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TalkingNutrition

Providing perspectives on recent research into vitamins and nutritionals

dga-2015

Who Wants to be a Statistic? Follow Expert Recommendations

By Michael McBurney

The majority of health costs globally are spent treating rather than preventing sickness.  Vaccines are effective  preventions against a range of communicable diseases whereas nutrition prevents non-communicable diseases. Based on proven effectiveness, the Advisory Committee on Immunization Practice has made recommendations for vaccinations, now up to 17 vaccine programs, since 1964. Similarly, Dietary Guidelines, first issued in 1980, identify nutrition-related public health nutrition concerns and provide guidance to help people eat a healthier diet. Reviewed and updated every 5 years, the most recent are the 2015 Dietary Guidelines.

In a systematic review of 12 vaccination interventions for estimated reach, cost to implement, and cost effectiveness, Jacob and colleagues characterized the following intervention categories:

1) Interventions intended to enhance access by reducing financial barriers: 1) home visits to increase vaccination rates, 2) programs reducing client out-of-pocket costs for vaccinations, 3) vaccination programs in schools and organized day cares, and 4) vaccination programs in the USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

2) Interventions that increase demand: 1) client reminder and recall systems, 2) client or family incentive rewards, 3) vaccination requirements for children to attend child care, schools,  and college, and 4) community-based interventions implemented in combination.

3) Provider- or health system-based interventions to increase vaccination receptivity: 1) provider reminders, 2) provider assessment and feedback, 3) standing orders, and 4) healthcare system-based interventions implemented in combination.

Interventions with the greatest reach are those implemented by health systems – health plans, hospitals, and health care centers, and within non-medical organizations such as schools. Programs utilizing client incentives and reducing client out-of-pocket costs, home visits, and combined community-based interventions were the most expensive. Reminder systems, whether for providers or patients, were the cheapest.

Intervention Strategy

Median Cost per Person per Year (US$)

Median Cost per vaccinated person (US$)

  Managed Care Organization

$1.20

$13

  Clinic

$4

$32

  Hospital

$7

$71

  School

$21

$32

  WIC program

$22

$80

  Community

$46

$617

  Homes

$149

$129

  Pharmacy

$2

$19

The unfortunate fact is that many people do not adhere to vaccination or dietary recommendations. Following vaccination and dietary recommendations saves the lives of children and adults. Don’t become a statistic.

Main Citation

Jacob V, Chattopadhyay SK, Hopkisn DP, Morgan JM, Pitan AA, Clymer JM, and the Community Preventive Services Task Force. 2016 Am J Prev Med doi: 10.1016/j.amepre.2015.11.003


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