An Ounce of Prevention

An Ounce of Prevention

Call to Action

Shenson and DiMartino In a twist that is typical of the way Shenson seems to work — by finding good in the most unlikely places — SPARC was born out of the Clinton administration's failed plan for national health care. With Michael Alderman, chair of the department of epidemiology at Albert Einstein, Shenson published an op-ed piece in The New York Times in April 1994, when the media was flooded with expert opinions on the health care system. However, as Shenson and Alderman pointed out, the one thing no one was talking about was health.

Shenson with Associate Director Donna DiMartino at the SPARC offices in Lakeville, Connecticut.

"Policy makers address every flaw in the system except the most grievous one: Americans live less healthy and shorter lives than people in most other industrialized countries." They noted that cancers and cardiovascular diseases that could be treated with early screening and intervention account for half of all deaths in the U.S. The editorial called for a national health corps to deliver preventive measures and proved to be the impetus for the founding of SPARC.

Virgil Stucker, who as the director of the Berkshire Taconic Community Foundation helped to launch SPARC(he now works with the Northern Berkshire Health Systems and serves on the SPARC board), recalls an early meeting with the mayor and health commissioner in Pittsfield, Massachusetts. "We were almost thrown out of the room. What were we doing suggesting they could do a better job at delivering flu shots? But within nine months of the meeting, we had helped increase the number of people getting flu shots in the area by 112 percent. We helped bring together the government agencies and local doctor's offices. And when Pittsfield needed a new health commissioner a few years later, the mayor appointed me and Doug Shenson to the search commitee." Stucker believes that SPARC's success is due to the fact that the goals of the organization are clear and easy to understand, and SPARC does not go into local communities as a competitor with existing agencies. "I know that because we said yes to this mission, we are actually saving lives," he adds. "That makes you feel great."

In the five years since SPARC organized the first steering committees throughout the region, the organization has gone from a bare bones operation to operating with a staff of five and funding from the CDC and the Robert Wood Johnson Foundation. It has worked with 75 different collaborators and piloted projects to immunize teenagers against hepatitis B at local high schools. It has seen the use of pneumonia vaccine among Medicare patients double in two counties and the rate of mammography of women coming to flu clinics in one county double as well. SPARC realized this last achievement by training outreach workers, a mix of retired and semi-retired women, to interview women over 50 at flu clinics and see if they would agree to receive a phone call to set up a mammogram. The initial project succeeded in signing up 300 women who had not undergone the test in the previous 12 months. SPARC plans to expand this initiative to other counties this year. The key, Doug Shenson says, is bundling preventive services to reach the greatest number of people and to use resources well. Under managed care, the health system is so "squeezed," he adds, that doctors cannot fully address preventive care. Increasingly there is time only to treat illness.

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