Healthcare in America and How to Change

Until roughly around the 1980s, the United States remained at the forefront of healthcare by most metrics such as life expectancy and infant mortality. From the 1980s onward, most population health statistics have declined considerably to the point where Americans live shorter lives than those in much poorer countries like Greece, Cuba, and Chile (Galea, 2017). Yet healthcare spending remains exorbitant, with Americans by far outspending their counterparts around the world. The reasons why American health has declined is due to a number of interrelated contextual variables. The healthcare system itself is not to blame; it remains among the world’s best and most advanced, with truly remarkable tools, technologies, and techniques at the disposal of most Americans. Sure, poverty and affordable healthcare remains one of the most significant barriers to achieving population health goals, but America’s failing bill of health is also related to broader social and political issues. The proliferation and even celebration of ignorance undermines public health awareness initiatives, for one. Second, the infrastructure of the United States is not conducive to healthy lifestyles. Not only do Americans live in car-dependent enclaves, but they also fail to recognize that their cities and suburbs are categorically unhealthy places to live. Americans need to cultivate a culture of health, one that values civic pride, respect, and personal responsibility.
To improve the health of all Americans, the society itself needs to change in a deep and meaningful way. The election of Donald Trump and the Trump administration’s political trajectory signals a turn for the worse. Americans can spend all they want on healthcare, but until the culture becomes more progressive and intelligent, Americans will continue to suffer from preventable diseases at rates that are unsustainable. Food, agriculture, and nutrition are cornerstones to good health. Americans inherently mistrust top-down public health policies, such as government interventions. Therefore, it is important to devise creative solutions such leverage the power of social media, celebrity endorsements, and other means of making healthy lifestyles more normative. It is also critical to radically transform the agro-business model towards one that is health-centric rather than one that is market-driven. Diverting arable land to cash crops like corn, used only to transform into high fructose corn syrup, needs to be framed as being categorically unethical. The growing popularity of farmer’s markets in American urban centers may not be enough to steer the public in the right direction, encouraging more people to eat fewer processed food items, less meat, and more greens and whole grains.
There is no one strategy for promoting health in America. Change may take generations to take root. However, a few things can be done immediately including the revitalization of public infrastructure. More parks, more bike lanes and sidewalks, more walkable communities filled with small businesses instead of eyesore strip malls might help more Americans feel good about their communities. Investments into education and the arts also help Americans refocus their energies and attentions away from robotic consumerism and towards the cultivation of critical and creative thinking. Businesses also need to incorporate health-related strategies into their programs of corporate social responsibility. Offering better work-life balance options for employees, promoting healthy eating and healthy lifestyles in the workplace, and creating a culture of health are all specific strategies that can be taken without resorting to intrusive measures that many Americans will rebel against anyway. With conscientious efforts, Americans can mitigate many of the potential problems posed by the current political situation and create a healthier future. All of these issues related to this course and to the field of human services in general. Human services is about comprehensive change, focusing on the macro level issues and mezzo-level institutions that can support and enable transformative public policy.




References

Galea, S. (2017). An unhealthy mismatch. The Milbank Quarterly 95(3): 486-489.