The best way to maximize your chances of surviving COVID-19 without hospitalization is to be healthy when you contract it.

Pre-existing conditions such as respiratory problems, vascular disease, obesity, and diabetes exacerbate the coronavirus health effects. Most of us know that so-called comorbidities raise the odds a person will end up hospitalized by the disease. And most of those conditions are preventable.

Personal fitness influences how well we tolerate most illnesses and injuries. Employers who provide health insurance know they can bring down costs by encouraging workers to take better care of themselves. But the best way to do that is not how most people might assume.

The land of the free is the land of the unhealthy, at least when compared to other societies with similar resources. The latest Global Burden of Disease Study reveals a nation where young children die at shockingly high rates, life expectancy is short, and disease-free years are too few.

TOMLINSONS TAKE: Hospitals gouge private health insurance to care for others

The mortality rate for mothers and infants in the United States is 6.5 per 1,000 births, compared to 4.9 in other wealthy countries. The number of years the average American lives in good health is 65.5 and getting shorter due to rising rates of obesity and heart disease. The average Japanese enjoys 20 additional good years.

While other countries have seen dramatic increases in life expectancy, Americans have seen no improvement in a decade.

Americans made up more than half of the worlds overdose deaths in 2019. U.S. doctors over-prescribe opioids, rehab programs do not use the best methods, and street drugs are laced with dangerous additives. But drug abuse and chronic disease are symptoms of larger problems that go beyond medical intervention.

Research has shown that social, economic and behavioral factors are far more critical than medical conditions in determining our quality and length of life, something reinforced by the latest Global Burden of Disease Study published in The Lancet medical journal this month.

An exclusive focus on health care is a mistake, the editors wrote. Health is created from a broader prospectus that includes the quality of education (primary to tertiary), economic growth, gender equality, and migration policy.

Limited access to fresh food, smoking and drugs, moldy housing and lack of transportation damage more peoples health than genetics. Life expectancies in Texass wealthiest census tracts are 17 years longer than those in the most impoverished areas, the National Center for Health Statistics found.

Research shows 80 percent to 90 percent of a persons health is determined by non-medical factors.

More than 88 percent of companies that employ more than 200 workers include so-called wellness programs with their health insurance, according to the Kaiser Family Foundation. But since most of the incentives focus on medical conditions, not social issues, wellness programs have shown limited benefits, according to most studies.

The problem is health insurers and employers are reluctant to address the so-called social determinants of health. They do not want to pay higher wages, remediate mold in homes, cover taxi fare to quality grocery stores, subsidize rent in better neighborhoods or provide access to better schools.

The Houston-based Episcopal Health Foundation gave $2.6 million to the Dell Medical School in Austin to research how non-medical issues affect public health in Texas. Experts hope to determine exactly how best to save money on health spending by raising living standards so that everyone benefits.

Of all the factors that determine whether or not a person or population is healthy, medical care is actually a pretty small piece, Elena Marks, the foundations CEO, told a Rice University webinar.

In 2018, the U.S. spent $3.5 trillion on health care; only 2.6 percent was spent on social factors, according to federal data. European countries that spend twice as much on social services have far healthier populations.

TOMLINSONS TAKE: The economy will recover faster if Texans contain COVID

The consequences for employer-based health programs could be dramatic. Could paying higher wages to improve a workers living standard result in lower health care costs and less missed work? Might a weekly farmers market with cooking lessons lead to fewer hospitalizations and money saved?

When it comes to COVID-19, social factors are driving the pandemic, with poor people who live in substandard housing without access to healthy food and routine health care getting the sickest. If we address those issues beforehand, no pandemic or any other crisis would cause as much economic damage.

We saw this during Hurricane Harvey and now were seeing it during COVID. Its time to do something about it, Marks said.

Ultimately, the best way to improve our collective health is to lift people out of poverty, provide them with a quality education and ensure an equitable stake in the nations health. Prevention is always cheaper than a cure.

Tomlinson writes commentary about business, economics and policy.

twitter.com/cltomlinson

chris.tomlinson@chron.com

Read the rest here:
COVID proves better pay and housing are quickest ways to better health - Houston Chronicle