LA Times

Dean,

Nice.

Yep, the prevention is funded through through a joint partnership with the NHS and local authorities (towns). The NHS, being a primary care focus rather than secondary or tertiary care, puts lots of resources into prevention.

Dean,

Sounds challenging and rewarding! How great to know your work prevents injury and improves the quality of care for citizens.

You said the falls prevention programme is mandated. Is it also funded? Does the UK fund prevention to the same degree it funds rehabilitation?

There is a move toward prevention here, too. The insurance agencies have prevention programs that they offer. They provide free phone counseling, but not the actual services. They used to cover 100% of the cost of annual physicals at given intervals and preventative testing beginning at specific ages. But now preventative coverage is the same as treatment for sickness except with a very low max coverage. So while they seem to be awakening to the need for preventative care, their actual coverage of it has decreased.

I've wondered how US insurance will ultimately cope with funding preventative care, especially with our failing economy. It makes sense that is costs less to prevent disease than to heal or manage it. But when you are already spending so many resources on the restorative end, where do you get the resources to fund the prevention? That is true for both insurances and individuals.

Janey, thanks for asking. Being that most of my PT career has been working with older adults, and that population is projected to skyrocket in most western countries over the next 2 decades, I imagine that will be the population that I will work towards affecting policy, educating about, and advocating for. For my final project for school I'm actually doing a needs assessment for an entire city with regards to the elderly and falls and laying the ground work for developing a falls programme. A falls prevention programme is already mandated by the Department of Health, but how it is developed is up to the locality. Eventually I could see myself influencing the built environment for older adults, community resources, care levels or nursing home regulations. This population needs immediate attention as they consume a vast quantity of resources. We need to ensure that they can age with dignity and optimal function whilst preserving resources for future generations. In short, we need to keep them out of the hospital. It is an interesting change to move from rehabilitation to prevention. But who better than us who know how impaired mobility and function happen better than anyone else?

I hope that answered your question.

Dean,

Thank for the comment. Always appreciate your insight.

What could your position in public health look like? I'm assuming there are different scenarios that could play, but one that is more favorable than the other?

Very good observation. Health inequalities are one of the driving forces behind public health, as is clean drinking water.

In my home country, there seems to be an attitude of "Why should I pay for your health care/drinking water/education/etc?" There is a profound erosion of our sense of community, not just with our global partners, but even with our fellow countrymen.

You're absolutely right, the money spent on lavish homes and numerous cars could easily fund clean drinking water for many around the world and still provide an impressive abode for those generous enough to share.

Thanks for reminding me why I'm transitioning to public health.