Healthify Blog

States Spending More on Social Services Relative to Medical Care Are Healthier

A new study is showing that states that spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t, USA TODAY reported.
The study is the first to compare state spending on social services to spending on Medicare and Medicaid, and how that ratio correlates to residents' health, the newspaper reported. According to USA TODAY, the study included the following facts and figures:
  • For every dollar of Medicare and Medicaid spending for residents of the average state, an additional $3 was spent on social services and public health between 2000 and 2009
  • Washington, D.C. and states including Colorado and Nevada had the highest ratios of social service and public health spending relative to medical costs -- about $5 for every dollar of medical treatment -- and were much healthier
  • New York and Massachusetts joined traditionally poor-health states including West Virginia, Kentucky and Louisiana with the lowest ratios of social services to medical spending, averaging about $2.30 on social services for every medical dollar spent
  • People in states with the lowest social service/medical spending ratios tend to have higher rates of heart attacks, lung cancer, mental illness and obesity
  • In one example, a 20 percent change in the median ratio of social to health spending led to a 0.33 percent drop in the number of obese adults the following year (this figure is from's summary of the study)
  • Adults with obesity incur about $2,700 more in average annual health care expenses than those who aren't obese
The notion that social services can have a bigger impact on people's health than medical care is at the very root of Healthify's mission. When social determinants of health such as food, housing and employment are inadequately addressed, it makes sense that health outcomes are worse, even if a lot of money is being spent on medical care. 
High levels of spending on medical care could actually be the consequence of unaddressed social determinants of health, insofar as those factors lead to chronic health conditions or frequent emergency room visits. Nonetheless, the study's authors cautioned against using the study as a reason to reallocate funding from Medicare and Medicaid to social services, saying "we have reported statistical associations and could not infer causality," according to
USA TODAY reported that the study's lead author, Yale University public health professor Elizabeth Bradley, published a book in 2013 along with co-author Lauren Taylor called "The American Health Care Paradox: How Spending More is Getting Us Less." In the book, the authors wrote that the United States lagged behind nearly every other developed country in social service spending, outspent them in medical spending and had nearly the sickest citizens, the newspaper reported.
All of these ideas taken together point to the need to step up efforts to address social determinants of health -- something Healthify is doing by providing the technology to efficiently connect people to social programs that can help them get on the path toward good health.
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Topics: social determinants of health public health