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Preventive care, such as immunizations and screenings for cancer and high blood pressure, saves lives. So why aren’t millions of Americans getting these relatively inexpensive services?

We were recently involved in a new report that analyzed prevention measures across all 50 states. It looked at prevention through the lenses of access to health care, immunizations, and efforts to prevent chronic disease. The final report, United Health Foundation’s America’s Health Rankings Spotlight: Prevention, released in partnership with the American College of Preventive of Medicine, revealed troubling disparities in access to recommended preventive care.


Having a dedicated health care provider is key to overall prevention. Yet about 40 percent of Hispanic adults said they didn’t have dedicated health care provider, compared with 23 percent of non-Hispanic black adults and 18 percent of non-Hispanic white adults. According to the spotlight report, having a dedicated health care provider was highly linked to getting screened for colorectal cancer.

Income mattered, too. Barely half of adults ages 50 to 74 with annual incomes less than $25,000 reported getting colorectal cancer screening, compared with nearly three-quarters of those making $75,000 or more. Geography also played a role. Childhood immunization rates ranged from 63 percent in West Virginia to 84 percent in Maine.

These findings should serve as a call to action for the public and private sector, for public health professionals and clinicians, and for individuals and communities.


To address disparities in disease prevention, we must first focus on providing high-quality, affordable care that truly meets people where they are. That could mean house calls for seniors, urgent care centers for busy moms, or bringing mobile medical clinics to schools, parks, and community centers.

Access alone won’t bridge the gap. People need more support and education about the importance of prevention and how to successfully navigate the complex health care system. Clinicians need help, too, in the form of tools that support their delivery of evidence-based preventive care. It’s also important for the public health community to continue looking at the big picture by monitoring the use of preventive services and highlighting both best practices and disparities.

Here’s a compelling case study: A few years ago, only 68 percent of children ages 19 to 35 months in Maine were getting the recommended immunizations against whooping cough, chickenpox, polio, and other diseases. State officials made childhood immunizations an area for improvement in 2014. Since then, the rate has increased to 84 percent, surpassing the US Department of Health and Human Services’s Healthy People 2020 target of 80 percent. Maine public health officials are now well-positioned to help states that are lagging behind boost their immunization rates.

All Americans deserve to live full and healthy lives. Highlighting these troubling disparities in preventive care is important, but it is just the first step. Now we must band together — as public health workers, as clinicians, and as individuals — to address these disparities and their underlying causes. Doing that will help millions more Americans move closer to living longer, healthier lives.

Reed Tuckson, MD, is an external senior medical adviser to United Health Foundation. Daniel S. Blumenthal, MD, is president of the American College of Preventive Medicine.

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