Health is More than Healthcare: Its Time for a Social Ecological Approach

Abstract

Editorial The inaugural edition of the Journal of Nursing and Health Studies comes at an important time-not only for healthcare in the United States but globally as well. In the U.S., the emergence of accountable care organizations [1] has led to a greater focus on prevention-moving beyond just treatment and tertiary care. Traditionally, American health systems have excelled at providing acute care. Biotechnology labs support this, spending billions searching for miracle drugs. World Bank data indicates the U.S. spends approximately 17% of GDP on healthcare, which may be contrast to neighboring countries, Mexico at 6% and Canada at 10% [2]. Altogether, these efforts can overlook populations who have limited access to healthcare (or when quality health services are available, they remain unaffordable). Consequently, groups who experience disparate percentages of chronic illness often go underserved by traditional health systems. This impacts not only patient wellness, but healthcare costs for everyone. While strategies exist for addressing these issues (e.g. home health services, disease management programs, and community outreach initiatives), these efforts are often not well coordinated with institutional healthcare. Recently, I attended an inspiring presentation delivered by Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson foundation. Her presentation was entitled, " Joining Forces to Build a Culture of Health. " The room was filled with health practitioners, academics and students. At the end of the presentation, during the Q&A, an individual (who happened to be a nurse), stood up and relayed a story about an individual she and her colleagues kept seeing recurrently in the emergency room where she worked.