It has become a truism in the worlds of health care and public health that direct medical care accounts for only a small part of our actual health status. Even the best medical care, on average, will extend and improve our lives less than the combined benefits of nutritious foods, access to places to be physically active, safe and healthy homes, good air quality, lack of chronic stress, social support, and other aspects of what are sometimes called the “social determinants of health.” As much as 80 percent of the factors that influence our health, it turns out, operate outside the walls of the hospital or clinic.
We know this, but the way we spend our money as a society doesn’t reflect it. Instead of prioritizing the social determinants of health (SDOH) and preventive health strategies to improve overall population health, we prefer to wait until people are sick and then respond with expensive medical care. As a result, the United States spends more on health care than the rest of the developed world, but our outcomes are mediocre at best. We live shorter, unhealthier lives than we could be living.
