and results in a return of $42 for every $1 invested. Similarly, a
$12 investment in a child’s bicycle helmet prevents $580 in medical
costs and results in a return of $48 for every $1 invested.
• The cost of providing dental care for children enrolled in Medicaid
and living in communities without fluoridation is twice as high as for
children who receive the benefits of fluoridated drinking water.
DESPITE these statistics, federal, state and local public health systems
are losing ground. Today, what was supposed to be a new public health
investment — the Affordable Care Act’s Prevention and Public Health
Fund — is being used to backfill public health budget shortfalls and is at
risk of being eliminated entirely.
In 2013, the American Public Health Association is calling on you to join
communities nationwide as we celebrate NPHW and tell the stories
that illustrate how public health has made our lives healthier, safer and
better. We are all examples of the public health return on investment.
WE ALL HAVE A ROLE in supporting public health and in putting
prevention to work in our lives, whether it be at home, at school, at
work, while we’re on the move or in our communities. By making and
supporting the healthy choice, we can be living examples of the public
health return on investment.
Talk to friends and family to help raise awareness in your community
and among its leaders. Here are just a few ways to get involved in your
community during NPHW:
Health and prevention begin at home. From installing smoke and carbon
monoxide alarms to serving healthy meals to preparing your household
for an emergency, it’s no stretch to say that just a few easy steps can
mean the difference between staying safe, injury or worse.
It’s as simple as this: Healthy children learn better. From nutrition
standards in school meal programs to indoor air policies that reduce
asthma complications to reinstating physical education, schools are just
as important to teaching good health as they are to teaching reading,
writing and arithmetic.
Public health works hard for us. From smoke-free policies that protect
restaurant workers to safety standards that save the lives of construction
workers to simply posting hand-washing reminders that reduce the
spread of disease, public health means we don’t have to trade our health
and safety to support ourselves and our families.
Public health is the perfect traveling companion. It keeps drivers,
passengers and pedestrians safer through efforts that promote child
safety seat standards, educate on impaired driving and support lifesaving seat belt and helmet laws. And public health is becoming a pivotal
voice in the movement to design transportation systems that safely
accommodate and encourage all modes of travel, including walking,
biking and public transit.
Our individual health is tied to our community’s health. This is critical to
understand and impart to decision-makers as we call for a strong public
health system. Whether it’s the immunizations that prevent disease,
the tobacco bans that encourage people to kick a deadly habit or a new
pedestrian crosswalk at a dangerous intersection, public health has the
power to lift the health of entire communities.
• Educate yourself on public health. Because public health is always
working in the background, it can be easy to overlook. In fact, it’s often
said that the work of public health is invisible. Help make public health
visible by becoming aware of its many roles in our lives.
• Write a letter to the editor of your local newspaper about the
importance of public health in your life. For example, talk about a
tobacco cessation program that helped you quit smoking or a free flu
shot clinic that put the healthy choice well within reach.
• Support school policies that support healthy children and teach
healthy habits.
• Support public health through engaging in prevention. Form a
neighborhood walking group, encourage healthy food options at
workplace meetings, keep up with recommended vaccinations or
create a family emergency preparedness plan.
These are only some of the ways you can make a difference. Join APHA
today in support of public health. With a strong public health system by
our side, we can improve our nation’s health.
Identify local leaders who have been vocal on public
health measures and invite them to issue a proclamation
during NPHW. Encourage them to sign the proclamation
at a town hall meeting on the importance of supporting
a strong public health system.
 Attending and promoting NPHW events. Resources for
planning and publicizing activities are at
 Becoming a NPHW partner by signing up at
and linking to the site.
 Organizing an event and posting to the online calendar of
events at
 Collaborating with local partners and APHA’s Affiliates
( to promote NPHW.
 Publicizing NPHW on your Facebook,
Twitter and other social networking accounts.
Link to, the @NPHW Twitter
account and
 Communicating with local media about the importance of
NPHW and pitching local story angles.
 Engaging bloggers in a discussion about your local NPHW
 Educating your members of Congress about NPHW by
sharing resources from