The United States spends more on health care than any other country. Yet Americans die sooner and experience more illness than residents in many other countries. Why? And how do we improve this nation’s health performance? This question has been studied at great length and the results are frustrating… The problem is not a matter of large numbers of uninsured or social and economic disadvantage; and cannot simply be explained away by the racial and ethnic diversity of the U.S. population.

 A need to intensify efforts to pursue existing national health objectives that other high-income countries have mastered; and gaining public involvement and understanding about the inherent tradeoffs in lifestyle choices are two very good places to start. The U.S. ranks as the world leader in obesity and the high prevalence of diseases related to obesity, such as diabetes, could be helped by initiatives that succeed in lowering the average body mass index of the population as an example.

Americans are less likely to smoke and may drink less heavily than their counterparts in other countries; however, they consume the most calories per capita, abuse more prescription and illicit drugs, are less likely to use seatbelts, and  have more traffic accidents involving alcohol. The list of factors that contribute to our disadvantage is familiar to experts in public health and social policy. Long standing concerns: infant mortality, injuries, violence, adolescent pregnancy, sexually transmitted diseases, drug abuse, obesity, diabetes, heart and lung disease and disability. Many evidence-based strategies to address these specific public health challenges have been identified, and we even have national objectives to address them.

The trick is… How do we get American’s to connect the dots? Beliefs, behaviors, expectations and realities are not congruent. As hospital leaders, our shared vision is “an optimally healthy society.” Our goal is “every Californian should have access to safe, high quality, affordable medically necessary care.” Hospital leaders and clinical providers work hard every day to serve the needs of their patients and communities. As we work to identify and prioritize the health needs of our local communities, let’s make this personal. Make it your mission to ask each patient to make a personal commitment to improving their health and ask that they pay it forward. Let this message of personal responsibility over ones’ health spread like the flu!

The cost of inaction is too high.