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Woolf Lecture/Beyond Healthcare: Strategies for Improving Health and Lowering Costs

Steven H. Woolf (MD, MPH), Director of Virginia Commonwealth University’s Center on Society and Health and Professor of Family Medicine and Population Health, addressed a large group of William & Mary faculty and students, as well as staff of Williamsburg area nonprofits on March 20, 2014.  Dr. Woolf’s talk focused on how tackling social factors -- inadequate education, poverty, and unemployment -- would have a far greater impact on improving our nation’s health than would medical technological advances. 

Citing a 2013 National Research Council and Institute of Medicine report which he edited, Dr. Woolf stated that although the U.S. spends more per person on health care than other high-income countries, Americans generally do not live as long and are not as healthy.  The probability of survival to age 50 in the U.S., for example, is among the lowest of 21 high-income countries, noted Dr. Woolf.  The U.S. also has relatively high mortality rates from diseases and injuries, when compared to 16 other “peer” countries.  For deaths from non-communicable diseases, only Denmark has a higher rate.    

In examining some of the factors that might explain the U.S.’s poor health outcomes, Dr. Woolf remarked that the health care system, such as trips to the doctor’s office, is itself responsible for only a small part of a nation’s health and well-being.  Dr. Woolf argued that health care accounts for only about 10 – 20 percent of health outcomes while individual health and illness is affected much more by social factors, including personal health behaviors, the “built” environment, education, employment, and income level.

Focusing on education as an example, Dr. Woolf reported that the amount of education a person receives is “closely tied” to a person’s life expectancy.  People with higher educational attainment are less likely to report having fair or poor health and to have a lower level of disease, such as coronary heart disease and diabetes.  Dr. Woolf observed that solving the high school dropout problem would have a significant effect on improving our nation’s health and that addressing educational disparities alone would avert far more deaths than would new biomedical advances, such as new technology or drugs.

Dr. Woolf was elected to the Institute of Medicine of the National Academies in 2001, served as member and science advisor to the U.S. Preventive Services Task Force, and authored the Health Promotion and Disease Prevention in Clinical Practice textbook.  In addition to writing in academic journals, Dr. Woolf has testified before the U.S. Congress, consulted with government agencies in the U.S. and Europe, and written editorials in major newspapers. 

Dr. Woolf’s lecture was co-sponsored by William & Mary’s Schroeder Center for Health Policy and the Thomas Jefferson Program in Public Policy, together with the Williamsburg Health Foundation.