Education Can Be Good for Your Health : Promising Monterey-Salinas Test Program May Offer a National Approach

State and federal governments, private insurers, large employers and anyone else concerned about soaring health-care costs should take a close look at the results of a health education program that Stanford University researchers ran in Monterey and Salinas. The five-year program was popular, innovative and, most important of all, effective. All this at a cost of about $2.65 a year per person!

The program’s core was a media blitz, using TV commercials, direct mail, newspaper columns and the like, that told people what they can do to live better and longer. Three areas in particular were highlighted: the benefits of regular exercise, the dangers of smoking, the risks of eating too much fat and salt. The effort paid off.

The program, funded with $15 million from the U.S. Department of Health and Human Services, included monitoring the health of 600 persons. In Monterey and Salinas, Stanford researchers found that the communitywide smoking rate dropped by 24% over the life of the program, compared to only 9% in Modesto and San Luis Obispo, cities used as control groups. Blood pressure, serum cholesterol and resting pulse rates also fell.

What do these numbers mean in terms of lives that could be saved? John Farquhar, chief researcher on the project, says that reducing the major risk factors for heart disease and stroke could help prevent as many as 800 heart attacks in Monterey County in the current decade. If the education programs were used nationally, says William Harlan of the National Heart, Lung and Blood Institute, as many as 250,000 heart attacks a year could be prevented.

There’s little mystery about why the campaign was effective. Awareness about the effects of smoking, diet and exercise on health tends to be highest among the better educated and more affluent. The Monterey-Salinas program deliberately aimed at reaching a mass audience, used a simplified approach, included Spanish-language radio spots and involved the schools. And it got its message across through repetition. People listened, people understood, and many acted to change their behavior in beneficial ways.

People who take better care of themselves have less need for costly health care, miss fewer work days because of illness and tend to live longer. It’s clear now that a mass education program can persuade people to change their personal behavior for the better. The Monterey-Salinas project provides a national model for a promising program to help bring health-care costs under control.