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By Matthew Rees

Food and Health Fact #95: The social and behavioral determinants of health

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This week's "food for thought" excerpt comes from More than Medicine: The Broken Promise of American Health (2019), by Robert M. Kaplan.

"[Americans'] tendency to impute great power to a system driven by medical interventions, and to deemphasize the effects of social and behavioral risk factors such as obesity and homicide, reflects widespread misunderstanding of the people being cared for. Medical science in America today treats people like auto garages treat cars. Is your oil low? Add some. Is your hemoglobin low? Add some by taking medicines that raise it. . . . This 'find it and fix it' philosophy works for some health problems, but not for all. Treatments may improve some physiological measure while having no effect on longevity or overall health. They may be harmful as well, producing serious side effects.

"Meanwhile, over-focusing on biological mechanisms directs attention away from the many social and behavioral determinants of good and ill health. Current biomedicine recognizes the quality-of-life and longevity effects of violence, poverty, racism, workplace policy and stress, and poor education. But the current practice of medicine pays very little attention to these influences: they cannot be easily addressed with medicines or surgeries."