Half of Americans missing their ounce of prevention

Preventive care, when based on solid evidence, can save lives and money. So we were disconcerted to learn about the findings of a just-released report from the Centers for Disease Control and Prevention (CDC). Nearly half of all Americans did not receive routine clinical preventive services, according to the report based on data collected prior to 2010. The purpose of the report was to establish a baseline for such services before implementation of any healthcare reforms included in the Affordable Care Act of 2010.

The findings of this report indicate that tens of millions of people in the United States have not been benefiting from key preventive clinical services, and that there are large disparities by demographics, geography, and health care coverage and access in the provision of these services, wrote CDC director Dr. Thomas R. Frieden, in his foreword to the report. For instance, only 46 percent of people with coronary heart disease were prescribed aspirin or antiplatelet therapy to prevent exacerbations of heart symptoms or heart attack, and just 43 percent of adults with hypertension had their blood pressure under control. And how many adults had received the influenza vaccine? Only 28 percent. The statistics for at least some preventive measures are, thankfully, a bit less bleak: 70 percent of adults for whom cholesterol screening had been recommended were actually screened, and 87 percent of adults diagnosed with diabetes reported keeping their blood sugar status at an acceptable level.

As the report concludes, aside from the evident changes that need to occur among communities and public health institutions, both healthcare providers and patients need to be more responsible. "Hypertension is the most significant silent killer in the U.S," Dr. Ross points out. "It's the underlying cause of numerous cardiovascular events, including heart attack and stroke. And patients themselves need to be aware of their options. Getting a flu vaccine, finding out whether a daily aspirin is right for you, getting your cholesterol checked: these are all basic but important steps that most people can take to prevent more serious problems."

And as for quitting smoking, for which only 7.6 percent of patients were prescribed any kind of tobacco cessation medication, ACSH's Dr. Gilber Ross shakes his head. "Of course doctors need to emphasize to their patients the importance of quitting smoking, he says. While the actual medications currently on the market don't actually help smokers to quit very effectively, that s no excuse for caregivers to simply forgo advising their smoking patients to quit, and to get them in the mindset of succeeding, eventually. Maybe someday clinicians will learn about using reduced risk nicotine delivery systems to really help them quit.