NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, May 3, 2012

In his TedMed talk last week, where he called for a renewed focus on improving root causes of health problems rather than waiting until they cause full blown illnesses, Sandeep Kishore noted this somewhat startling statistic: Of the 30 years of average life-expectancy gains the United States made in the last century, a surprisingly small amount of that average increase–just five years–stems from improvements in the sort of medical care we get in hospitals. The rest of those gains came from other sources, like improvements in water quality and sanitation, vaccinations, and other improvements in public health.

And while that may sound surprising, it’s consistent with a lot of what we know about health. For example, Steven Schroeder, the past president of the Robert Wood Johnson Foundation, has estimated that only about 10% of how healthy we are and how long we live is determined by health care. Instead, how we live our lives–our choices and behaviors, our physical surroundings, our socioeconomic circumstances–turn out to be far more important over the long run.

But, as Kishore argued, even though we know that there’s a lot more opportunity to improve health and well-being by improving our social and physical environments and personal situations, we spend a lot more money and effort on treating people once they’ve become sick.