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The Value of Wellness

The United States is the global leader in medical research and medical care. However, there are reasons for concern. Despite spending more than $3.2 trillion annually on health care, which is more than any other country, we continue to have room for improvement when it comes to life expectancy and other indicators of health. Chronic diseases such as heart disease, cancer, diabetes, and chronic obstructive pulmonary disease are the leading causes of death and disability in the United States and among the most costly, yet these afflictions may be preventable. The World Health Organization reports that at least 80% of all heart disease, stroke, and type 2 diabetes and up to 40% of cancer could be prevented if people ate better, engaged in more physical activity, and ceased to use tobacco. And while there has been some stabilization in deaths from some chronic diseases, the United States is now facing unprecedented increases in deaths due to suicide, liver cirrhosis from alcohol consumption, and drug overdoses largely due to overdose deaths involving prescription or illicit opioids. The president called upon then-Acting Secretary of Health and Human Services Eric D. Hargan to declare the opioid crisis a nationwide public health emergency. These so-called deaths of despair are affecting Americans across the country and are brought on in part by a lack of hope and opportunity. The opioid epidemic affects our families and communities, and it is taking a toll on our economy. The economic burden of the prescription opioid crisis is $78.5 billion annually in health care, law enforcement, and lost productivity. The good news is that, as stated in a 2016 Surgeon General’s report, “research shows that for each dollar invested in evidence-based prevention programs, up to $10 is saved in treatment for alcohol or other substance misuse-related costs.” These prevention programs go beyond preventing or lowering the risks of addiction; they also have been shown to prevent delinquency, teen pregnancy, school dropout, and violence. Effective public health interventions and policies that target deaths of despair and chronic diseases lead to a healthier population with lower health care spending, less school and workplace absenteeism, increased economic productivity, and an improved quality of life. By investing in the prevention and treatment of the most common chronic diseases, one estimate shows the United States could decrease treatment costs by $218 billion per year and reduce the economic impact of disease by $1.1 trillion annually. The conditions in which we live and work have an enormous impact on our health, long before we ever see a physician. Wellness starts in our families, our schools and workplaces, in our playgrounds and parks, and in the air we breathe and the water we drink. I will briefly discuss wellness and the business sector, wellness and national security, and priorities for my tenure as Surgeon General.