When we look at health and well-being, the focus tends to be on daily habits and genetic predispositions, but we rarely look at how ZIP code predicts health despite its disproportionate effect. That’s because health is affected by environment, and environment is affected by income. These are known as social determinants of health how access to safe and affordable transportation, quality schooling and clean air, for instance, can determine health outcomes.
The Economist recently reported on the vast difference in life expectancy across America, with an average life expectancy in Fearrington, North Carolina is 97 and in Stillwell, Oklahoma it’s 56. With such a high average, Fearrington outpaces Japan by 13 years. Meanwhile, Stillwell is on par with Somalia. Why the stark contrast? The median household income in Fearrington is $81,900. In Stilwell, it’s $25,000. In addition, while Fearrington is mainly white, Stilwell is populated with Cherokee who were forced to move to the area in the 1800s, a legacy that lives on. Unfortunately, studies have shown that access to Medicare doesn’t necessarily improve health outcomes for the poorest.
In fact, in many countries, income is inextricably linked to health. In the US government’s report, “Healthy People 2020,” economic stability is one of the five key determinants, encompassing employment, food insecurity, housing instability and poverty. For a country with the third-highest GDP, it’s time to put a spotlight on this link so that we can break it.
How could innovation play a role here? As a serial entrepreneur, that’s always my lens. Unlike the United Kingdom, the US doesn’t have a systematic way of capturing all of the relevant data, but a collaborative effort between the US Census Bureau, Harvard University and Brown University has created this Opportunity Atlas to show how income, location and race affect longevity. Will this change the median household income in Stilwell? No. But without awareness, change is unlikely if not impossible.
I think we can all agree that everyone deserves to live in a state of wellness. Yet many people in America find themselves in food deserts, are subject to lead poisoning from the paint in their homes, or lack the education or language necessary to effectively communicate with their doctors. This is exactly the kind of data startups like Socially Determined are collecting in order to improve health outcomes. NowPow, which operates in Chicago, has a similar mission, and like Socially Determined it works with the community accessing care and the caregivers.
As individuals, we can’t possibly take all this information into account because it’s so difficult to aggregate. But that’s what makes this space ripe for innovation. If you’re looking to buy a home using Zillow or StreetEasy, wouldn’t you want to know how each property shakes out in terms of average life expectancy? Real estate agents wouldn’t be in favor, but it would be in the interest of the public good. And everyone should have the tools they need to make informed choices about where they live and how they’ll live.