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The Future of Population Health (Volume 101)
Quarterly Article
Daniel Dawes
Juan Gonzalez
September 2024
March 2024
Back to The Milbank Quarterly
Policy Points:
Notwithstanding its status as a world leader in developing the latest health care advances as well as for spending on health care, the United States has continued to fall behind other developed countries in health rankings. Even though it spends more on health care than any other country and consumes more than half of the world’s health care resources, the United States has seen increasing mortality and falling life expectancy for people ages 25–64, who should be in the prime of their lives.1,2 When disaggregated by race, ethnicity, geography, and other demographic variables, the inequalities in health status and health care are quite striking.
It is now well understood and widely accepted that the social determinants of health affect all aspects of people’s daily lives. In fact, it is known that the social determinants of health directly affect and often even determine or drive populations’ health choices and access to adequate, affordable, and nutritious food options; safe housing, blue and green spaces; reliable and safe transportation; education and literacy; opportunities for economic stability; and sanitation, among other important factors. In addition to genetics, health care, and behavior, the direct significance of all the social determinants of health variables and their contribution to health, wellness, and life opportunities have come to light. The clear link between health risks and the conditions of the places where people live, learn, work, and play have now been illuminated.3
