Improving Population Health: The Business Community Imperative - Preventing Chronic Disease: November 2010: 10_0086

http://www.cdc.gov/pcd/issues/2010/nov/images/cover_nov10.jpg
November 2010
Volume 7: Issue 6
ISSN: 1545-1151

SPECIAL TOPIC
Improving Population Health: The Business Community Imperative
Andrew Webber, Suzanne Mercure

Suggested citation for this article: Webber A, Mercure S. Improving population health: the business community imperative. Prev Chronic Dis 2010;7(6). http://www.cdc.gov/pcd/issues/2010/nov/10_0086.htm. Accessed [date].

PEER REVIEWED
Abstract

Information on the economic effect of poor population health is needed to engage the business community in population health improvement. In a competitive global market, the United States has high health care costs and poor outcomes (measured by such factors as healthy and productive lives) compared with other countries. US business needs to understand population health and not focus just on the health of employees at the worksite. We describe a long-term approach to population health, including incentives, and identify what is needed to engage business leadership in population health improvement.


The Competitive Challenge

Today, we are spending over $2 trillion a year on health care — almost 50% more per person than the next most costly nation. And yet, as I think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren’t any healthier. In fact, citizens in some countries that spend substantially less than we do are actually living longer than we do.

President Barack Obama, Speech to the American Medical Association, June 15, 2009

The US business community competes in a dynamic global economy. The United States has historically achieved success in the global marketplace by excelling at traditional measures of business performance: innovation, technology application, production engineering, capital deployment, marketing, sales, distribution, and customer service. Increasingly, however, 2 related factors put the US business community at a competitive disadvantage: disease burden such as obesity (1) and increases in costs such as health insurance premiums for employers (2).

Business leaders not yet schooled in all the determinants of health (3) and a US health care system biased toward the treatment of illness often say, “With the growing and added investments I am making in health care for my workers and their dependents, surely my company is producing a healthier and more productive workforce.” Sadly, this is not the case. As President Obama stated, the United States spends twice as much per citizen on health care as any other country on earth yet ranks in the lowest tier of advanced countries in health outcomes. In other words, the United States produces more health care for less health (4).

A Commonwealth Fund study illustrates more precisely the competitive disadvantage the United States is facing (5). The study demonstrates that the United States, in comparison with other industrialized countries, ranks lowest in metrics of health care that include quality, access, efficiency, and equity indicators; lowest in metrics of long, healthy, and productive lives; and highest in per capita costs. Other data from the Dartmouth Atlas (6) show not only wide variation in health care services but that populations in regions with higher spending levels and more physician visits and hospitalizations do not experience better outcomes or quality of care. Seen through this lens, how well the US business community responds to the related challenges of improving health and transforming health care becomes a key driver of market success and of America’s future competitiveness and economic security.

This commentary focuses on the role of employers in improving population health. Four issues are addressed: 1) population health from the perspective of employers, 2) incentives for employers to improve population health, 3) opportunities for employers to improve population health, and 4) employers as change agents for improving population health.

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Preventing Chronic Disease: November 2010: 10_0086