QUESTIONS ABOUT COSTS, BENEFITS, AND THE EFFECTIVENESS OF HEALTH PROMOTION PROGRAMS
hough it may seem to some as if prevention has become T the dominant thrust of Federal health policy for the 1980s, it is unlkely that future historians examining the current era will one day consider an allocation of one-to-two percent of total health expenditures a major or even significant issue o f our time. Nevertheless, the subjects of prevention and health promotion are receiving considerable attention from the popular press as the media have diligently tried to discover the outline of a positive national health strategy from Reagan Administration pronouncements and Congressional testimonials.
Among the many messages emanating from Washington these days is that the general state of the nation's health, though relatively good, will be improved still further through the prevention of disease, disability, and untimely deaths (1). Constituent agencies of the U.S. Public Health Service and the National Institutes of Health have been mandated to reorganize their priorities and allocate some portion of their budgets to prevention initiatives. Only limited new dollars are expected for the support of these activities. The private sector, including practicing health professionals, is being encouraged to give more attention to prevention, and health science educational institutions are being asked to make voluntary curricular changes embracing these new emphases. Regardless of the real extent of such developments, there is the underlying presumption that health promotion/ disease prevention efforts have the potential to change human lifestyle and risk-taking behavior related to health. The expected improved health status suggests the possibility of considerable saving in expenditures for health care (2,3).
As the pressures increase for greater emphasis in public and private health programs on health promotion and disease prevention, it is expected that discussions will involve the 0 1982 by The Regents o f the llniversity o f C;ilifornia