Don’t let zip code define our health outcomes

The average life span for an American fell once again, now hitting a 25-year low. But we should also worry about the quality of life than merely focus on the length of lifespan because, in the past century, the portion of years humanity spent in moderate to poor health has stayed the same. On average, people spend about 50% of their lives in less-than-good health, including 12% in poor health. 

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. There is no doubt that circumstances outside of health care can either enhance or impair your health. For example, where you live influences how you live, whether you have access to healthy food, places to exercise or health services when needed. Your zip code also affects your personal and family’s economic prosperity based on the availability of jobs, unemployment rates, education, and training opportunities. These social factors shape and define your health and well-being. 

Here is an example of how zip code matters, between the Chicago Loop and the west side of the city, which are merely 6 miles apart, there is a difference in life expectancy of 16 years. At a population level, medical care is estimated to account for only 10-20% of the modifiable contributors to health outcomes; the other 80 to 90% are called the determinants of health: health-related behaviors, socioeconomic factors and environmental factors. The power of these societal factors is immense compared to a health care system’s ability to undo them. 

And yes, let us remind ourselves that we spend more on health care than other developed nations, annually an average of $12,914 per person and about 18.3% of the gross domestic product (GDP). It is frustrating to witness that we spend more than 95% of our health care expenditure on direct medical care while less than 5% goes into preventive population care. The truth is that decades of research on the root causes of poor health and opinions of public health advocacy experts have not been able to change underinvestment in optimal health and well-being.

It is about time we reframe our thinking around health and health care. Especially for our local community, let us create a more holistic approach to health care by addressing health’s physical, mental, social and spiritual dimensions. Everyone should have an opportunity to have optimal health and not just access to medical care to receive care during sickness. Our community should spend resources on creating safe outdoor places for physical activity, access to healthy, affordable foods, walking school buses, safe walking and bike paths that promote human-powered transportation, healthier worksites to make healthier choices easier and outdoor green spaces. Growing evidence suggests that being in nature positively affects people’s mental health. Studies have shown that green spaces can lower levels of stress and reduce rates of depression and anxiety, reduce cortisol levels and improve general well-being. 

Alignment, collaboration, and partnerships across community stakeholders can move the field forward to understand and address the community-level conditions that affect our health so that the zip code no longer defines our health outcomes. Understanding and addressing social determinants of health can create healthier and happier communities if we collectively prioritize it.

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