Jason Purnell: Better health care not enough to address health disparities

Faculty; Policy; Public Health

U.S. health care spending grew by 5.3 percent in 2014, to a record $3 trillion, the Los Angeles Times reported last week.

While more and better health care is necessary, it is probably not sufficient to advance better overall population health and to address lingering health disparities, says an expert on public health at Washington University in St. Louis.

“We need a better understanding on the part of the public and policy makers about the contexts in which health and illness develop, and a movement beyond individual effort as the solution,” said Jason Purnell, PhD, assistant professor at the Brown School.

Purnell has written the chapter, “Financial Health as Public Health,” in the newly released book, “What It’s Worth: Strengthening the Financial Future of Families, Communities, and the Nation.” The book was published Dec. 8 by the Federal Reserve Bank of San Francisco and the Corporation for Enterprise Development.

“American families are stressed and stretched, and their household financial status has to be part of any set of solutions to health,” he said. “Targeted investments are also needed in early education, supports within schools, mental health, and community and economic development — all with the aim of a healthier, more productive population.”

Purnell’s chapter addresses the social determinants of health that have a considerable impact on the health of populations.

“America has a relatively poor showing when you compare our health outcomes with those of other wealthy nations,” he said. “There are limitations of even the Affordable Care Act to deal with that.”

Writes Purnell: “We know that poverty, violence, and inadequate resources, services, and amenities affect the health of communities as well. We must find creative ways of making health promotion a central part of community and economic development.

“In these and many other ways, the inextricable, often stress-laden link between financial well-being and physical and mental health must become the centerpiece of public understanding and public policy. Both our economic health as a nation and the very lives of the American people depend on it.”