By transforming healthcare from a system that pays for volume and complexity of medical services to a system that pays for a more holistic view of health, we can deeply impact the health of children today.
Editor's note: R. Lawrence Moss, MD, FACS, FAAP, is the president and CEO of Nemours Children's Health System based in Jacksonville, Florida.
It’s the year 2020, and it’s a beautiful day in the neighborhood—for some children. Despite our country’s efforts towards improving socioeconomic factors like unemployment, teen pregnancy and high school graduation rates, we can still predict a child’s health, their future income, and even their life span, based solely on their zip code. According to the Child Opportunity Index 2.0, a new report from Brandeis University, 10 million American children live in low-opportunity neighborhoods, which puts them at a stark disadvantage to those in high-opportunity areas.
Researchers analyzed 72,000 neighborhoods across America, examining factors such as access to good schools, parks, and healthy food. In all metropolitan areas, they found at least a seven-year difference in life expectancy between residents in low- and high-opportunity neighborhoods.
In a new white paper I recently published, How Children Can Transform the Economy… and Healthcare, I note the leverage for strategic investments in the well-being of children to impact not only their own lives, but strengthen the outlook and contributions of the next generation of future U.S. citizens.
We’ve known for decades that social, economic, and environmental factors have a major impact on health, yet our healthcare system persists in spending the vast majority of its resources on medical treatments—tests, surgical procedures, medications, and so on. However, a substantial body of evidence suggests that medical care actually accounts for only about 15% of our health.
The remaining 85% is determined by the multiple underlying factors that shape our lives—including education, food security, employment, freedom from violence, avoidance of childhood trauma, access to transportation, and much more. By transforming healthcare from a system that pays for volume and complexity of medical services to a system that pays for a more holistic view of health, we can deeply impact the health of children today, and the next generation of adults.
According to a recent Harris Poll commissioned by Nemours, nearly two-thirds of American parents of children under 18 report at least one economic, environmental, or lifestyle factor that limits their family’s ability to lead a healthy life. Sixty-eight percent of parents encountered at least one of these factors in the past 12 months: Being unable to pay one or more of their bills (32%), skipping a doctor/dentist appointment because they couldn’t afford to pay for visits, or find transportation (32%), worrying about running out of food (23%), worrying about their family’s personal safety (17%), trouble finding work or affordable child care (17% each), or being unable to find a grocery store with healthy food options (10%).
Our survey shows how shockingly normal it is for families to struggle to meet basic needs that are crucial for children’s health. While we must remain committed to providing the highest quality acute medical care when needed, we must also recognize that families need so much more—from high-quality education to nutritious food to policies and programs that lift the health of entire communities. To do this, we must work together. Effective partnerships will amplify and extend the reach of our work to maximize the benefits for our children.
We’re seeing health systems across the country find ways to connect their patients to resources that go far beyond medical treatment. At Nemours, we’re doing this through intentional collaboration with our community partners in early childhood education, adult care, food pantries, and more. Nemours and other children’s hospitals are doing this because it is a way to get more from the care we provide, and because it’s also a very smart investment in the future economic health of our country.
For example, a recent study from Opportunity Insights, a research group at Harvard University, examined the return on investment of 133 past and present federal social policies. Not surprisingly, those policies that directly targeted young children had the highest value because they continued to pay dividends long after childhood.
If we, as a society, would collectively address the social factors that influence children’s health, we would permanently improve the health and the economy of our country by reducing the toll from chronic diseases, creating a healthier, more productive workforce.
As trusted authorities with substantial infrastructures, children’s hospitals are well-positioned to lead the way. Through partnerships with social service agencies, government, and commercial payers, we can greatly magnify the effectiveness of the medical care we deliver by also addressing the underlying social determinants of health for all.
Dr. R. Lawrence Moss was a participant at the HealthLeaders CEO Exchange last fall. The CEO Exchange is one of the healthcare thought leadership and networking events that HealthLeaders holds annually. Our CEO Exchange is an invitation-only event that brings together top leaders from across the country to participate in small discussion groups, share best practices, and network freely. To inquire about attending a HealthLeaders Exchange, email us at email@example.com.
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“We’ve known for decades that social, economic, and environmental factors have a major impact on health, yet our healthcare system persists in spending the vast majority of its resources on medical treatments—tests, surgical procedures, medications, and so on. ”
—R. Lawrence Moss
Photo credit: Nemours Children's Health System President and CEO R. Lawrence "Larry" Moss, MD, delivers a presentation during a HealthLeaders CEO Exchange gathering in Park City, Utah. (HealthLeaders/David Hartig)