Policy is more powerful than any pill, and that’s what it will take to keep Americans alive.
According to data recently released by the Centers for Disease Control and Prevention, 2017 continued a life expectancy decline for Americans over the last three years — a morbidity slump unseen in the United States since a devastating flu epidemic in 1918. Today, in the richest nation to exist on earth, people are living progressively shorter lives.
More shameful still is that the deaths accelerating our decline are preventable, such as those lost to the opioid crisis. What should be a national emergency does not stand a chance of garnering our collective attention against the next tweet from the president. This reality speaks to how we’ve arrived at this crisis in the first place: There is no significant political force to drive the public policy that can truly make Americans healthier.
I am not talking about health care. An improved health care system to which everybody has access can play a role, but research shows that socioeconomic and environmental factors play an even greater role in preventing premature death than does access to medical services. The evidence indicates that Americans who have health insurance still have poorer outcomes than people in other industrialized countries, even though we pay double per capita for it versus what they do. Health care is hardly the end-all, be-all solution.
America hasn’t been suffering from a mass outbreak of personal responsibility abdication. In reality, the United States has failed to produce sufficient opportunity for people to be healthy.
This failure has largely occurred through a lack of investment and attention to public health and related social policy, according to studies at the local, state and national levels. These policies have been shown to extend people’s lives.
In the absence of bipartisan political leadership to advance public health and socioeconomic policy in Washington, D.C., and statehouses across the country, the health care industry’s hulking gravitational pull is straying us away from policies that can make us healthier. Health care now accounts for a fifth of our gross domestic product, and the industry’s largesse is cycled back into our political process. With nearly a half-billion dollars spent in 2017, the health care industry is the leading spender in federal lobbying to perpetuate a system that fundamentally profits from Americans being sick.
A more cost-effective approach invokes so-called “upstream” interventions that can keep Americans out of the doctor’s office in the first place. Heart disease and cancer, America’s leading causes of death, could be decreased through policy that promotes healthier lifestyles, beginning with education policy and continuing through initiatives that shape how we work and live as adults.
Economic factors also contribute to increasing rates of “deaths of despair,” such as suicide, opioid overdoses and ailments driven by addiction. These causes of premature death are the chief accelerators of our declining life expectancy. As economic inequality in America widens, and considering that the top 1 percent of income earners in America get to live nearly 15 years longer than the bottom 1 percent, it is well past time to recognize economic policy as health policy.
The fact that health care polled at or near the top of concerns for many 2018 voters is not a detriment to a policy agenda that includes all the things that can truly make us healthier; it is an open doorway through which we should charge. Here in Colorado, we have built the state’s largest health advocacy organization in four short years by organizing and winning on issues ranging from health care to nutrition to social justice.
The ability of Americans to stay well and alive should be fundamental measures on which elected officials are held accountable. When we build a nationwide constituency capable of doing just that, Americans can finally realize the opportunity to live full, healthy lives.
Jake Williams is the executive director of Healthier Colorado and the host of the “Wooden Teeth” podcast on politics and public health.
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