The Social Determinants of Health

Here are the dots we have to connect, well enumerated by the participants in this roundtable on social determinants of health.On the one hand, we understand social factors-obesity and nutrition, smoking, transportation, jobs, housing.At the same time, we have issues of access to "personal healthcare, " what's called "amenable mortality."We have to do better with both.It's time for healthcare delivery to step out-to shift the focus of diagnosis and treatment to the home.S hould your zip code determine how long you live?It's been said zip codes predict life-span more accurately than genetic codes.When you look at the maps, the data are unavoidable … and unacceptable.Sadly, Philadelphia records the worst disparity-20 years.Baltimore is right behind.A child born today in one neighborhood will see the dawn of the 22nd century.A child born a mile away is unlikely to make 2090-among the worst life expectancies in the world.Our goal has been to reduce longevity disparities to within 5 years.Can we do that?