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    Social Factors Affect Americans' Health

    Expert Panel Checks Barriers to Better Health at Work, Home, and in the Community
    WebMD Health News
    Reviewed by Louise Chang, MD

    Feb. 28, 2008 -- While the presidential candidates are busy debating how to reform health insurance, a group of experts says it's going to find out what makes Americans sick before they ever get to the doctor.

    The Robert Wood Johnson Foundation is launching a new commission designed to get to the bottom of racial and economic health disparities and to find out why even Americans with good health insurance have poorer health than people in other countries.

    "For reasons that don't appear to have much to do with health care, there are big gaps between how healthy we could be and how healthy we are," says Mark McClellan, MD, a fellow at the Brookings Institution think tank and co-chairman of the commission.

    The group says it wants to influence the health care debate by putting hard reasons behind what a lot of data already show -- that nonmedical factors like income, support from friends, education level, and where you live have a big impact on how healthy you are.

    "All of these factors have a bigger impact on whether we stay healthy than visits to the doctor," says McClellan, who directed both Medicare and Medicaid and the FDA. 

    "This commission couldn't have come at a better time politically. We are having a national debate about health care," says Anna Greenberg, PhD, senior vice president of Greenberg Quinlan Rosner Research, a polling company that issued a report on Americans' obstacles to health.

    The commission says it wants to examine real-world issues, such as grocery stores in poor neighborhoods without a good selection of produce and workplace attitudes that discourage exercise and encourage stress.

    David Williams, PhD, the commission's staff director, says the effort will "look beyond our traditional comfort zones." 

    As an example the commission distributed a map of the Washington, D.C., metropolitan area. Using data from a University of California San Francisco study, it showed that life expectancy in wealthy Montgomery County, Md., is 81.3 years. That's compared to an average life expectancy of 72 for residents of the District of Columbia, just nine miles away.

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