Americans are generally less healthy than people of other rich countries. We have more infant mortality, heart disease, obesity and AIDS, more gunshot injuries and car crashes. We also have bigger disparities of health—whether it's disparities of income, race, or geography.
Recent research showed mortality rates going up among less-educated white Americans. This is at a time when most of the advanced world is seeing gradual, across-the-aboard increases in life expectancy.
In a new analysis, Laudan Aron, a senior fellow at the Urban Institute, says we focus too much on health care to raise health standards. We spend twice as much money per person on this compared to comparable countries, and it doesn't seem to be helping much.
(FPL=federal poverty level)
"We need to broaden our understanding of health. Health is driven by much more than what happens in the doctor’s office, so our health problems can’t be solved by health care alone," she says.
"Poverty, for one thing, is bad for your health—not just because being poor makes it harder to see a doctor, but also because being poor makes it harder to afford nutritious food or a home in a safe neighborhood."
The Urban Institute's web package highlights the type of programs—like a nurse-family initiative in Dallas, and one to eliminate lead in Baltimore homes—it thinks can address the gap in "health equity." These programs aren't health care, but they promote healthy behavior.
"Decisions about education, development, and transportation are as much about health and well-being as they are about schools, housing, and highways," Aron says.
Have something to say about this article? You can email us and let us know. If it's interesting and thoughtful, we may publish your response.