Merging Health and Social Services

Abstract

Merging health and social care, including prevention, to improve quality of life and well-being is a form of population health that is especially effective for the older population. In 1993, the seminal article by McGinnis and Foege shined light on the fact that the United States needs to integrate more social supports and prevention into the healthcare system. 1 The article claimed that 95 percent of the healthcare spending in the United States goes to medical care, while only 5 percent is dedicated to population health measures. McGinnis and Foege make the case that the imbalance of health to social care expenditure is the reason for the poor health outcomes realized in the United States. The authors attributed 40 percent of deaths to behaviors, 30 percent to genetics, 15 percent to social determinants, and 5 percent to environmental exposures. This left ten percent of health outcomes attributable to medical care. In the following years, the quote has been repeated over and over, and the percentage of health outcomes attributable to healthcare has been adapted over time. The highest percentage quoted is 30. Most experts use the quote that is considered generous: healthcare is only responsible for 20 percent of health outcomes.