Q&A: Why Public Health Programs Matter for Everyone

Understanding the Financial Impact of Health-Related Investments

In recent years, the United States has implemented new laws that significantly reduced funding for various government programs, particularly those focused on health and social well-being. As a result, many essential services have faced budget cuts, raising concerns about the long-term effects on public health.

Dennis Scanlon, a distinguished professor of health policy and administration at Penn State, is a leading expert in health economics. His research focuses on how investments in health-related initiatives impact both individuals and society as a whole. According to Scanlon, all levels of government should track the financial costs and potential savings associated with programs that influence people’s health. This approach would allow government agencies and taxpayers to better understand the true value of these investments.

Scanlon recently discussed the importance of evaluating the financial impact of investments in what are known as the social determinants of health. These factors include socioeconomic conditions, physical environments, and personal health behaviors, which play a significant role in shaping an individual's overall health.

What Are Social Determinants of Health?

When people think about health, they often focus on medical care—such as hospitals, insurance, medications, and healthcare professionals. In the U.S., healthcare spending averages around $14,000 per person annually and accounts for more than 17% of the nation's GDP. However, experts suggest that access to quality healthcare explains only about 20% of whether someone is healthy.

The remaining 80% of health outcomes can be attributed to other factors, collectively referred to as the social determinants of health. These include:

• Socioeconomic factors: Education, income, and family support.
• Physical environment: Pollution levels, access to healthcare facilities, and neighborhood safety.
• Health behaviors: Diet, sleep patterns, smoking, and sexual activity.

These elements collectively shape a person’s health and well-being. Despite this, some analysts argue that the U.S. invests too heavily in healthcare and not enough in other areas that could improve public health, such as housing, food security, and transportation.

How Do These Factors Affect Health?

The influence of health behaviors on overall well-being is widely recognized. For instance, poor diet and lack of sleep are linked to mental health issues, heart disease, and diabetes. Similarly, socioeconomic factors can have profound impacts on health. Questions like whether a family can afford safe housing or reliable access to nutritious food highlight the complex relationship between financial stability and health outcomes.

The physical environment also plays a critical role. Historically, poor sanitation and unsafe living conditions contributed to shorter life expectancies. While modern infrastructure has improved many aspects of public health, disparities still exist, especially in underserved communities.

Why Study Social Determinants Together?

From an economic perspective, it is crucial to evaluate these factors holistically rather than focusing on isolated issues. By considering the trade-offs in spending decisions, governments can better allocate resources where they will have the greatest impact.

Currently, many programs addressing social determinants operate independently, with different funding sources and no unified evaluation system. This fragmentation makes it difficult to assess their full impact on public health and government spending.

For example, the Supplemental Nutrition Assistance Program (SNAP) helps ensure food security, but there is no comprehensive data showing how funding for SNAP affects long-term healthcare costs, such as Medicaid or children's health insurance. Without this information, it is challenging to determine the true return on investment.

Should the U.S. Invest in Individual or Population Health?

This question often sparks debate based on personal values and political beliefs. Some argue that individuals should take responsibility for their health, while others believe society should support the well-being of all citizens. The U.S. has historically taken a mixed approach, with examples like the Environmental Protection Agency’s lead bans benefiting everyone, while individual health insurance systems reflect a more personal approach.

Improving Data Collection and Decision-Making

To make informed decisions, the U.S. needs better data that connects different government programs and their impacts. By gathering and analyzing data across silos, policymakers can identify effective programs and eliminate wasteful spending. This approach would help ensure that tax dollars are used efficiently and that investments in social determinants yield measurable health benefits.

Ultimately, understanding the relationships between health, socioeconomic factors, and the physical environment is essential for creating a healthier, more equitable society. With better data and a more integrated approach, the U.S. can make smarter investments in public health and reduce long-term costs.