Don’t let zip code define our health outcomes

The average life expectancy for an American has dropped once again and is now at a 25-year low. However, instead of just focusing on longevity, we should also worry about quality of life because over the past century, the proportion of years humanity has spent in moderate to poor health has remained the same. On average, people spend about 50% of their lives in poor health conditions, of which 12% is unhealthy.

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. There is no doubt that conditions outside of healthcare can improve or impair your health. For example, where you live affects how you live, such as whether you have access to healthy food, places to exercise, or health care when needed. Your zip code also affects your personal and family’s economic well-being, depending on the availability of jobs, unemployment rates, and education and training opportunities. These social factors shape and define your health and well-being.

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Here’s an example of how important the zip code is, there’s a 16-year difference in average life expectancy between the Chicago Loop and the west side of town, just 6 miles away. At the population level, medical care is estimated to account for only 10-20% of modifiable contributions to health outcomes; the other 80-90% are called determinants of health: health-related behaviors, socioeconomic factors, and environmental factors. The power of these societal factors is enormous compared to a health system’s ability to reclaim them.

And yes, let’s remember that we spend more on healthcare than any other developed country, with an average of $12,914 per capita per year and about 18.3% of gross domestic product (GDP). It is frustrating to witness that we spend more than 95% of our healthcare expenditures directly on medical care and less than 5% on preventive population care. The reality is that decades of research into the root causes of poor health and the views of public health advocacy experts have not changed the under-investment in optimal health and well-being.

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It’s time to reframe our thinking about health and healthcare. Let’s create a more holistic approach to health services, especially for our local community, by addressing the physical, mental, social and spiritual dimensions of health. Everyone should have the opportunity to have optimal health, not just access to medical care to receive care during illness. Our community must invest resources in creating safe outdoor spaces for physical activity, access to healthy, affordable food, walking school buses, safe walking and cycling routes that encourage human-powered transportation, healthier workspaces and open green spaces to facilitate healthier choices. Increasing evidence shows that being in nature has a positive impact on people’s mental health. Studies have shown that green spaces can lower stress levels and reduce rates of depression and anxiety, lower cortisol levels, and improve overall well-being.

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Harmony, collaboration, and partnerships among community stakeholders can move the field forward to understand and address community-level conditions that affect our health so that zip code no longer defines our health outcomes. Understanding and addressing the social determinants of health can create healthier and happier communities if we collectively prioritize it.

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