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A Healthy Populace Requires More Than Medical Care

In the halls of Congress, most attention regarding our nation’s health focuses on reforming our health care system. But health and health care are not the same, and health reform alone won’t improve the health of all — or even most — Americans.Consider this: For the first time in our history, the United States is raising a generation of children who may very well live shorter, sicker lives than their parents.[IMGCAP(1)]Shocking but true. Across the board, Americans are not nearly as healthy as we could be. That’s true of our children, too, regardless of their families’ income, education and race or ethnicity. Nationally and in every state, even children in the most advantaged families could be much healthier. That’s why the Robert Wood Johnson Foundation Commission to Build a Healthier America just released a report urging citizens and leaders alike to incorporate health into all aspects of everyday life and decision-making — from education to child care to community planning to business practices. The commission’s charge was to find sensible solutions outside the medical care system that will help improve the health of all Americans. Because research demonstrates that early childhood has a tremendous impact on a person’s health across a lifetime, our recommendations focus heavily on support for children and families. This is where our best investments lie, an important consideration given the nation’s current financial problems.And the sooner we make these investments, the better. We ask Congress to significantly increase support of early childhood development programs for very young children in low-income families. This is not just about how many dollars we spend; it’s about doing what’s best for our country’s future. One may ask: What do education and child care have to do with health? A lot, as it turns out. A good education will help lay the foundation for a healthy life. As a doctor, I know firsthand that poor health rarely occurs in a vacuum. It is shaped by many factors, including education and family income and the resources and opportunities they provide, like access to nutritious food and adequate housing. In other words, health has more to do with how and where we live than whether and how often we see a doctor. Generally, we see a doctor when we’re sick. The ideal is not to get sick in the first place. Since medical care accounts for only an estimated 10 to 15 percent of preventable mortality, we need to focus on these other, more powerful social factors. Take education, for example. Every child should have the opportunity to receive an excellent education. Poor education can lead to limited job options and lower income, which in turn can limit a family’s chances to live in healthy homes and neighborhoods.And guess what: People who have more education tend to live longer than people who don’t. On average, college graduates can expect to live five years longer than people who haven’t finished high school.What distresses me most is the prospect of the lifetime of poor health, limited opportunities and lost potential that so many children face. Health reform alone won’t solve this problem. If we addressed education, child care and other social issues as part and parcel of health, we wouldn’t have so much illness in this country. But instead of ensuring that our children are growing up healthy, we are pouring money into medical care for adults whose illness or disability might have been prevented. That makes no sense.I challenge our nation’s leaders — not only here in Washington, D.C., but in every sector across the country — to think outside the box. Yes, health care reform is critical. But let’s not fool ourselves that it’s the be-all and end-all to improving health for all Americans. Let’s broaden our view of what health really means and all that we can do to achieve better health.By focusing on children and their families, we can help ensure that today’s healthy youngsters are tomorrow’s healthy adults. We must give children the support they need in their most formative years — not just access to medical care but also high-quality early education and child care. Let’s alter our current course and give our children better lives.Former Senate Majority Leader Bill Frist (R-Tenn.) is a member of the Robert Wood Johnson Foundation Commission to Build a Healthier America.

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