Head Upstream for Health

Published on January 26, 2017

NPS Bear Photo.png

At Katmai National Park, the Alaska brown bears know their existence depends on salmon.  To maximize their chance for survival, the bears head up the Brooks River where the fish are concentrated and efforts to capture them most effective.

Health providers, too, know that as they are increasingly expected to provide value and better health for consumers, their efforts must shift upstream to maximize health outcomes – outside the four walls of the clinic, into the world of the consumer.

Think Outside the Box

As described by the Robert Wood Johnson Foundation, 80-90% of health is determined outside the four walls of clinical care. Behavior, physical environment, and socio-economic factors determine health or emerging sickness long before a patient enters a clinic or hospital.

Engaging in healthy behaviors – not smoking, being physically active, maintaining normal body fat, and eating a healthy diet – cut an individual’s risk of developing cancer by 50% and chronic illness by up to 80%. And yet, less than 3% of the population exhibit 4 or 5 of these behaviors.  Most of the population – a whopping 87%– engage in 2 or fewer healthy behaviors, increasing their risk of developing a disease. How, then, can providers impact health outcomes if interventions occur late in the game, so far downstream that the patient is already sick?

Consumer data holds a key.

Data Drives Discovery

Variation in consumer behavior leads to poor health outcomes, generating $1.5 trillion dollars in unnecessary healthcare spending [see the statistics below].  Consumer variations can be identified – does someone live near a park, do they travel, have long commute times, do they own a dog?  Once identified, analysis paints a picture of whether or not a person is likely to engage in healthy behaviors, like leading an active lifestyle.

Health Care Spending Statistics:

The United States as a whole spent $3.3 trillion in 2015.

75% of that was spent on chronic illness and cancer treatment.

Healthy behaviors could cut the incidence of these illnesses by more than 50% – that’s more than $1.5 trillion in potential savings

Using Active Lifestyle as one variant of consumer behavior, Carrot Health has created a model that applies individual and community proximity to fitness centers, parks and trails, retail purchasing patterns, and commute-times and distances and assigns a rank of physical activity.  Here is that ranking mapped across US counties:

Carrot Health Inactivity Index


Notice how closely the Carrot Health ranking of physical activity correlates to a CDC map ranking the of number of preventable deaths, by county, if patients had access to quality health care AND adhered to behavioral changes to improve their condition (or avoid sickness altogether):

CDC Map - Preventable Deaths by County.png


Rates of avoidable death from heart disease, stroke and hypertensive disease by county, US 2008-2010.  CDC, 2013

Analysis Into Action

Our health system is evolving.

Value is increasingly determined by health outcomes rather than by fee-for-service, or late-in-the-game sick care. Combining consumer data with clinical care gives providers an edge.

Our clever ursine cousins in Katmai National Park, what would they think about providers who migrate upstream to impact a patient’s life for good?

Smarter than your average bear.

To learn more, download our whitepaper: From Sick Care to Health Care: Health Systems Can Add Value by Moving Upstream.

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