Prevention in public health: What works?

Glorian Sorensen
Glorian Sorensen, professor of social and behavioral sciences

May 21, 2014 — No other industry of the size and complexity of the U.S. health care system operates with so little understanding of the results of its investments, Dean Julio Frenk told an audience gathered May 15, 2014 at Harvard School of Public Health (HSPH) for a symposium on what works in health care. “That is why comparative effectiveness research is absolutely critical,” he said.

Comparative Effectiveness Research (CER) — the comparison of existing health interventions to determine which works best and provides the greatest value —gained attention when it was included as an initiative passed as part of the Affordable Care Act, but the field has a long history at the School. Efforts include the influential Center for the Evaluation of Clinical Procedures, launched in 1972, and the current work of the Center for Health Decision Science, as well as research in biostatistics, clinical epidemiology, and other departments. The School also offers training in the field through the long-running summer program in Clinical Effectiveness for physicians. In 2010, Dean Frenk named CER one of his Flagship Initiatives.

“We believe that public health interventions should be part of the comparative effectiveness agenda,” said Milton Weinstein in his opening remarks at the symposium, “Beyond the Affordable Care Act: What Works Best in Public Health?” Weinstein is Henry J. Kaiser Professor of Health Policy and Management and chair of the Dean’s Flagship Initiative on CER. The event, which was held in the Martin Conference Center at Harvard Medical School, highlighted research at HSPH — on topics including vaccines and dietary policies — that demonstrates the effectiveness and value of interventions that prevent disease and premature death.

Francesca Dominici, professor of biostatistics, described research she and colleagues are doing on power plants to document whether switching from coal to natural gas over the past 20 years has reduced particulate emissions and saved lives.

Glorian Sorensen, professor of social and behavioral sciences, told the audience of interventions that reduce occupational injuries and promote health on the job. One study from her research group found that blue-collar workers were less likely to report participating in workplace health promotion programs than white-collar workers. However, they found that blue-collar workers were more likely to participate in tobacco control and nutrition programs if they were combined with efforts by their employers to improve occupational safety.

The keynote speaker was Jeffrey Koplan, MPH ’78, vice president for global health at Emory University and principal investigator for the Emory Global Health Institute – China Tobacco Control Partnership.

Watch opening remarks from Julio Frenk and Milton Weinstein

— Amy Roeder

Photo: Mike Mazzanti