In recognition of National Public Health Week, Dean Laura Siminoff offers her take on the direction of public health research and practice in the United States.  She argues that instead of investing the majority of our healthcare research funds into finding cures for diseases, we should look more closely at preventing those diseases in the first place. 

As a society, why should we focus on preventing diseases as well as trying to cure them? 

Some of our largest funding organizations invest pennies of our health care research dollar on prevention, compared to the billions of dollars we invest into creating drugs to treat or cure diseases.

If you said to me, “would you like me to provide you with the best care once you get cancer—or—maybe we could spend a little more money so you never get cancer.  What would you prefer?”  As a cancer researcher who works with cancer patients and their families, I would prefer never to get cancer.  If I have cancer, of course I want the best treatment available.  But shouldn’t we direct more of our health care research dollars into prevention to prevent as many people from getting cancer as possible?  Yes, I think we should.

Projects like the Precision Medicine Initiative, which seek to use genetics to “turn off” diseases, are currently getting the bulk of funding in health research.  Is there a better approach?

The Precision Medicine initiative is a very “sexy” idea, and it may yield some important results.  But let’s not forget how important it is to figure out how to get people to practice safe sex, so that they don’t get AIDS.  Or how to help the 17 percent of Americans who smoke to quit—because cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths every year.  Or how to reduce the epidemic of obesity that’s driving up the incidence of diabetes—the leading cause of kidney failure and new cases of blindness among adults. 

So what’s the important message when it comes to public health?

Let’s convince our legislators and people in the executive branch of our government that prevention is sexy too.  If we invested money in the real basics of people’s health, it would be so much cheaper.  If you don’t want to do it for issues of social justice, do it to save money.  Giving people access to decent, accessible health care is so much cheaper than having them show up at an ER, where it costs over $100 just to give them an aspirin.

How do you convince lawmakers that prevention is an effective approach, and that it’s worth investing in?

The statistics are there—it’s really obvious.  But we clearly don’t have a good enough lobby for it yet.  I think it’s a challenge for us.  That’s why we have a Health Services Administration and Policy Department here.  We need to train people who are expert in policy, who know how to take data that’s generated by researchers in a college such as this one, and how to communicate that and translate it into policy.  Thinking about issues in this way really is the heart and soul of public health.