Clinical Preventive Services
Clinical preventive services are very effective in preventing disease or detecting disease early, when treatment is more effective. The U.S. Preventive Services Task Force (USPSTF) recommends a set of clinical preventive services for persons aged 65 years and older. For a complete list of all recommended services, see the USPSTF Web site. Among the recommended clinical preventive services are a core set of services, based on age and gender. These core services include influenza and pneumococcal vaccinations, lipid disorders, colorectal cancer screening, and additionally for women, breast cancer screening.
Despite the effectiveness of these potentially life-saving preventive services, only 25% of adults aged 50 to 64 years in the United States, and fewer than 40% of adults aged 65 years and older are up to date on these services. This is true despite the fact that these services are paid for by nearly all insurance plans, including Medicare and Medicaid.
Promoting the broader use of preventive services by adults aged 50 years and older is a key public health strategy.
The Older Adult topic area in Healthy People 2020 includes an objective: Increasing the proportion of older adults who are up to date on the core set of clinical preventive services. The target of this objective is to increase by 10 percent the proportion of men (from 46.3% to 50.9%) and women (from 47.9% to 52.7%) who are up to date on the core set of clinical preventive services by the year 2020. This approach aims to provide a more meaningful measure of the delivery of clinical preventive services in the community.
In March 2011, CDC, in partnership with HHS' Administration on Aging, Agency for Healthcare Research and Quality, and Centers for Medicare and Medicaid Services released a report, "Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap." The report underscores fundamental gaps by magnifying state and national self-reported data for adults aged 65 and older who are not receiving the recommended services, and highlights the need to link community and clinical strategies that focus on the underserved.
In November 2009, CDC, AARP, and the American Medical Association released a report highlighting opportunities to broaden the use of potentially lifesaving preventive services. The report, “Promoting Preventive Services for Adults 50-54: Community and Clinical Partnerships,” identifies a set of recommended preventive services, delineates successful strategies to promote and facilitate their delivery in community settings, and provides national and state-level data to monitor progress in these services reach this key population.
Included in the report is a pull-out chart providing easily-referenced data for each state on key indicators for recommended preventive services: (State-by-State Percentages for Key Indicators [PDF–1.2M]).
- View and compare summary national, regional, state and selected local data with the Promoting Preventive Services interactive data tool
Each year, CDC releases critical issue briefs focusing on health issues for older adults. These briefs provide journalists, public health and aging services professionals, researchers, and others with current and easily accessible scientific and programmatic information on selected issues. In January 2012, CDC released a brief focusing on clinical preventive services for older adults. View Report [PDF–99K].
The SPARC program (Sickness Prevention Achieved Through Regional Collaboration) has shown documented success in broadening the use of recommended preventive services among older adults. A rigorous evaluation supported by CDC found increases in immunizations for influenza and pneumococcal disease, and screening for breast, cervical, and colorectal cancers as well as screening for elevated cholesterol and high blood pressure.
SPARC’s approach is to establish collaboration and coordination among a wide variety of community agencies and organizations (e.g., local health departments, area agencies on aging, health care providers, and other key players) with a vested interest in improving the health of community residents. SPARC does not deliver services; rather, it creates, facilitates, and monitors communitywide strategies that make it easier for individuals to get their screenings and immunizations in places convenient for them. An innovative feature of SPARC is Vote & Vax, a strategy that makes vaccines and appointments for cancer screenings available at polling places on election days. For more information on Vote & Vax, see http://voteandvax.org/ .
CDC has developed the SPARC Action Guide [PDF–2.6M] to assist communities in adopting the SPARC model. The Guide offers the opportunity to learn more about the core preventive services and SPARC's potential for improving the health of a community. It also outlines a step-by-step process that a community can undertake to embrace the SPARC approach while implementing a program that meets the community's own unique needs and priorities.–
In 2006, the Atlanta Regional Commission initiated the SPARC model with technical assistance from CDC and SPARC President Douglas Shenson, MD, MPH. The Atlanta pilot is described in an article in CDC’s e-journal, Preventing Chronic Disease [PDF–126K].
With CDC assistance, AARP and the American Medical Association have developed a brochure highlighting preventive care services associated with the Medicare program’s “Welcome to Medicare” visit and yearly wellness visits. View Brochure [PDF–259K].
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