The stunning swiftness with which medical innovators are developing vaccines for COVID-19 further underscores that our health care system, when it comes to know-how and the creation of new treatments and technologies, is second to none in offering the tools to keep people healthy.
Yet, the disparity between capability and results remains. In very little time, the United States will pass the $4 trillion mark in annual health care spending. But we still have a lower average life expectancy than other high-income nations, a comparably high rate of avoidable deaths and a disproportionate number of Americans who are hospitalized for treatable illnesses like diabetes and high blood pressure.
The problem is one that goes well beyond bedside care and cutting-edge medicine. Our health care system is superb at treating the symptoms of illness when they develop, but we require a broader perspective to prevent those symptoms from developing in the first place. Our largely uncoordinated approach to addressing these social determinants of health – such as a lack of healthy food options, unavailable transportation to get to a doctor’s appointment or a scarcity of safe housing – needs to transition to a more systemic and comprehensive methodology that keeps at-risk individuals and families from falling through the cracks that lead to illness and shortened lives.
We have seen encouraging developments. Multiple health care companies are devoting considerable resources to this challenge. Since 1997, CVS Health and Aetna, a CVS Health company, have combined to invest more than $1 billion in the development of affordable housing units and associated community initiatives. Tivity Health has engaged in partnerships that have delivered more than 300,000 meals to homebound seniors during the COVID-19 crisis, addressing both nutritional needs and social isolation. The public sector has stepped up as well, with Medicare Advantage plans and Medicaid directing more resources to priorities like nutrition benefits and counseling support for domestic violence victims.
But the needs remain great. One in every 10 households in the United States remains food insecure. A quarter of us do not have a primary care provider. And in a society increasingly reliant on the internet, 40 percent of Americans don’t have broadband access.
Recently, our companies joined with dozens of other organizations in a roundtable we sponsored with the Healthcare Leadership Council to develop consensus around three foundational steps needed to take the social determinants effort to the next necessary level.
First, we – health plans, providers and public and private entities of all variety engaged in societal well-being – need to agree upon a common starting point and set of goals. The Healthy People 2030 initiative already gives us a framework to build upon.
Then, we need to enlist community organizations throughout the country in this effort. Over the last few years, Fort Worth, Texas, has pursued a neighborhood-by-neighborhood change in environmental and social networks and has seen a double-digit increase in the number of citizens who describe themselves as “thriving” and a multimillion-dollar reduction in health care costs. Programs like these, tailored to individual community needs and recognizing local nuances, need to be replicated from coast to coast.
And the third element of our foundation should be the development of a national clearinghouse with information about available programs to address social determinants and best practices that have been established throughout the country.
We believe very strongly that a nation with the resources and medical technology expertise of the United States should also have a population that is in the best state of health. Achieving this goal requires a forward-thinking and innovative allocation of resources that will improve the immediate environments in which we live and provide the opportunity to make healthy decisions. We’re moving in the right direction, but we need collective actions to pick up the pace.
Richard Ashworth is president and CEO of Tivity Health. Christopher Ciano is president of Aetna Medicare, a CVS Health company.
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