Senator Harkin’s HeLP (Healthy Lifestyle and Prevention) America Act (S2558)

On June 22, 2004, Senator Harkin introduced an omnibus bill called the HeLP (Healthy Lifestyle and Prevention) America Act (S2558). This legislation is more than 300 pages and contains at least 20 programs to stimulate health promotion in workplace, school, and community settings, with specific programs for disabled people, food marketing, Medicare reimbursement for preventive services, and research on obesity. A National Health Promotion Trust Fund will pay for programs by fining tobacco companies that fail to cut smoking rates among children, and ending federal subsidies for tobacco advertising and closing other tax loopholes. See the editorial by Senator Harkin on pages 461–462 for more details.

I have two reactions to this bill.

First, from a legislative standpoint, it is the most important development in the history of health promotion in the United States. For the first time, federal legislation has been introduced that recognizes the role health promotion can play in addressing the health and medical cost crises the United States is experiencing. Regardless of the eventual disposition of this specific bill, health promotion is now part of the national health dialogue. Senator Harkin has started the conversation and the rest of the US Congress must respond. Equally important, the field of health promotion is likely to grow by a factor of 10 by the end of the decade as a result of programs stimulated by this legislation.

Second, this bill will never pass in its current form. Senator Harkin does not expect it to. He expects it to be broken into 10, 20, or 30 bills based on the interests of various constituencies. Even broken up, it will be difficult to pass because it requires support from so many different Congressional Committees. Senator Harkin holds leadership positions on the Agriculture Committee, and the Labor, Health, Human Services and Education subcommittee of the Appropriations Committees and is a member of the Health Education and Labor Committee. He will have substantial influence on those committees, but he needs support from other committees to get this bill passed. For example, the Healthy Workplace part of the bill includes a tax credit for employers who offer health promotion programs. The tax credit portion would need to be passed by the Finance Committee. He needs to line up similar support in the House of Representatives. The broad health promotion community must take responsibility for building this support throughout the Senate and the House of Representatives.

Health Promotion Advocates, a volunteer grass roots group I chair (www.HealthPromotionAdvocates.org), has decided to build a coalition to pass the Healthy Workplace Act portion of this bill. This part of the bill gives employers a 50% tax credit of up to $200 per employee for comprehensive health promotion programs, calls for a national campaign to explain the financial benefits of health promotion to business leaders, funds universities and other professionals to conduct program evaluations for employers, funds other professionals to provide programs to small businesses, and directs the Centers for Disease Control and Prevention to develop model program guidelines.

We are focusing on the Healthy Workplace Act first because we think we can pull together the necessary resources from employers and health promotion providers to get this bill passed. We also believe it will stimulate rapid growth in the field which will in turn advance the quality of programs in all sectors. Finally, we helped Senator Harkin compose this portion of the bill.

We encourage other health promotion groups to step forward and help Senator Harkin pass other components of this bill, and we look forward to helping them in those efforts.

To get involved, call 248-682-0707 or send an email to volunteers@HealthPromotionAdvocates.org.

Michael P. O'Donnell, PhD, MBA, MPH
Editor in Chief, American Journal of Health Promotion