A Clinical Support System (CSS) such as a Health Promotion Center focuses efforts on preventive care. Education of the public is necessary about poor life style behaviors. Educating young people about the dangers of poor dietary habits, smoking, sexual behaviors, alcohol abuse, drug abuse, and violent acts continues to be an important area to focus. Those that need to provide education at the local level include hospitals, physicians, nurses, other healthcare providers, schools, and law officials.

Reducing healthcare consumption, by people taking responsibility for their own life style behaviors, will decease overall healthcare spending. Preventive care is the best solution in reducing healthcare spending, because decreasing the potential of developing chronic illness and lessening the amount of violent behavior will result in less demand for healthcare.

Costs of Chronic Disease

The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases: 

• More than 90 million Americans live with chronic illnesses. 
• Chronic diseases account for 70% of all deaths in the United States. 
• The medical care costs of people with chronic diseases account for more than 75% of the nation’s $1.4 trillion medical care costs. 
• Chronic diseases account for one-third of the years of potential life lost before age 65. 
• Hospitalizations for pregnancy-related complications occurring before delivery account for more than $1 billion annually.
• The direct and indirect costs of diabetes are nearly $132 billion a year. 
• Each year, arthritis results in estimated medical care costs of more than $22 billion, and estimated total costs (medical care and lost productivity) of almost $82 billion. 
• The estimated direct and indirect costs associated with smoking exceed $75 billion annually. 
• In 2001, approximately $300 billion was spent on all cardiovascular diseases. Over $129 in lost productivity was due to cardiovascular disease. 
• The direct medical costs associated with physical inactivity was nearly $76.6 billion in 2000. 
• Nearly $68 billion is spent on dental services each year. (CDC, 2005)

Cost-Effectiveness of Prevention: Benefits Associated with Healthy Behaviors.

• For every $1 spent on water fluoridation, $38 is saved in dental restorative treatment costs. 
• For a cost ranging from $1,108 to $4,542 for smoking cessation programs, one quality-adjusted year of life is saved. Smoking cessation interventions have been called the gold standard of cost-effective interventions. 
• The direct medical costs associated with physical inactivity were $29 billion in 1987 and nearly $76.6 billion in 2000. Engaging in regular physical activity is associated with taking less medication and having fewer hospitalizations and physician visits. 
• For each $1 spent on the Safer Choice Program (a school-based HIV, other STD, and pregnancy prevention program), about $2.65 is saved on medical and social costs. 
• For every $1 spent on preconception care programs for women with diabetes, $1.86 can be saved by preventing birth defects among their offspring. 
• According to one Northern California study, for every $1 spent on the Arthritis Self-Help Program, $3.42 was saved in physician visits and hospital costs. 
• A mammogram every 2 years for women aged 50–69 costs only about $9,000 per year of life saved. This cost compares favorably with other widely used clinical preventive services. 
• For the cost of 100 Papanicolaou tests for low-income elderly women, about $5,907 and 3.7 years of life are saved. 
• After controlling for physical limitation and major socioeconomic factors, more than 12% of annual medical costs of the inactive persons with arthritis is associated with physical inactivity. Physical activity interventions may be a cost-effective strategy for reducing the burden of arthritis. (CDC, 2005)

The broad consider of health concept is increasing being used by employers and managed care organizations who face financial pressures to reduce their medical costs. Employers’ use of health risk appraisal questionnaires is a recognition that their employee’ health can be improved, less expensively, by changes in their lifestyle behavior. Incentives given to their employees to stop smoking, reduce their weight, and exercise enable employers to retain a skilled workforce, while reducing medical expenditures. The emphasis by managed care organizations on reducing per capita medical costs is leading several of them to identify high-risk groups who can benefit form early preventive measures to reduce costly medical treatments. (Heshmat, 2001, p. 93)

The incentives to adhere to healthy lifestyle behaviors is better and improved health and less cost to the consumers, healthcare providers, and third-party payers,