Steven Schroeder
The United States spends more on health care than any other nation in the world, yet it ranks poorly on nearly every measure of health status. How can this be? What explains this apparent paradox?
In the 117th Shattuck Lecture before the Massachusetts Medical Society on May 19, 2007, and published this week in the
New England Journal of Medicine, Steven A. Schroeder, MD, addressed those questions:
"The two-part answer is deceptively simple-first, the pathways to better health do not generally depend on better health care, and second, even in those instances in which health care is important, too many Americans do not receive it, receive it too late, or receive poor-quality care. In this lecture, I first summarize where the United States stands in international rankings of health status. Next, using the concept of determinants of premature death as a key measure of health status, I discuss pathways to improvement, emphasizing lessons learned from tobacco control and acknowledging the reality that better health (lower mortality and a higher level of functioning) cannot be achieved without paying greater attention to poor Americans. I conclude with speculations on why we have not focused on improving health in the United States and what it would take to make that happen."
At UCSF, Schroeder is distinguished professor in health and health care, and director of the Smoking Cessation Leadership Center. The Shattuck Lecture, which invites celebrated health care leaders to address significant medical issues, is delivered each year at the annual meeting of the Massachusetts Medical Society.
We Can Do Better-Improving the Health of the American People
Steven A. Schroeder, MD
New England Journal of Medicine357:1221-1228, September 20, 2007
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Related Links:
Steven A. Schroeder, MD
Division of General Internal Medicine, UCSF Department of Medicine
Smoking Cessation Leadership Center
