Developing a comprehensive prevention action plan to improve population health in North Carolina

Healthcare costs and spending continue to escalate nationwide. Preventing chronic disease and other health conditions is one way to improve population health and potentially curb healthcare costs. At the request of major health foundations in the state, the North Carolina Institute of Medicine convened a diverse task force of experts to develop a prevention action plan for the state. North Carolina currently ranks 37th for overall health among states and ranks in the bottom third for many other health measures. When compared to the nation, a higher percentage of the state's adult citizens smoke (20.9% versus 18.4%), fewer are physically active (44.0% versus 49.5%), and more are obese (29.5% versus 26.7%). The task force first determined the state's leading causes of death and disability and their underlying preventable risk factors. The task force then developed evidence-based recommendations addressing tobacco use, poor nutrition, physical inactivity, risky sexual behavior, infectious diseases, food-borne illness, injury, substance abuse, mental health, environmental risks, health disparities, and social determinants of health. The resulting prevention action plan, released October 2009, is a blueprint for prevention work in North Carolina, providing guidance for new legislative funding and foundation grant-making, and assisting in prioritizing prevention efforts at the state and local levels. Collaboration using a common action plan offers a promising opportunity to improve population health in North Carolina and to lower healthcare costs and spending. This model may provide practical information and guidance for others interested in creating a comprehensive plan to address preventable death and disability.