14862 6/9/05 3:19 PM Page 1 T RI-COUNTY H EALTH D EPARTMENT An Ounce of Prevention... What Is It Really Worth? A NNUAL R EPORT 2004 14862 6/9/05 3:19 PM Page 2 An Ounce of The Times, They Are a Changing An Apple A Day ublic health’s prevention efforts have had 50¢ Prevention Is Worth a dramatic influence on health in the a Pound of Cure PUnited States. During the early 1900s, infectious diseases were the main causes of death and disability throughout the world. In t’s an old, familiar saying … but what is it the first half of the 20th really worth? Just what does prevention century, most Americans cost and how much does it save – both in died from pneumonia, 2004 Per-Capita I County Contribution to terms of money and lives? influenza, tuberculosis or Tri-County Health Dept. diarrheal diseases. $5.74 Dollars and Sense As a result of the wide use of immunizations and ri-County Health Department seeks to better sanitation and improve everyone’s health, and do it in housing conditions, we have controlled many economically responsible ways. deadly infections and eradicated others by T preventing them. We promote good health at a reasonable cost. Aspirin for Cardiovascular Health Since public health resources are limited, we Today, the leading causes of death are chronic 1¢ often focus on prevention strategies that yield diseases such as heart disease, stroke, cancer the most benefit for the investment. and diabetes – yet these are often preventable. Fully 70 percent of all Americans who die each Preventive health is based on the belief that it year die of a chronic disease … and cancers is better to avoid having a disease or disability and cardiovascular diseases together account than to treat one. Spending money to prevent for half of all these deaths. Cost of Auto Safety disease and promote healthy lifestyles makes Equipment Per New Car good economic sense. $839 Tragically, many of these illnesses could have been prevented, or at least have been treated For example, the with early screening and intervention. They measles-mumps-rubella include lung cancer and stroke caused by vaccine saves up to tobacco and high blood pressure, heart disease $16.34 in direct and diabetes from obesity. Though heart medical costs for each attacks and strokes seem like sudden events, Water Purification and dollar spent. It’s Fluoridation they may actually have been years in the making. .00001¢ estimated that every dollar spent on Unfortunately, infectious diseases still remain influenza shots for a threat. Forty thousand people die of older adults saves up to pneumoccal pneumonia in the United States $60 in hospitalization each year, making it the leading cause of death costs. And for each among vaccine-preventable diseases. Yet only dollar spent on drinking water fluoridation, Yearly Influenza Shot 46 percent of Americans over the age of 65 $15 up to $80 is saved in dental treatment costs receive the pneumoccal vaccine. for children. In addition, emerging infections such as Prevention is one of the most important yet Severe Acute Respiratory Syndrome (SARS) most neglected topics in modern health care. and West Nile virus are constantly appearing. We can save millions of lives and billions of Others, such as malaria, tuberculosis and dollars by helping people change unhealthy bacterial pneumonias, are now appearing in Penicillin and Subsequent Antibiotics – behaviors. But how do you get people to forms that are resistant to drug treatments. Priceless change old habits? We must remain vigilant and responsive. 1 14862 6/9/05 3:19 PM Page 3 Good, but Not Good Enough There’s Strength in Numbers ore Americans are living longer, ri-County Health Department is the Disposable Latex Gloves healthier lives than at any time in largest local health department in 9¢/pair Mour history, but we can do better. TColorado, serving the 1,030,000 residents of Adams, Arapahoe and Douglas Counties. Some of our programs are supported by federal and state funds or by grants, but just how much does all of this cost the Individual local taxpayer? Sterile Germ Barrier 4¢ $5.74. That is how much each of our three counties contributes to our budget per Despite impressive gains, Americans live resident. Talk about a good investment! shorter, less healthy lives than people in most Chicken Soup other industrialized countries. As you will read in this report, our 49¢ accomplishments in 2004 are impressive. Part of the problem is that the United States We are committed to developing innovative needs to think differently about the prevention programs that reduce the health and economic of diseases. Most people only see a doctor consequences of disease and injury, ensuring a when they are sick or hurt. long, healthy life for all people. Folic Acid to If You Have Your Health, You Have Prevent Birth Defects Medical care is primarily curative. Public 1.5¢ health is primarily preventive. We need Everything medical care some of the time, but we need public health all of the time. Sadly, only about Throughout this annual report we highlight 1% of health care expenditures are devoted to many public health products and services. Disposable Syringe public health prevention efforts. Most are very low-cost or completely free to 41¢ consumers, and all are a terrific value. Sometimes, Cheaper Is Better So when it comes to an ounce of prevention, what is it really worth? ... Priceless. overty and lack of education are at the root of many health issues. However, Sharps Container for many health problems can be prevented Bloodborne Hazards P $4 through amazingly simple and extremely inexpensive methods: protection from environmental hazards; handwashing to stop the spread of germs; immunizations to prevent disease; birth control to prevent unplanned pregnancies; prenatal care to improve birth Child-Resistant outcomes; and good nutrition throughout all Safety Caps stages of life. 9¢ Some of the most effective tools to prevent and fight disease – vaccinations, mammograms, colon cancer screening, Pap tests, tobacco cessation, cholesterol tests and blood pressure checks – are inexpensive but Tri-County Health Department – massively underused. Priceless 2 14862 6/9/05 3:19 PM Page 4 hantavirus, plague, rabies and West Nile virus; and other Germ Warfare dangerous diseases and conditions such as encephalitis, meningitis, toxic shock syndrome, SARS and tuberculosis. Control of Communicable ri-County Health Department helps prevent Diseases manual infectious diseases that can be spread by person- In 2004, Tri-County Health Department conducted $21 to-person contact, by animals or through food T 880 notifiable disease investigations including a record and water. These include such serious diseases as E. coli, number of reported pertussis cases – 273 cases in the hepatitis A, meningitis and pertussis (whooping cough). Tri-County area out of 1,214 in Colorado. This outbreak also occurred nationally. Improvements In an outbreak, the Tri-County Health Department in vaccination rates could help reduce the burden disease control staff trace the cause of an illness to its of disease. source, determine who else is at risk, and put control measures into Mosquito Larvacide $6 We utilize our Health Alert place … such as Insect Repellent Network (explained on page with DEET $4 immunizing the 6) to distribute the Public at-risk population, Health Update, a newsletter issuing glove containing timely public orders for health warnings and restaurant workers information for health or establishing care providers. quarantines. A combined system of surveillance, reporting and FightTheBiteColorado.com In 2004, we published 6 West Nile Virus control is very effective in preventing widespread editions of the Update. Prevention Education outbreaks, and is practiced by virtually all health Topics included pertussis, Campaign – $0 departments across the nation. West Nile virus, influenza surveillance, foodborne Health care providers and laboratories are required by illness outbreaks and adult obesity. You may view past law to report a total of 65 different diseases to us, Updates and other disease prevention and control whether suspect or confirmed. materials at www.tchd.org/disease.html. These include 11 vaccine-preventable diseases such as measles, mumps, whooping cough, poliomyelitis and Rub-A-Dub-Dub tetanus; 16 different foodborne illnesses including Various Immunizations botulism, E. coli and hepatitis A; five sexually- urprisingly, the most important thing that you can $15 - $75 transmitted diseases including HIV/AIDS, gonorrhea do to keep from getting sick is to wash your hands. Free to Qualifying Clients and syphilis; 13 animal-borne illnesses such as SWith frequent handwashing, people wash away germs that they may have picked up off of contaminated surfaces, from E.coli O157:H7 Select Notifiable Diseases: other people, or from animals and 11 2004 vs. 5-Year Median animal waste. In addition to colds, 19 some potentially serious diseases – Mousetrap Giardiasis like influenza, hepatitis A, meningitis 49¢ 130 and E. coli – easily can be prevented 129 if people make a habit of washing their hands. Hepatitis A 9 Handwashing also prevents those 21 infected from transmitting their Hepatitis B, Chronic infection to others through food Handwashing with Soap 211 preparation or close contact. 1¢ 192 Meningococcal Disease Simple handwashing can save a lot on 5 medical bills. Since an application of 7 soap costs less than 1¢, a single penny’s worth of prevention can avert Pertussis (Whooping Cough) a $50 visit to the doctor’s office … 264 or thousands of dollars in hospital 112 bills. So rub-a-dub-dub, don’t forget Healthy Citizens – Three County Totals, 2004 5-Year Median, 1999-2003 to scrub! Priceless 3 14862 6/9/05 3:19 PM Page 5 medication, visiting a physician more often and being Through Thick and hospitalized more often.