Health care can be expensive and access varies significantly, leading many Americans to struggle to pay their medical bills or access culturally and linguistically appropriate health services. Chronic diseases can have devastating consequences; therefore, to improve our nation’s health we must tackle these problems head-on; A Guide to Understanding America’s Health Problems provides a great starting point.
Chronic Diseases
At least nine out of the top ten leading causes of death in America are chronic diseases, including cancer, heart disease, respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD), diabetes, stroke, and arthritis. Each condition may last over one year and have serious negative impacts on daily activities like working or sleeping as well as family life and quality of life.
Many diseases are incurable but treatable with medications and other treatments; unfortunately these therapies can be very costly and present significant indirect costs in terms of lost productivity and increased medical bills, which has an immediate negative effect on quality of life and ability to earn a living, particularly in rural areas with limited healthcare systems and resources.
Chronic disease rates are on the rise and will only continue to increase over the coming decade, in large part due to Baby Boomer aging and lifestyle factors like smoking, lack of physical activity and poor diet contributing to chronic illnesses and their symptoms. Their prevalence varies considerably by state and region.
Many illnesses can be avoided through eating healthy food, getting enough exercise, and cutting back on unhealthy habits like excessive alcohol consumption or using tobacco. But environmental and social factors beyond your control also play a part. These determinants are known as social determinants of health – they include access to quality education, safe housing, affordable transportation options and supportive communities – along with your choices that affect how healthy you are overall and risk for chronic disease development.
Preventive Care
Preventive healthcare refers to any approach taken in healthcare that seeks to avoid disease rather than treat its symptoms after they arise, such as educational programs, regular medical examinations and screening tests, vaccinations and lifestyle counseling.
Under the Affordable Care Act (ACA), preventive services are now frequently free under private insurance plans that comply with it; thus enabling many more people to get the wellness exams and screenings they require for early detection of potentially life-threatening conditions that might otherwise develop into full-blown illnesses.
Though preventive care programs are an excellent step in the right direction, its true success relies on patient involvement in making healthy choices and accepting responsibility for their own health. While doctors and nurses may educate their patients about regular exercise, healthy diet, avoiding smoking and alcohol abuse – ultimately it’s up to each individual to be proactive about their wellbeing and take whatever steps necessary in order to stay well.
Preventive care includes annual well-woman visits, most immunizations, and routine cancer screenings such as mammographies. Furthermore, many hospitals offer health promotion programs designed to teach patients the most effective practices for managing chronic illnesses and adopting healthier habits – from properly taking their medications to educational materials about eating well and sleeping better.
The Centers for Disease Control and Prevention is working hard to make preventive care more accessible to Americans. Their National Prevention Strategy strives to foster healthier lifestyle choices and equip communities with high-quality preventive services more easily. Identifying areas for intervention while simplifying access for high-quality preventive services for communities is just part of that initiative.
NYC medical clinics specialize in preventative healthcare services, including screenings, vaccinations and lifestyle counseling. These clinics strive to keep their patients as healthy as possible through proactive measures that benefit both short and long term health. Such preventive measures help keep America on its healthiest course and help reduce disease, disability and premature mortality rates.
Social Determinants of Health
People’s lives–where they live, learn, work and play–can have profound effects on their health. These influences, known as social determinants of health, often play more of a role than medical care or individual lifestyle choices in shaping outcomes of health conditions. According to CDC data, common social determinants include income, education housing and access to healthy food as well as neighborhood safety and environmental factors that influence people’s healthcare needs in living their best life.
Crime or pollution-filled environments can have an enormously detrimental impact on their stress levels and overall wellbeing, potentially increasing cardiovascular disease risk, depression and impeding activity and healthy food choices. Therefore it is imperative that all Americans have access to high-quality care available.
Health care experts have increasingly recognized the need to address non-medical factors influencing health – known as social determinants of health – such as non-medical factors and social determinants of health. Organizations and companies are testing new strategies for improving outcomes by targeting the root causes of poor health rather than simply treating symptoms post hoc; hybrid models which combine clinical interventions with community initiatives have proven most promising.
However, several obstacles threaten our progress in addressing these issues. Of particular note is the Trump administration’s focus on work requirements for individuals receiving assistance programs that could restrict resources and efforts dedicated to this cause. Another challenge lies with unconscious bias within providers that could jeopardize patient quality of care from patients of color.
At the American Medical Association (AMA), we are dedicated to helping overcome obstacles preventing patients from accessing health services. A report adopted at the November 2020 Special Meeting by AMA details what needs to be done, recognizing that a collaborative approach among all stakeholders–local government agencies, schools, businesses, foundations, community and faith-based organizations as well as other partners is absolutely critical for success.
Health Care Pricing
Many Americans struggle to afford health care. With rising health care costs competing with food, housing and transportation costs for consumer spending dollars, rising health care costs hinder economic growth by diverting resources away from other uses – meaning businesses that spend too much of their profits on health care may reduce other expenses or lay off workers altogether.
American medical research and cutting-edge technology may be world renowned, yet their healthcare system struggles to deliver quality services at an affordable cost. Beyond costly prescription drugs, U.S. costs also feature relatively higher surgical procedures, diagnostic tests and other health services due to excessive administrative expenses, market power by specialists and insurers (see Fact 9) and higher wages paid out to physicians and other health-care providers ( Fact 9 ).
Many Americans live in communities with poor health outcomes, such as higher rates of chronic illness and limited access to primary healthcare services. These issues are further compounded by high out-of-pocket costs for insurance and health care; nearly half of adults report difficulties paying deductibles and copayments when making doctor visits or filling prescriptions – the share among lower income adults reporting difficulty even increases further.
Health care costs can be an enormous barrier for making healthier decisions, according to recent research. A study showed that people without enough funds to buy healthy foods or exercise regularly were also more likely to postpone regular health activities such as receiving their annual skin exam or flu shot on schedule.
Future successes for health-care reform require addressing the drivers of high health-care costs and lowering out-of-pocket expenses so more Americans can access an excellent system.
David Cutler’s special feature for Harvard Magazine in May-June explores three driving forces behind health care spending–administrative expenses, corporate greed and price gouging, and increased use of costly medical technology–and offers possible solutions to address them.