Incorporating social determinants of health into patient care.

I n the last decade, US healthcare leaders have worked to increase medical coverage, decrease cost, and improve access to quality of care. These efforts have produced positive results, such as a reduction in readmissions and a decrease in medication errors, but the US remains an unhealthy country overall. In fact, if we use life expectancy at birth as a proxy measure of a population’s health as offered by the World Health Organization (WHO), the US doesn’t fare well. A Peterson Center on Healthcare and Kaiser Family Foundation analysis of 2018 Organization for Economic Co-operation and Development (OECD) data demonstrated that US life expectancy at birth was growing at a slower rate than that of 12 comparable developed countries.1 As of 2016, the US had an average life expectancy of 78.6 years, the lowest of the 12 countries. The PetersonKaiser analysis also compared the measures of disease burden by calculating years of life lost due to premature death, as well as years of productive life lost to poor health or disability. In a country with the latest technology, sophisticated devices, and expert clinicians, Americans carry a higher disease burden than those living in comparable developed countries.2 The US also spends a disproportionate amount of money on healthcare. Americans spend over $3.5 trillion annually and more than $10,700 per person per year on healthcare and related expenses as compared with an average of $5,280 per person per year in comparable countries.3 In the US, 90% of healthcare dollars are spent on medical treatments that occur within a healthcare setting,