Beyond Medicine

This concluding chapter explains that the preeminent challenge of US social reform today is to create a balanced health system that can meet the challenges of the twenty-first century. Policies will need to simultaneously encourage continued progress in biomedical curative care, assure universal access to it, and enhance the social and physical environments that are imperative for a healthy life. This book's comparative historical analysis reveals that purposeful state action in France, Germany, and Sweden helped to create balanced health systems that produce better population health outcomes than the United States. The chapter looks at the Health in All Policies (HIAP) movement. Rather than relying on health care systems to attenuate the negative social determinants on individuals, HIAP recognizes head-on that transformational improvement requires political power. The health impact assessment (HIA) plays a central role in the Health in All Policies approach. It informs policy makers and the greater public about how seemingly unrelated decisions outside the health field can affect health.