Commentary: Texans lose millions in prevention funds without Obamacare


Despite tremendous improvements in the 20th century, the U.S. is still far from being the healthiest nation. According to a recent Commonwealth Fund report, we spend far more on health care than any other high-income country, but our lives are shorter and less healthy.

We must treat those who are sick and injured. But to become a healthier nation, we must also invest in prevention and wellness to prevent people from becoming sick in the first place. The Prevention and Public Health Fund — a key part of the Affordable Care Act — is a unique program doing just that. By keeping people healthier, costs are saved as well.

The fund — our nation’s largest single investment in prevention — has provided more than $6 billion since 2010 to support a variety of public health activities in every state; Texas alone has received over $124 million. This includes initiatives that detect and respond to infectious disease threats including Ebola, influenza, and hospital-acquired infections, prevent lead poisoning, fight obesity and curb tobacco use.

Some of the investments in Texas supported by the Prevention Fund include $5.24 million to fund the Childhood Obesity Research Demonstration (CORD) Project, a partnership between academic institutions, hospitals, and public health agencies as well as community organizations in Austin and Houston. CORD aims to reduce the number and percentage of children ages 2-12 years who are overweight or obese and decrease the prevalence of chronic disease associated with unhealthy eating and lack of physical activity.

Another Texas program thanks to the Prevention Fund was a $1.5 million grant to the city of Houston focused on impacting community livability and health through policy, environmental and system interventions for the city and Harris County. Austin Health and Human Services Department also received over $3 million to work to address the needs of the residents — with a special focus on populations with heath disparities. The Healthy Austin Program focused on increasing access to parks, playgrounds and trails, enhance the built environment to support healthy living, create tobacco-free environments, and create accessibility, identification and affordability of healthy foods.

Some programs strengthen Texas as a whole. The Texas State Department of Health Services received over $1.3 million to prevent, detect and respond to disease outbreaks, including those caused by influenza and foodborne pathogens. Texas received over $4.8 million in fiscal year 2015 to improve access to vaccines, including through a program which provides a vaccine safety net to uninsured, low-income adults. These funds help state and local public health departments purchase vaccines for uninsured Americans, monitor the safety of vaccines and respond to disease outbreaks through investigations and rapidly vaccinating at-risk unvaccinated populations.

It is clear that the Prevention Fund is already having a profound impact on the physical and economic health of communities here in Texas and across the country — particularly those struggling with rising rates of heart disease, stroke and diabetes — by supporting programs that improve American diets, increase physical activity and reduce tobacco use. The fund is helping to create healthier communities, schools, workplaces and homes by making healthy living easier.

However, all of this progress is at risk. Congress is vowing to repeal the Affordable Care Act — and with it the Prevention and Public Health Fund. Repealing the prevention fund without providing a corresponding increase in public health funding would result in a major loss of funding for core public health programs. The fund makes up more than 12 percent of the Centers for Disease Control and Prevention’s annual budget and is integral to helping states keep communities healthy and safe. Eliminating the fund would make it extremely difficult for our local Texas health departments to prevent disease and injuries.

Public health and prevention efforts save lives and save money. It is imperative that we maintain the funding made possible by the Prevention and Public Health Fund so we can make the U.S. the healthiest nation by investing in prevention and well-being and restraining the growth of health care costs as Congress originally intended.

Troisi is an infectious disease epidemiologist at the University of Texas Health Science Center at Houston School of Public Health and chair of the American Public Health Association Action Board.



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