An ounce of prevention.... : what are the returns? 2nd ed.
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    In 1996, the Centers for Disease Control and Prevention (CDC) celebrated its first half century of working to safeguard the nations health. While specific health threats have changed over time, the fundamental challenge remains the same. CDC strives to improve the quality of people's lives by preventing disease, injury, and disability through collaboration with public and private partners throughout the world.

    As the nation's prevention agency, CDC seeks not only to improve health, but to do so in economically responsible ways. In times of limited human and financial resources, public health efforts should focus on areas that yield the most benefit for our investment. Many prevention interventions, particularly at the community levels, are excellent strategies for promoting good health at a reasonable cost. A standardized approach to evaluating the economic impact of public health programs and policies is vital for obtaining comparable information.

    Prevention effectiveness research provides a sound economic perspective for guiding public health decision making and resource allocation. Few things of benefit to society are either truly cost saving or free. For example, the maintenance of a national defense system costs billions of dollars; it is in place because the resulting security is deemed worth that cost. Similarly, public health should be held to the appropriate investment standard of reaping reasonable benefits as a result of the money expended.

    All of the health interventions presented here contribute to people leading longer, healthier lives, and often result in considerable financial savings. Some childhood vaccines, for example, generate a savings of up to $29 in direct medical costs for every dollar spent. Other interventions, such as yearly mammograms, carry a net cost, but are still considered cost-effective because they provide reasonable value for the money invested.

    For each prevention strategy in this publication, the following information is presented: the impact of the related disease, injury, or disability on U.S. society; the prevention strategies and their effectiveness; the costs incurred due to the disease, injury, or disability; and the cost-effectiveness of the intervention. While articles were selected based upon an extensive search and rigorous evaluation, the information presented here is limited by the methods, assumptions, and accuracy of the original research. The reader is referred to the Appendix for a description of the assumptions and variables of the articles citing cost-effectiveness data. Original publications should be consulted when a more thorough understanding is needed. Similarly, many of the studies cited were conducted in selected populations, and caution needs to be exercised in generalizing the findings. Clearly, continued research is essential to demonstrate the effectiveness and value of these and other public health strategies.

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