The Other Determinants of Health

Published on June 7, 2016

If you add up all the annual visits to a health care professional, the CDC reports that the “average” consumer sees a practitioner ~3 times a year.  And 40% of us have 1 (or zero!) visits.

So, using just a handful of data points, how can our physicians predict our future health?  Short answer – they can’t.

There is not enough data in the electronic medical record (or claims history) to understand consumer behavior – let alone predict it.

Why would you drive and only use the rear-view mirror?

How, then, can we better understand the future health risks to an individual or a population?80_Percent_Health_Drivers_Non_Clinical.png

Most of our lives are spent outside walls of the health care system.  99.97% of it, in fact.  Spoiler alert: the factors that drive health outcomes like Longevity & Quality of Life are related to how we behave and where we live, not clinical care.

In fact, as shown in the image, the Robert Wood Johnson Foundation attributes 80% of our health to Behaviors, Social/Economic Factors, and Physical Environment – where we spend our lives.

For example, when looking at patients’ social needs, those without reliable access to affordable, nutritious food are 30% more likely to report they have hyperlipidemia than their food-secure counterparts.

You can find your state & county health risk factors on the County Health Rankings & Roadmaps website.

When we look at behaviors, adults who exhibit three or more of the following behaviors are 610% more likely to be in “poor” or “fair” health than those without those behaviors: smoking, excessive drinking, insufficient sleep, physical inactivity, and obesity. These and other findings are shared in the Americas Health Ranking’s Impact of Unhealthy Behaviors report.

If we want to understand and improve health for both the individual and the population we have two choices:

1) Wait until our customers (patients) seek care, and treat them (rear-view mirror “sick care”), or

2) Understand the social, behavioral, and environmental factors that determine our health, and proactively intervene in the community to reduce our risk and improve health (“provide health”)

I prefer the latter.

For more information on the approach used to calculate risk factors, check out County Health Rankings & Roadmaps and Carrot MarketViewTM.

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