STATE OF THE USA HEALTH INDICATORS: LETTER REPORT by Institute of Medicine of the National Academies

Author:Institute of Medicine of the National Academies
Language: eng
Format: epub
Tags: Health and Medicine : Public Health and Prevention. Health and Medicine : Policy, Reviews and Evaluations
Publisher: NATIONAL ACADEMY PRESS
Published: 2009-02-17T00:00:00+00:00

Preventive Services

Indicator: Percentage of adults who are up-to-date with age-appropriate screening services and flu vaccination. Clinical preventive services include health care interventions designed to prevent the occurrence of disease or to detect disease that is already present. The term clinical refers to the fact that these services are provided to individuals one at a time, usually in clinical settings, rather than to communities or populations. Immunizations are a classic example of preventive services; colonoscopy is a clinical service that is considered both screening and prevention because pre-cancerous lesions can be removed before colon cancer develops. The term “screening” refers to the use of one or more diagnostic tests to detect disease in an early stage, before it causes symptoms and before it has caused serious or irreversible health problems. Clinical preventive services also include counseling and chemoprophylaxis.

Screening services have been found to improve health and reduce health care expenditures. For example, HIV screening in pregnant women greatly decreases mother-to-child transmission rates (Chou et al., 2005) and mammography has reduced mortality rates from breast cancer in women 40–75 years of age (Humphrey et al., 2002). According to the CDC, “Preventive screenings are an important part of health promotion efforts. Many preventive screenings have been recognized as a cost-effective way to identify and treat potential health problems before they develop or worsen” (CDC, 2007b). A study by Maciosek and colleagues (2006) that studied the health impact and cost-effectiveness of colorectal cancer screening found that for people aged 50 and older, screening for colorectal cancer at recommended intervals would prevent 18,800 deaths. They concluded that “colorectal cancer screening is a high-impact, cost-effective service used by less than half of persons aged 50 and older.”

Vaccination against influenza is another cost- and health-enhancing measure. The CDC notes, “Influenza vaccination is the most effective method for preventing influenza virus infection and its potentially severe complications” (CDC, 2008h). Rates of serious illness and death from the influenza virus infection rates are highest among children less than 2 years old, people 65 and older and those with serious medical conditions. From 1990 to 1999 the annual average number of deaths from influenza was 36,000 while from 1979 to 2001 there were 226,000 hospital admissions were associated with influenza (CDC, 2008a). The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccination for all adults, but especially for those who are at high risk for influenza complications or in close contact with persons at high risk (see Box 3) (CDC, 2008e).

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