Flattening the Trajectory of Health Care Spending: Promote Population Health

The Policy Challenge Social and behavioral factors influence the health of Americans as surely as do the efforts of physicians, nurses, and hospitals. To slow health care spending growth, we need to do a better job of addressing the determinants of disease, rather than waiting to treat its consequences. It is estimated that 70 percent of deaths in the United States and a comparable share of health care spending are due to behavioral or environmental causes,1, 2 but only 5 percent of our nation’s annual spending on health is directed toward reducing key health risks. The nation pays a high price for neglecting the possibilities of prevention. For example, high blood pressure dramatically increases the risks of heart disease, stroke, and kidney failure— all of which are major causes of death, disability, and spending through Medicare. Yet, according to ■ Although a majority of the premature deaths in the United States are due to behavioral and environmental factors, our country allocates only 5 cents of every health care dollar to prevention.