This article was co-authored by Bill McInturff, partner and co-founder, Public Opinion Strategies AND Al Quinlan, president Greenberg Quinlan Rosner Research

Quit smoking.  Eat right.  Exercise more.  For years, you’ve heard this from your family, your doctors, your teachers, your friends.  Now, you can hear it on pretty much any street corner in the country. A recent survey we conducted[1] provides compelling evidence that Americans have rejected “sick care” and are demanding that we work to keep people healthy in the first place, rather than treating them once they get sick.

Prevention is a popular notion these days, and perhaps it’s not particularly surprising that people want more of it.  When we asked people whether or not we should invest more in prevention[2], a big majority (76 percent) said yes, against just 16 percent who said no.  This is truly an overwhelming level of support for any initiative-it’s rare to get three-quarters of the country to agree on anything these days (much less on something that involves spending more money)-and it underscores the importance Americans place on prevention as part of their health care and their lives.

Now for those of you who would ask if it is just certain parts of the population who support this, our answer would be, “No.”  At least 65 percent of every demographic subgroup supports increasing our investment in prevention.  From coast to coast (79 percent in the Northeast, 78 percent in the South, 76 percent in the West, and 72 percent in the Midwest) and across the political spectrum (86 percent of Democrats, 71 percent of Republicans, and 70 percent of Independents), people believe we should invest more in prevention.  Even two-thirds of the least healthy among us[3] want a greater investment in prevention.

The importance the country places on prevention represents a real change in attitudes toward health in this country over the past couple decades.  In 1987, 45 percent of the country believed we should be giving more emphasis to prevention (11 percent wanted more emphasis on treatment).  Today, 59 percent say we need more emphasis on prevention, an increase of 14 percentage points in the prevention column (a real shift, albeit occurring over 20 years).

No good discussion of any type of program would be complete without discussing the always-burning question-what about the costs?  Does the cost associated with investing in prevention dampen support for it?  It doesn’t appear to.  By a wide margin (77 – 16 percent), Americans believe that prevention will save us money, rather than cost us money.  But saving money isn’t the real reason they want more prevention-health is.  Seventy-two percent say that “investing in prevention is worth it even if it doesn’t save money, because it will prevent disease and save lives,” while only 20 percent feel that investing in prevention is not worth it if it doesn’t save money.  When it comes to prevention, it’s less about cost and more about reducing disease, keeping people healthy, and improving quality of life.

But clearly, this is not just about trying to convince individual people to put down the junk food and cigarettes and hit the gym.  It’s also about making it easier for people to make healthier choices.  And there are policy implications here.  Health care reform begins to make its way through Congress at a time when 72 percent of the country thinks we’re becoming less healthy and 60 percent believe that the American health care system needs a complete overhaul or major reform.

So we put prevention up against five other specific health care reform proposals to see where it ranked, including a national insurance pool, tax credits to small businesses and prohibiting health insurers from denying coverage based on health status, all of which have attained some level of popularity in recent months.  Investing in prevention trumps them all, ranking as the top health care reform priority of the national electorate (70 percent say it is a very important priority).

At the end of the day, we’re left with a relatively simple conclusion:  the public wants a greater investment in prevention, and it ought to play a significant role in creating legislation that will help determine the direction of health care in our country.

[2] Prevention was defined for respondents as “providing people with information and resources and creating policies that help people make healthier decisions.”

[3] Least healthy is defined as scoring between 0 and 5 on the health scale, and falling into at least 2 of the 3 following categories: currently a smoker, had 5 or more drinks in the past week and/or exercise a few times a month or less.

Related blog post:

RWJF Health Reform blog