In Newly Published Article in the Annals of Bioethics and Clinical Applications, NACDD Board Member Dr. David Hoffman Calls for More Ethical Approach to Healthcare Through Federal Investment in Chronic Disease Prevention


CONTACT: Paige Rohe

ATLANTA (Feb. 23, 2021) – NACDD Board Member and Policy Committee Chair Dr. David Hoffman has published an article in the current edition of the Annals of Bioethics and Clinical Applications on “Ethics and Prevention of Chronic Disease.” Dr. Hoffman published the article as part of his role as Associate Professor of Ethics and Health Policy at Maria College in Albany, N.Y.

The article shares that only 1% of federal investment in healthcare goes to prevention, despite widespread scientific and economic research proving prevention is more cost-effective than reactive healthcare. For example, the article cites research suggesting that $240 spent on prevention can save $1,000 in in healthcare costs due to chronic diseases.

Therefore, Dr. Hoffman argues that investing almost exclusively in reactive healthcare, currently the practice at the federal level, is a “breach of an ethical approach to public policy.” The article calls for avoiding “predictable harm that is occurring and will only increase without these investments.”

“We are creating a future where we may live longer than our children due to preventable chronic diseases,” said John W. Robitscher, MPH, CEO of the National Association of Chronic Disease Directors. “If we know we are heading in that direction, any parent would spare no expense to stave off such a horrifying future, and we certainly can do more as a nation than we are doing now.”

Despite the federal limitations on funding, Dr. Hoffman’s paper provides several examples of successful state-based investments in chronic disease prevention across multiple disease categories: obesity prevention in Illinois and Pennsylvania; diabetes in Kentucky and Montana; heart disease and stroke in Michigan and Wisconsin; cancer in West Virginia and New York; and Alzheimer’s in Colorado.

Dr. Hoffman calls for increasing resources to scale these and other successful state-based programs through the Centers for Disease Control and Prevention. Ultimately, Dr. Hoffman suggests that by promoting health and preventing suffering from chronic disease, we also have the opportunity to promote greater economic opportunity, especially among Americans of color who have been disproportionately impacted by chronic disease and preventable disability.

“The important message here is we know that much of the burden of chronic conditions fall on people unnecessarily and unfairly due to race, economic status, and other factors unrelated to our genetics,” Dr. Hoffman said. “We know what can make a difference; policymakers need to do the right thing.

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