Jeremy Cantor, MPH, Program Manager, Prevention Institute
One of the most effective ways to reduce health care spending is by promoting prevention. In California alone, an investment of just $10 per person per year to promote physical activity, enhance nutrition, and prevent tobacco use could yield more than $1.7 billion in annual health care savings within five years. Across the country, chronic conditions like heart disease, cancer, stroke, and diabetes account for more than 75 percent of all health care spending. In an effort to lower these rates through community prevention efforts, $145 million for Community Transformation Grants (CTGs) will be awarded from the Prevention and Public Health Investment Fund created with the passage of the Affordable Care Act (ACA). The Centers for Disease Control and Prevention (CDC) will distribute the grants, and the bid process will emphasize effective collaborative work between cities, states, and community organizations.
Language in the ACA specifically mentions that activities funded by the CTGs can include “creating the infrastructure to support active living and access to nutritious foods in a safe environment,” reflecting the importance of improving safety to achieve community health. To promote equity, CTGs will require the reduction of health inequities for one or two specific populations in the community or state. To achieve this goal, innovation will be encouraged in responding to community needs and building a new evidence base for prevention strategies.
State and local jurisdictions, national networks of community organizations, state or local nonprofits, and Native American tribes will likely be eligible to apply for the grants, with partnerships encouraged. At least 20 percent of the grants will be awarded to rural and frontier areas, such as far northern California and parts of the Central Valley. The CTGs will also likely include a capacity building component for communities lacking the capacity or experience in community policy and environmental change. The capacity building will include training and technical assistance in establishing leadership and coalitions.
One way that CTGs can help communities is by funding programs that encourage physical activity. For example, the Fruitvale District of Oakland has one of the highest concentrations of children in the city yet the fewest after-school activities and teen centers. In response to an alarming 50 percent drop-out rate among Latinos there, several community groups approached the City of Oakland about partnering with them to establish the Fruitvale Neighborhood Sports Initiative at the City’s recreation center to increase physical activity in community youth. As a partnership between several entities aimed at improving health, the NSI is a perfect example of a program that would be eligible for a CTG.
The Prevention and Public Health fund is a smart investment that will pay off by promoting health and preventing people from getting sick in the first place. Supporters in Congress call prevention funding “one of the most significant cost controls in the health care legislation.” For every dollar we spend on prevention, we see a five-to-one return on investment in just five years. We simply can’t fix our economy without it.