By NextBestFitInvest outside health care
Spend on housing, nutrition, and public health, which drive much of the outcome gap.
Addresses causes outside health care.
Review ledgerHow this path connects
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Fund housing, nutrition, and public-health programs from health savings
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
- Worse outcomes than peer countries despite the highest spending
Spending on housing, nutrition, and public health addresses diet, housing, violence, and overdoses as root causes of the outcome gap, with benefits extending beyond health.
- Housing, food, and transportation drive health, but health care isn't designed for them
Spending on housing and nutrition addresses social conditions contributing to the outcome gap.
- Prevention and public health are underfunded
Spending on public health addresses root causes of the outcome gap, with benefits extending beyond health.
- Adds paperwork, coordination, or complexity
Spending on housing, nutrition, and public health extends outside the health budget and requires coordination with other agencies.
- Takes years, or money up front, before it pays off
Spending on housing, nutrition, and public health takes years to show results.
Who's affected
- Low- and middle-income households
- Worse outcomes than peer countries despite the highest spending: Poor health outcomes especially affect low-income and minority communities.
- Housing, food, and transportation drive health, but health care isn't designed for them: Health systems lack tools and funding to address social conditions shaping their health.
- Black, Hispanic, and Native communities
- Worse outcomes than peer countries despite the highest spending: Poor health outcomes especially affect low-income and minority communities.
- People experiencing homelessness
- Housing, food, and transportation drive health, but health care isn't designed for them: Health systems lack tools and funding to address social conditions shaping their health.
- People who will need care in the future
- Prevention and public health are underfunded: Limited prevention funding leaves chronic disease driving treatment needs.
- People with ongoing or specialist care needs
- Prevention and public health are underfunded: Limited prevention funding leaves chronic disease driving treatment needs.
- Hospitals, clinics, and care organizations
- Prevention and public health are underfunded: More chronic disease creates more treatment business.
- Taxpayers and public budgets
- Adds paperwork, coordination, or complexity: Spending on housing, nutrition, and public health extends outside the health budget and requires coordination with other agencies.
Where it has been tried
- Nordic countries: Higher social spending, lower health spending.
- Finland: From 2008 to 2022, Finland's long-term homelessness fell by 68% during its Housing First policy, according to official housing statistics.