“I think when the average person thinks about health, they think about medical care and access to insurance,” said David Williams, professor of public health at Harvard University and staff director for the commission. “The scientific research is very clear that medical care—as important and as vital as it is—is not a strong determinant of health.”
Recommendations made by the commission—a 16-member group made up of health and academic leaders—include health systems adopting new “vital signs” that assess nonmedical indicators for health, and creating reimbursement incentives to promote their use. Also, social factors influencing health, such as housing and employment, should be incorporated into community health needs assessments. Other recommendations include incorporating a focus on health within efforts to economically revitalize communities, and investing in early childhood development programs that guarantee access for all low-income children under age five.
“To a large degree, our healthcare system functions as a repair shop that takes care of us once we get sick, but because it isn't focused on prevention, it doesn't have a lot to do in most cases with whether we get sick or not in the first place,” Williams said. “What determines our health, then, is the opportunity to be healthy in the places where we spend most of our time—our homes and our communities.”
Improving the nation's health would depend on building a culture of health where making healthy choices were more easily accessible, Williams said. A lack of access to nutritional food or space for physical activity has been linked to higher rates of chronic conditions such as obesity, diabetes, hypertension and heart disease in many low-income communities, compared to populations with higher income levels, for example.
The latest report is a continuation of the work the commission released in 2009, when it presented 10 recommendations for improving the country's health.
Follow Steven Ross Johnson on Twitter: @MHSjohnson