The Public's Call for Health: Heeding the Signals and Embracing Opportunities

It's January, a time when people inevitably resolve to live healthier lives, replacing bad habits with good ones like improved diet and increased exercise. But what outdated habits could America seek to change in the interest of solving its persistent health issues?

The cost of health care in America is not contained. Health spending rose to almost 18 percent of GDP in 2023; more than 60 percent of American adults live with one or more chronic diseases; and life expectancy has improved much more in other developed countries than in the United States in recent years.

Concurrently, many Americans feel disconnected and hopeless. In fact, 58 percent of Americans believe that life for “people like them” is worse now than it was 50 years ago. This driver has an incredible bearing on health, contributing to the national mental health crisis and diseases of despair that trouble communities and affect the economy. Coupled with escalating costs, it also fuels general dissatisfaction with the health system, as seen in the unsettling reaction to the tragic death of a health care CEO.

This pattern highlights signals that traditional health metrics often miss, such as disconnection and hopelessness, which continue to undermine America's health. The narrative that health is mainly about doctor visits and the absence of illness has to change. The traditional health narrative has led to a focus on costly and inefficient treatments for existing conditions rather than prevention.

Without a significant shift in approach, the same troubling health statistics will persist, and the public's sentiment about health will remain unchanged.

Three actions are needed to drive change: 1) a new and more accessible narrative about health and why it matters, 2) alignment of spending to well-being outcomes that support human flourishing, and 3) data that actually helps us act cohesively to support health and well-being.

Public health experts for decades have called for a system that prioritizes prevention and fosters healthier environments, tackling health issues at their roots. But what has been missing is a new health narrative in broader society. Adopting and maintaining momentum for this reframe starts with shifting mindsets about what it means to be healthy and well, rooted in the things people already care about—family, community, connection, and our livelihood.

What is the resolution?

• Rewire the American view of health to embrace a focus on family and community well-being.
• Diversify the voices shaping the health narrative to include more than just those of health system leaders. Make health topics more “viral” in spaces and places where Americans are.
• Restore trust in the systems that promote health, which may involve rethinking the role of health institutions, especially given the decline in trust since the COVID-19 pandemic.
• Connect the health narrative to broader themes, such as thriving, collective well-being, and community resilience.

America's health spending should be redesigned around what actually produces health on a daily basis. Despite exorbitant spending on health care, increases in U.S. life expectancy are forecasted to stall by 2050. We know that 80 percent of health is determined by factors outside the doctor's office and social spending, not medical spending, has been shown to have a greater effect on improving health outcomes. Opportunities to align budgets to drivers of health present themselves on a regular basis, whether it's new funding opportunities or efforts to recover following disasters, not just during “budget season.”

What is the resolution?

• Examine America's health care budgets and ask the question, “does this investment actively produce health or just mitigate disease?”
• Invest in initiatives that build connections between people to help them thrive.
• Match communities' health budgets to what drives health outcomes, meaning investments in the behavioral and environmental factors that influence health.

The artificial divide separating the economy and health needs to be closed, especially when it comes to measurement. Evidence shows that health impacts the economy in various ways (PDF), such as influencing productivity, labor participation, and overall economic growth. However, health measures are often confined to health departments, focusing on morbidity and mortality statistics without connecting to other community indicators. And from an economic standpoint, health is frequently viewed as a luxury, rather than being essential to economic engagement and a productive workforce. To address this, a measurement system needs to be developed that captures the broader impacts of health on the economy, integrating health metrics with economic indicators to better inform policy and decisionmaking.

What is the resolution?

• Establish partnerships between health departments and economic agencies to create joint metrics that capture the interplay between health status and economic productivity.
• Encourage cross-sector collaboration to design metrics that reflect the value of positive health as a driver of innovation and economic resilience.
• Develop integrated data platforms that facilitate the sharing of health and economic data across sectors, enabling a comprehensive view of how health influences economic outcomes.
• Collaborate with community organizations to contextualize health metrics, ensuring they reflect local economic conditions and social determinants of health.

This could be a time for desperately needed rethinking, not more tinkering around the edges, to forge a new approach to national health. Health is a necessary condition for America's communities and its economy. By changing the nation's health narrative, investing in assets that promote thriving, and using smarter ways to measure success, a healthier, more hopeful American future can emerge.