Health Promotion FIRST

Health Promotion FIRST

Background

Health Promotion FIRST (Funding Integrated Research Synthesis and Training) ACT was first introduced by Senators Lugar (R-IN) and Bingaman (D-NM) in the 108th Congressional Congress as Senate bill 2798 and were reintroduced in the 109th, 110th and 111th Congresses. The bill was sponsored by Senator Richard Lugar (R-IN) and introduced on March 13, 2007. This bill provides for increased planning and funding for health promotion programs of the Department of Health and Human Services.

This bill never became law as a stand alone bill, but key provisions were included in the Patient Protection and Affordable Care Act of 2010 and have become law. This bill was proposed in a previous session of Congress. Sessions of Congress last two years, and at the end of each session all proposed bills and resolutions that haven’t passed are cleared from the books. Members often reintroduce bills that did not come up for debate under a new number in the next session. Portions of these bills, as noted below, were enacted in the Patient Protection and Affordable Care Act of 2010.

Bill Description

Health Promotion FIRST (Funding Integrated Research Synthesis and Training) ACT will provide a more strategic and cost effective federal plan to enhance the science and practice of health promotion. The result will be more efficient use of federal resources, more equitable funding opportunities for the broader public health community, better program outcomes and improved health of the population. The cost of this legislation is zero.

1. Strategic Planning

No cost; supported by Secretary’s discretionary budget. Requires the Department of Health and Human Services (DHHS) to seek input from diverse perspectives in setting health promotion goals and developing a strategy to achieve these goals. Strategic plans are required in six specific areas. How to best: 1). develop the basic and applied science of health promotion; 2). Synthesize and disseminate health promotion knowledge to scientists, practitioners and the public; 3). support and develop the health promotion professional and scientific community; 4). integrate health promotion efforts within the DHHS; and 5) serve the needs of people in rural and low income inner city settings. Additionally each member of the President’s cabinet will be challenged to explore how to best harness the authority and resources of their department to improve health.

Why is this important? Lifestyle related diseases are responsible for 40%50% of all premature deaths, 80% of chronic diseases, and 25%50% of all medical costs in the United States, yet federal planning for health promotion is incomplete. Furthermore, most health promotion efforts have been developed by practitioners rather than scientists. As such, many efforts lack a solid conceptual framework supported by empirical findings. They are often dominated by narrow educational and medically driven approaches that limit program success. People’s lifestyle practices are influenced by many factors beyond their knowledge and the services they receive from health care providers. To be successful in developing and maintaining healthy lifestyles, people need to live in environments that support their efforts to eat right, be physically active, manage stress, avoid abusive substances, and practice appropriate medical self care. The most effective strategies will be developed through thorough strategic planning that draws on the expertise of diverse disciplines, and many of these strategies can be implemented using the existing resources and authority of the departments of the federal government.

2. Enhancing the Science of Health Promotion

No cost; supported by the discretionary budgets of the Directors of the National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC) and the research budget at NIH.

Basic Research. Requires NIH to develop a health promotion research agenda, and overtime, to allocate research funds cost effectively, based on the burden of disease. Why is this important? A well designed plan is necessary to effectively mobilize the research community to address important health promotion basic research questions and to secure appropriate funding for health promotion research.

Applied Research Agenda. Requires CDC to develop a health promotion research agenda.

Why is this important? A well designed plan is necessary to effectively mobilize the research community to address important health promotion applied research questions.

Selection of Prevention Research Center Program Grant Recipients. Conveys full authority to CDC to set eligibility criteria and select organizations to receive Prevention Research Center grants. Also explicitly states that any qualified organization is eligible to apply. This removes restrictions that had previously limited CDC to selecting winners from a small pool of institutions.

Why is this important? This levels the playing field and maximizes opportunity for the broader public health community, and provides CDC open access to all the talents and diverse perspectives it needs to help solve the health problems of the nation.

3. Attracting the Best Talent and Avoiding Big Government

No cost.

Attracting the Best Talent. Calls for more focused efforts to attract the most qualified scientists and practitioners to perform the work described in this legislation.

Why is this important? Many of the most talented health promotion experts are practitioners in community, workplace, school and clinical settings. They focus on program delivery and are rarely tied into federal policy efforts. Involving them will help programs reflect the needs of the community and the realities of practice and ultimately will improve program outcomes.

Avoiding Big Government. Clarifies that the overall priority of this legislation is to develop a sustainable health promotion infrastructure among universities, research institutions, nonprofit and for profit organizations, not to increase the size of local, state or federal government agencies.

Why is this important? The federal government sometimes tramples existing fragile infrastructures when it rapidly expands investments in emerging fields. This leaves the field decimated when federal funds are withdrawn, or saddles the federal government with unsustainable long term funding obligations.

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