Task Force on Prevention

The burden of chronic disease in North Carolina signifies a need to make dramatic improvements in population health. Investing in prevention can reduce this heavy burden by saving lives, reducing disability, and, in some cases, by reducing health care costs. The NCIOM’s Prevention Task Force studied the leading causes of death and disability in the state and developed evidence-based recommendations to address the preventable risk factors underlying these leading causes. This report presents the findings of the Task Force’s work and recommendations to improve population health in North Carolina over the several years.
Full Report | Executive Summary | Issue Brief | Chapters | Errata Issued 07-2010 | Prevention Action Steps
Jeffery P. Engel, MD
State Health Director, Division of Public Health
North Carolina Department of Health and Human Services
William L. Roper, MD, MPH
CEO, University of North Carolina Health Care System
Dean, University of North Carolina School of Medicine
Robert W. Seligson, MBA
Executive Vice President and CEO
North Carolina Medical Society
Project Director  Jennifer Hastings, MS, MPH
Project Director
NC Institute of Medicine
North Carolina spends a greater percentage of its gross state product on health care than is spent nationally (13.8% versus 13.3% nationally), but fares poorly in overall health rankings. North Carolina is close to the bottom in state rankings (40th out of 50 states and DC) in terms of life expectancy at birth. North Carolina is also 38th in years of life lost, 36th in the number of deaths per 100,000, and 36th in terms of overall health rankings. The burden of chronic disease and other preventable ills in our state is skyrocketing. As our health worsens, costs to both the individual and the system as a whole are rising.

The leading causes of mortality and morbidity for adults are chronic diseases such as heart disease, cancer, and cerebrovascular disease. Injuries are one of the leading causes of death for younger age groups. The best way to treat these diseases and injuries is to prevent them from occurring in the first place. However, as in many places, health care spending in North Carolina is drastically skewed toward paying for therapeutic procedures to manage or treat acute or chronic health problems. As a state, we have not invested heavily in the population-based interventions that can help keep healthy people healthy and can help keep those with poor health conditions from becoming unhealthier.

The overarching goal of the Task Force was to develop a North Carolina Prevention Action Plan to help guide the Division of Public Health and community organizations in prioritizing their prevention efforts. The Plan can also be used to help guide foundation grant making and new legislative funding.

To accomplish this goal, the Task Force
1) Comprehensively examined the preventable, underlying causes of the 10 leading causes of mortality and morbidity in the state.
2) Examined health disparities.
3) Prioritized prevention strategies to improve population health using evidence-based and best and promising practices.
4) Developed a comprehensive approach to prevention that includes strategies to address the four factors impacting health outcomes.

The NCIOM Task Force on Prevention met from April 2008 to August 2009 to develop the NC Prevention Action Plan. The work of the Task Force culminated in a one-day summit to announce the Prevention Action Plan. Summit attendees included policy makers, public health leaders and practitioners, health professionals, insurers, and business and community leaders.

Collaboration and Support
The Prevention Task Force was a collaborative effort of the North Carolina Institute of Medicine and the Division of Public Health, North Carolina Department of Health and Human Services. Generous support for this project was provided by the four major health foundations in North Carolina, which include
-Blue Cross and Blue Shield of North Carolina Foundation
-Kate B. Reynolds Charitable Trust
-NC Health and Wellness Trust Fund
-The Duke Endowment