ALS Disease Focus Is Not a Top Priority

Americans can be quite creative and this is often rewarded by a viral response. There are many things that ALS can do with dozens of millions…

But as discussed previously, disease focus is a problem in the United States. Successful distractions by any number of major and minor diseases (in incidence or impact) could prevent the United States from ever dealing with the major priority areas or addressing them with the right timing. Often the lack of sufficient investment results in limited resources and limited ability to make an impact.

Our nation will not improve without addressing the basics, particularly impacting most of the nation's children:

1. Child well being
2. Early education
3 - 10. Areas such as Better housing, Improved security, Public health, Safe and Efficient Transportation, Improved Environments, Causes of early death,

About 10. Primary care and basic services for 40%+ of the nation left behind

Spending that is population-based is most important because of the jobs and social determinant improvements where America needs recovery. Conversely cutting high priority spending areas is what helps to prevent recovery where needed - spending generally targeted for cuts in recent years.

Next Level Priorities - Substantially reducing deaths due to health care delivery

Far down the list - major disease causes of death and disability, making health care fancier

Farther down the list is minor diseases focus until the top ten priority areas are addressed as well as many of those in the top 100.

If we keep working on the minor priority, we may never get to the major ones such as facilitating better American children.

Priorities for Nations

We must address the human needs of most Americans - especially children. Improvements in the earliest months and years of life are the most lasting improvements for a nation with impacts upon education, health, legal, employment, and other areas. The Institutes of Medicine often has disease focus, but it also has done work in the area of early childhood intervention - important work that has too often been ignored.

We must support the human infrastructure that serves where needed - the nurses, teachers, public servants, public health, and primary care

Other nations have demonstrated the advantages of investments in early childhood and child well being. The United States finishes last or next to last in overall child well being with poor performance compared to developed nations across all categories. As more nations are added, the US falls to a lower last place finish. It is not a surprise that the United States is falling behind in so many areas and is increasingly dependent upon foreign born and first generation Americans.

We must resist the short term thinking of those that continue to disrupt human infrastructure.

We must make population based investments. We must resist cuts of funding where funds are best distributed to neighborhoods in need of cash flow
  • Social Security
  • Child development
  • Early education
  • Nutrition/SNAP/Food stamps
  • Public health, primary care, and basic services spending specific to 40% of the population most behind
You might recognize these as high priority cut cut cut areas for those that want to cut spending on most Americans while rewarding the fewest Americans. Only those least aware of most Americans would make such plans. These cuts plus sequestration have been collapsing economic activity where needed - preventing recovery where needed. People can overcome much, but their recovery and recovery of a nation is more difficult when designs send government spending or benefits elsewhere.

Areas with lesser income, education, health care, jobs, and other social determinants are even more dependent upon population based spending. They have more elderly, poor, near poor, and unmet health needs. They have lesser health and education outcomes.

It is not hard to determine population based investments. Track the proportion of spending sent to certain counties or zip codes. Divide by the proportion of the US population at that location. This also allows an estimate of the lack of such spending in certain locations - locations that often fail to be organized to apply for funding such as certain states, rural areas, and areas with higher poverty and less education.

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Blogs indicate that primary care can be recovered and should be recovered.

Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair of the STFM Group on Rural Health.


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