Prevention and Public Health Fund

2. Why is the Prevention Fund necessary?
Today, seven in ten deaths in the U.S. are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease, and cancer, and 75 percent of our health care dollars are spent treating such diseases. However, only 3 percent of our health care dollars go toward prevention.

To adequately meet our prevention needs, and to control our unsustainable growth in health care costs, a 2012 Institute of Medicine (IOM) report recommended that we increase federal funding for public health and prevention by $12 billion annually, a doubling of the FY 2009 federal investment in public health.

A key first step toward meeting this need is the Prevention and Public Health Fund. According to recent research, this kind of investment has the potential to improve health outcomes and reduce costs. For example, every 10 percent increase in funding for community-based public health programs is estimated to reduce deaths due to preventable causes by 1 to 7 percent, and a $2.9 billion investment in community-based disease prevention programs would be estimated to save $16.5 billion annually within five years (in 2004 dollars). (FAQ top)

3. How much money is in the Fund?
The Fund is intended to provide a stable and increased investment in activities that will enable communities to stay healthy in the first place, and it was designed to gradually build from $500 million in FY 2010 to $2 billion per year by FY 2015. Despite a recent legislative reduction of $6.25 billion over nine years to help postpone a cut in Medicare physician payments, and some use of the Fund to replace existing appropriations, the Fund still represents a crucial investment in the health of our communities and in our nation’s long term fiscal health. (FAQ top)

4. How is the Fund being used?
So far, the Fund has provided $1.25 billion for prevention and public health activities: $500 million in FY 2010 and $750 million in FY 2011. Another $1 billion has been allocated in FY 2012.

Combining federal, state, and local programs:

• more than $385 million (31 percent) of FY 2010-2011 funding has gone toward community-based prevention activities such as those aimed at preventing tobacco use and encouraging healthy living;
• more than $220 million (18 percent) has supported clinical prevention activities such as those aimed at increasing immunization rates and decreasing HIV rates;
• nearly $480 million (38 percent) has gone toward public health infrastructure and workforce development needs such as public health training centers; and
• nearly $165 million (13 percent) has been spent on research and tracking activities such as environmental public health tracking.

Examples of funded activities include:

• Through the National Public Health Improvement Initiative, Virginia has achieved information technology savings of $1.2 million, seen a 32 percent increase in enrollment in the state’s Medicaid Family Planning Program, and realized an overall increase in efficiency.
• Through the Community Transformation Grant program, Iowa is expanding access to blood pressure and tobacco use screenings at dental practices to over 300,000 patients, increasing the number of referrals to the state’s tobacco quitline service, and targeting health interventions at the region of the state with the highest stroke mortality rates. (FAQ top)

More information about the Prevention Fund and citations for the above numbers are available in APHA's June 2012 issue brief on the Prevention Fund.

Additional resources
(includes key resources highlighted above; also see our Useful Links page)

APHA resources

• Issue brief: The Prevention and Public Health Fund: A critical investment in our nation's physical and fiscal health (PDF, June 2012)
• Fact sheet: Prevention and Public Health Fund: Dedicated to Improving our Nation's Public Health (PDF, updated April 2012) 

APHA statements, articles, and media mentions

• APHA's The Nation's Health: Prevention and Public Health Fund paying off in communities: Success threatened by cuts to fund (August 2012)
• GOVERNING: Report: ACA Prevention Fund at Work in State and Local Public Health (June 2012)
• APHA press release: Cutting prevention fund sets dangerous precedent and puts public health in peril (February 17,  2012) (See other APHA press releases)
• APHA: Letter to House and Senate payroll tax extension legislation conferees opposing any effort to use the Prevention and Public Health Fund as an offset for other programs (January 27, 2012) (See other APHA letters)

Other resources on the Prevention Fund

• American Cancer Society's Cancer Action Network: Staying Well: Real Stories from the Prevention and Public Health Fund (July 2012)
• Association of State and Territorial Health Officials: Updated chart of Prevention and Public Health Fund allocations, FY 2010 enacted through FY 2013 Senate mark (June 2012)
• Trust for America's Health: Prevention and Public Health Fund Advocacy Materials (compilation of resources, updated May 2012)
• Health Affairs: Health Policy Brief: The Prevention and Public Health Fund (February 2012, subscription-based)
• Healthcare.gov: Prevention and Public Health Fund state fact sheets (updated February 2012)
• Trust for America's Health: The New Prevention Fund (state-specific information, updated July 2011)
• Senate HELP Committee: Protecting the Prevention and Public Health Fund: backgrounder and talking points on the Johanns amendment (September 2010)

Research and reporting on prevention funding

• New England Journal of Medicine: The Cost-Effectiveness of Environmental Approaches to Disease Prevention (July, 2012)
• The Atlantic: We should be in a race for prevention, not cures (May 2012)
• Institute of Medicine: For the Public's Health: Investing in a Healthier Future (PDF, April 2012)
• Trust for America's Health: Investing in America's Health: A state-by-state look at public health funding and key health facts (PDF, March 2012)
• Health Affairs: Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths (August 2011, subscription-based)
• Health Affairs: Why Behavioral And Environmental Interventions Are Needed To Improve Health At Lower Cost (May 2011, subscription-based)
• Urban Institute: The Role of Prevention in Bending the Cost Curve (PDF, October 2011)
• Health Affairs: Greater Use Of Preventive Services In U.S. Health Care Could Save Lives At Little Or No Cost (September 2010, subscription-based)
• Organisation for Economic Co-operation and Development (OECD): Health care systems: Getting more value for money (PDF, 2010)
• Trust for America's Health: Prevention for a Healthier America: Investments in disease prevention yield significant savings, stronger communities (includes "return on investment" estimates of prevention spending) (PDF, February 2009)

For more information, visit our Useful Links page.

APHA is continuing to update its health reform website and resources. Please check back as we add new content and links to existing pages, as well as new pages.   

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