HEALTH AFFAIRS | How can Main Street, America, move the needle in a city’s population health and wellbeing? It begins with a solid, organizational structure built for the long term.
I fondly call my hometown, Nashville, the “Silicon Valley of Health Services.” With 18 publicly traded national health care companies headquartered here with annual global health care revenues of over $70 billion, our city takes health seriously. One in 10 workers in the Nashville metro area are health care providers, nurses, or health aides. Even more work in the broader health sector, such as health management, financial, and legal roles. We have two outstanding medical schools, six schools of nursing, a dental school, and two schools of pharmacy. Our city is in the business of providing multiple health services to every state in the country.
Here is the cruel irony. When you compare us to similar cities, the health of Nashvillians is poor. We smoke at rates higher than Charlotte. We have blood pressure rates that exceed those in Austin. Our obesity rate surpasses Cincinnati’s. Our infant mortality rates are not even competitive. Our babies are more likely to die in their first year of life than in countries like Croatia, Serbia, and Qatar.
How can that possibly be? One of the things they didn’t teach me in medical school is that health services delivered accounts for only 10 to 15 percent of a population’s health status. We can build the best hospitals, provide the richest health plans, and I can be the best heart surgeon possible, but behavior and how and where people live, eat, work, and play have a far greater impact on an individual’s health.
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