National Academy of Medicine

Advancing the Health of Communities and Populations: A Vital Direction for Health and Health Care

By Lynn Goldman, Georges Benjamin, Sandra Hernández, David Kindig, Shiriki Kumanyika, Carmen Nevarez, Nirav R. Shah, and Winston Wong
September 19, 2016 | Discussion Paper

We have a long way to go to strengthen the public health system to provide adequate protection for communities. Dollar for dollar our health care expenditures fail to provide us with good health at the most basic level as measured by life expectancy and infant mortality. The United States spends 18% of its gross domestic product—more than $8,000 per person per year—on the provision of medical care and hospital services. That is 2.5 times the average of industrialized nations in the Organisation for Economic Co-operation and Development (OECD), but by any measure our population is less healthy; US life expectancy at birth is well below the OECD average, and our infant mortality is higher than that of all 26 other industrialized nations. In fact, Americans are at a disadvantage at every stage of the life cycle relative to counterparts in peer countries.

Recent events like lead contamination in drinking water in Flint, Michigan and other cities across our country; the epidemic of obesity and related chronic diseases in the US; outbreaks of new microorganisms in drinking water like naegleria and legionella; spread of Aedes mosquitos that carry tropical diseases like Zika, Dengue and Chikungunya; the serious impacts of catastrophic storms like Hurricanes Katrina and Sandy; and the epidemics of opiate addiction and HIV that are reappearing across the US are ringing alarm bells about our weak public health system.

About the Vital Directions for Health and Health Care Series

Vital DirectionsThis publication is part of the National Academy of Medicine’s Vital Directions for Health and Health Care Initiative, which commissioned expert papers on 19 priority focus areas for U.S. health policy by more than 100 leading researchers, scientists, and policy makers from across the United States. The views presented in this publication and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations.
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Suggested Citation

Goldman, L., G. Benjamin, S. Hernandez, D. Kindig, S. Kumanyika, C. Nevarez, N. R. Shah, and W. Wong. 2016. Advancing the Health of Communities and Populations: A Vital Direction for Health and Health Care. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201609l


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.