Substantial evidence supports the position that preventive health screenings and other preventive services are indispensable parts of the U.S. healthcare system. Yet despite clear benefits, from detecting cancer at early stages to preventing disease through vaccination, rates of preventive services are lagging behind where they should be.
Fewer than half of adults ages 65 or older are up to date with core preventive services, despite regular checkups and coverage by nearly all insurance plans, according to a 2010 report by the Department of Health and Human Services. In addition, fewer than 30% of adults ages 50 to 64 are up to date with core clinical preventive services, according to a 2011 Centers for Disease Control and Prevention (CDC) report.
Research going back about a decade suggests that ethnic and racial minorities, the socioeconomically disadvantaged, and rural populations are less likely to receive preventive services, such as vaccinations. According to the 2011 CDC report, 44% of blacks reported not receiving influenza vaccinations, compared to 29% of whites.
Though definitions vary, clinical preventive services generally encompass immunizations, screening tests and counseling “to prevent the onset or progression of disease and disability,” according to CDC. Such services can include influenza and pneumococcal vaccinations; screenings for breast cancer, colorectal cancer, diabetes, lipid disorders and osteoporosis; and counseling for smoking cessation.
“Clinical preventive services can be important in three stages of disease development,” says Douglas Shenson, MD, MPH, associate clinical professor of epidemiology and public health at Yale School of Medicine. These are before disease occurs (such as vaccinations), before disease is clinically evident (for example, breast cancer screening) and once disease is established, but before it has made its maximum impact (such as vision screening in individuals with diabetes).