COVID-19 has unveiled shortcomings of US health policy, Baker Institute expert says

When it comes to keeping the nation healthy, “medical care is actually a pretty small piece,” according to an expert in health policy at Rice University’s Baker Institute for Public Policy.

“Despite our obsession with health care in this country, it’s actually social, economic and behavioral factors that are much more influential and more determinative of our health status and our health outcomes,” said Elena Marks, a nonresident fellow in health policy at the Baker Institute and the president and chief executive officer of the Houston-based Episcopal Health Foundation.

According to Marks, the drivers of public health don’t come from hospitals — health is largely related to factors such as education, income, family or social support, housing, pollution, diet and exercise, and community safety.

“It’s the nonmedical factors that have exacerbated the effects of (COVID-19),” Marks said. Social, economic and behavioral factors such as chronic conditions, employment, housing and food security have contributed to the spread and intensity of the virus among vulnerable populations, she argued.

Marks presented a webinar April 23 to explain how a lack of investment in public health in the U.S. has contributed to the coronavirus outbreak. Her research shows medical services account for over 97% of the nation’s $3.6 trillion in national health expenditures — including public, private, insurance, tax and government dollars — while only 2.6% is spent on public health.

Credit: 123.rf/Rice University

“It’s the public health workforce that watches for patterns of disease, that plans for prevention and containment and promotes testing and contact tracing to stop the spread of infectious diseases,” she said.

Public health efforts — creating laws, policies and regulations that provide widespread access to preventative care and support healthy environments — are crucial, according to Marks.

“The inequities in our system grow even more so during disaster,” Marks said. “It’s time to deal with it.”