To create a culture of wellness, Risa Lavizzo-Mourey, CEO of the Robert Wood Johnson Foundation, urges business and government to prevent illness in the first place.

Question: How can people improve their health?

Risa Lavizzo-Mourey: If we really want to improve a person’s health, and make sure that the population is healthier, we have to create a culture of wellness in this country. The things that are going to actually help you or me stay healthy are not necessarily the things that happen inside a doctor’s office. They’re the things that allow us to choose healthy lifestyles on a day-by-day basis. The things that nudge just to get more exercise, to eat healthier, to quit smoking or not start smoking in the first place.

Business employers have a role to lay in this because they often create the environment that makes it easy for people to choose those healthy choices. Schools have role to play here because schools are where kids learn the lessons of a lifetime and schools have the opportunity to create those environments where kids can choose a healthy lifestyle. And our policy leaders have a role to play because they are the ones that enact the zoning laws and they help us create an environment that either encourages or discourages healthy lifestyles.

So I think the things that will actually make a difference and be low tech in improving our health are not the things that happen in the healthcare system. They are the things that happen in the larger environment and will create a culture of wellness.

We spend over 2 trillion dollars on medical care. But of that, 95% of it is going to treat people, not to preventing illness in the first place.

When you talk about prevention, it’s important to understand that a lot of the things that we can do to prevent illness, primary prevention happen outside of the healthcare system. Clinical prevention, colonoscopies, mammograms, things like that, are important but just as important, and in fact perhaps even more important, are the investments in community-based prevention that keep people healthy. We know that for every dollar that we can invest in community-based prevention, we will get a return on investment in about 5 years of $5.60. That is a great return on investment.

Recorded on: June 30, 2009.