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HealthierUS: The President's Health and Fitness Initiative

Chapter 5. The President’s Recommendations for Prevention

Get Preventive Screenings


photo of a health screeningPreventive screenings and tests save lives. Unfortunately, many Americans do not routinely follow some basic health screening recommendations. Routine screenings can identify a previously undiagnosed condition or risk of condition. This allows physicians to intervene early with treatments and therapies to control the condition or inform the individual of lifestyle changes that can be taken to improve health outcomes and costs.

For example, screening for high blood pressure and high blood cholesterol is an important first step in identifying individuals who are at risk for chronic diseases but may be undiagnosed. Screening and appropriate follow-up for high blood pressure and elevated cholesterol can also save the lives of those at risk for heart disease. Early detection and treatment for diabetes can improve health, and the CDC recommends health professionals screen high-risk patients periodically, even when those individuals are visiting their doctor for another reason. Such opportunistic screenings can alert a health professional to troubling results requiring follow-up care.

Many studies have shown that dietary changes and therapies can dramatically reduce the risk of heart disease and stroke, especially when these modifications reduce high blood pressure and high blood cholesterol. When coupled with lifestyle changes, these therapies can be even more effective in lowering the risk of a heart attack or stroke. About 90 percent of all adults now have their blood pressure measured at least once every two years. In 1998, only 67 percent of adults had had their blood cholesterol checked within the preceding five years. Of the estimated 17 million people with diabetes in the country, about 5.9 million are undiagnosed. Without effective diagnosis and treatment, diabetes becomes a leading cause of blindness, kidney failure, heart disease, and stroke.

There are additional simple, preventive measures many Americans can take to reduce bad health outcomes. Pneumonia and influenza are responsible for more than 30,000 deaths among older adults each year. Immunization can substantially reduce the severity, risk of hospitalization, and risk of death from these diseases.

The President’s Challenge:

Basic preventive health services such as health screenings are the most important health information Americans can receive about their current health status. Regular screenings can motivate individuals to modify their current activities and behaviors to improve their overall health. And seeking follow-up care based on basic preventive screenings can save lives. Every little bit of effort counts:

photo of a health screening
  • Take advantage of basic health screening practices recommended by your treating physician or other health professionals. Screening and appropriate follow-up care for high blood pressure and elevated cholesterol can save the lives of those at risk for heart disease and stroke. Regular screening can detect many forms of cancer at early, less dangerous stages.
  • Get your blood pressure checked regularly, particularly if you are a high-risk individual. Effective blood pressure treatment is easy and reduces risk of stroke by 40 percent. Easy to use machines are conveniently located in public places.
  • Ask your doctor about a routine screening for diabetes. Lack of treatment for diabetes can lead to blindness, kidney failure, and amputations. Early detection with treatment can reduce diabetes-related blindness by up to 90 percent, kidney failure by up to 50 percent, and amputations by up to 50 percent.
  • Get the appropriate immunizations each year. In 1999, 33 percent of adults aged 65 or older reported they did not get a flu shot in the previous year, and 46 percent reported they had never been vaccinated against pneumococcal disease.

Promoting Preventive Health: Administration Actions

Healthy Communities Innovations Initiative--$25 million has been included in the Fiscal Year 2003 Budget for the development of best practices in communities to improve the health of their citizens and to prevent diabetes, asthma, and obesity. The Healthy Communities Innovation Initiative will fund demonstration projects in five communities to enhance access to services, encourage positive behavioral changes, and improve community health.

The Initiative will build partnerships at the local level and will match Federal with local resources to improve prevention and treatment activities. It will be administered by the HHS Health Resources and Services Administration in collaboration with the CDC and the Office of Disease Prevention and Health Promotion.

Diabetes Screening and Awareness--HHS is partnering with several medical and private organizations to increase the utilization of important diabetes screening tools. The Food and Drug Administration, the American Diabetic Association (ADA), and the National Association of Chain Drug Stores have partnered in a nationwide "Take Time to Care" campaign to raise the awareness of diabetes among women, who are at a greater risk for the disease. Distributing information at grocery stores, pharmacies, and other public places, the campaign highlights the warning signs that women need to recognize; the literature identifies all the screening services that are available. The program aims to arm women with key facts about preventing diabetes and guide them to appropriate, effective treatments once diagnosed.

HHS and ADA also have unveiled a new expert panel’s recommendations about pre-diabetes. Pre-diabetes is a condition affecting nearly 16 million Americans where blood glucose levels are higher than normal, sharply raising the risk for developing type 2 diabetes, but the individual does not yet have diabetes. The panel’s new recommendations call for physicians to begin screening overweight people age 45 and older for pre-diabetes and to counsel their patients about the high risk of getting diabetes.

Strengthening and Improving Medicare--Medicare+Choice plans are an increasingly reliable source for quality screening and prevention services. As a part of the President’s broader initiative to improve the Medicare program, Medicare+Choice plans would be strengthened and made available to more beneficiaries. In addition to being more affordable and providing prescription drug coverage, Medicare+Choice plans provide extra benefits to support seniors with serious and chronic health conditions, such as programs to help patients with diabetes and cancer avoid complications. Medicare+Choice plans also provide innovative health care services that are generally not available in the traditional Medicare plan, such as annual checkups to catch health problems early, exercise and wellness programs, and programs to improve patient safety. Making Medicare+Choice plans more available would give seniors access to modern, reliable coverage options, similar to those available to all Federal employees through the Federal Employee Health Benefits Program.

Recommended Preventative Health Screenings



Age: 19 to 39

Age: 40 to 64

Age 65 and older

Comprehensive screening exam To promote wellness Frequency should be tailored to age and health status. Consult your health professional.
Diagnostic Testing
Blood Pressure To identify high blood pressure Every 2 years for all ages
Cholesterol To reduce risk of heart disease

At least every 5 years

Diabetes screening

To test for diabetes Depends on risk factors and age. Consult with your health professional.
Colon cancer screening: Options include: Stool blood (fecal test) Sigmoidoscopy, Colonoscopy, Barium enema To detect colorectal cancer After age 50: frequency depends on test:
FOBT: every year
Sigmoidoscopy: every 5 years
Colonoscopy: every 10 years
Barium enema: every 5 years
Sigmoidoscopy or colonoscopy To detect colorectal cancer or large polyps Every 5 years beginning at age 50
Vision exam To test vision and screen for glaucoma Discuss with your health professional.
Hearing test To monitor hearing Every 10 years Hearing loss increases at age 50 so discuss frequency of tests with your health professional.
Men Only
Prostate-specific antigen (PSA)/DRE for prostate cancer Blood test to detect prostate cancer Guidelines vary. Discuss with your health professional.
Women only
Mammogram and clinical breast exam Early detection of cancer Every 1 to 2 years starting at age 40
Cervical cancer screening/pelvic exam To detect cervical and ovarian cancer Every 1-3 years depending on risk Every 1-3 years depending on risk. Over age 65, if negative on previous screens, at your health professional’s discretion.
Rubella antibody To determine rubella immunity One time prior to first pregnancy
Osteoporosis To identify those at risk At least once after age 65; earlier for high risk women

Sources: U.S. Preventative Services Task Force

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