Whenever a budget crisis looms in Congress, policy wonks reflexively point to the tremendous impact of health care costs on our nation’s bottom line. Several weeks ago, Glen Mays, of the National Coordinating Center for PHSSR, and I met with congressional staff to discuss some of those budgetary impressions. This bi-partisan group didn’t leave with a step-by-step action plan to fix healthcare costs or half a dozen fact sheets advocating for a specific view, instead, we talked about how to find the best possible solution: evidence. Glen introduced the group to Public Health Services and Systems Research (PHSSR) and how this growing field answers questions about the organization, financing, and delivery of public health services within communities, and the impact of these services on the public’s health including reductions in some disease-specific mortality. This research paints a backdrop for evidence-based policy that is especially relevant in times of reform, fiscal and health states challenges, and new opportunities. As a former local and state health officer and current Deputy Chief Medical Officer at the American Heart Association, these findings are essential to my work today and would have been very useful in the past. For example, research has already told us that increased spending in public health has a strong association with slower growth in medical care costs. If I’m examining my local or state budget, I know that medical care costs are ballooning and would certainly consider a new direction to stem that tide. The evidence has also shown us that investments in public and community health can have unintended benefits, such as how bioterrorism preparedness efforts in Texas created a ready response to Hurricanes Katrina and Rita. Medical care is necessary but not sufficient for these instances, and while we believe that public health is an essential component for our communities to thrive, we need the research to demonstrate how we can maximize the impact of public health policies and services. The congressional staff at this briefing had a solid background of public health knowledge, and they were very interested in what kinds of questions PHSSR could answer. They want to know the evidence-base and how to build the evidence base. They want to hear about findings that will guide them to effective decision making. While I can show them how I’ve applied PHSSR in my work as a practitioner and policymaker, it is up to the research community to be more visible and disseminate their findings. There is a willing audience on Capitol Hill receptive to evidence, don’t let it go to waste.   Dr. Eduardo Sanchez is the Deputy Chief Medical Officer, American Heart Association and a member of AcademyHealth's board of directors.

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