More Than Medicine: The Broken Promise of American Health

While the United States is the leader by far in per capita spending on health care and producing amazing diagnostic and therapeutic advances, statistics consistently show below-average results in life expectancy and infant mortality compared with other developed countries. Why the disconnect? Former National Institutes of Health chief science officer Kaplan (director of research, Stanford Sch. of Medicine) argues that we spend too much on "curative medicine" and underemphasize social and behavioral factors. Research allocations tend to go to long-existing priorities renewed with little thought, owing to factors such as promotion by advocacy groups and researchers' desire to see their funding continue. New treatments, which may add only months to life, garner headlines and dollars, while lifestyle changes that can potentially improve well-being for decades receive less attention. Admitting the difficulty in both investigating and changing adverse lifestyle factors such as drug/alcohol abuse, smoking, lack of physical activity, and poor diet, the author suggests there's sufficient evidence for altering some of the current focus.