Forum Session

Unusual Suspects: Focusing on Nonmedical Determinants to Improve the Nation’s Health
November 5, 2010


Michele J. Orza, ScD & Jessamy Taylor, MPP


Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to improve health and prevent the need for expensive services. Many entities, from international institutions like the World Health Organization (WHO) to communities in the United States, are endeavoring to think bigger than health care and are taking a broad-based approach to improving health. This approach works on many fronts simultaneously, from the condition and environment of the communities where people work, live, and go to school to the socioeconomic status of the family to the attitudes and behaviors of individuals to the quality of medical care. Initiatives taking this approach attempt encompass the complete array of factors that determine health and their intersections and interactions, involve partners from many fields and both the public and private sectors, and face the challenges inherent in working together across so many potential boundaries. This Forum session examined the nonmedical determinants of health and efforts at the community, state, national, and international levels to improve health by focusing on them.


Gail R. Wilensky, PhD, Senior Fellow, Center for Health Affairs, Project HOPE; David J. Erickson, PhD, Manager, Center for Community Development Investments, Federal Reserve Bank of San Francisco; Robert F. St. Peter, MD, President and Chief Executive Officer, Kansas Health Institute; Adetokunbo "Toks" Omishakin, MURPDirector, Healthy Living Initiatives, Office of the Mayor, City of Nashville

Slides from the presentations by Dr. Wilensky, Dr. Erickson, Dr. St. Peter, and Mr. Omishakin are available for download.

Related Materials

For a fuller discussion of public health concepts and approaches that emphasize the nonmedical influences on health, see "High Hopes: Public Health Approaches to Reducing the Need for Health Care" (Background Paper No. 78, September 27, 2010).

Other Forum sessions focusing on this topic include "Getting Real: Data Sources, the Evidence Base, and Strategies for Improving the Health of Communities" (September 24, 2010) and "Healthy, Wealthy, and Wise? Examining the Impact of Socioeconomic Status on Health" (March 14, 2008).

See also the WHO Commission on Social Determinants of Health, the RWJF Commission to Build a Healthier America, and "Don't Forget About the Social Determinants of Health" (Gail R. Wilensky and David Satcher, Health Affairs, January 16, 2009).

For a collection of articles about community development banking and health, see the Federal Reserve Bank of San Francisco's Community Development Investment Review, volume 5, issue 3, 2009.

Other available Forum resources include: "Resilience and Renaissance: Efforts to Rebuild a Healthier New Orleans" (Site Visit, May 26-28, 2009); "Health Impact Assessments: What, Why, How, Who, Where?" (Forum Session, December 3, 2010); and "Focus on Reform: Public Health Provisions" (June 25, 2010).


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