• More about that “what makes us healthy” infographic

    I’ve already established that the Bipartisan Policy Center’s infographic was sourced with a citation to nowhere, raising doubts about the accuracy of the figures in it. I was not satisfied, and Adrianna McIntyre of Project Millennial wasn’t either. She did her own internet sleuthing. She began not with the BPC’s citation, but her own lecture slides archive.

    And then I remembered that I probably still had my lecture slides. I did! On the slide in question, the lecturer put “Source: Adapted from CDC, 1979; IOM, 1988; and PHS, 1993.”

    After puttering around the internet, I think the first is a reference to Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention, the second a reference to The Future of Public Health, and finally, the third to The Core Function Project, (gated).

    She also found a 2001 IOM report which says,

    An Institute of Medicine Committee on Health and Behavior: Research, Practice, and Policy was convened in 1998 to update the 1982 Health and Behavior report … the committee encountered limitations as to what it was able to address. [It] became clear that there are inadequate data to evaluate fully the cost-effectiveness of behavioral and psychosocial interventions in comparison with other ways of promoting health … Comparing behavioral and psychosocial interventions with other ways of promoting health on the basis of cost-effectiveness requires additional research.

    Conclusions:

    • If there is any research that supports the notion that health care accounts for only 10% of health or death or something it is far older than the BPC’s 2007 citation to nowhere suggests. Perhaps it dates from as long ago as 1979, or maybe 1988, or possibly 1993. Those are two- and three-decade old sources, which themselves likely reference even older research. Even if any of that does support a 10% figure, I don’t think we need to accept that as accurate today.
    • As recently as 2001, the IOM was unable to speculate on the cost-effectiveness health care vs. behavioral interventions.
    • It is still possible a credible source for BPC’s figures is out there. Neither I nor Adrianna have read every word of the documents we have cited. To be fair, some of them are unavailable or are cited so vaguely by what we have found that we can’t read them. Maybe you can find something out there that we haven’t noticed.

    How much does health care contribute to health? I’m not sure anyone knows, but I have a stack of papers to go through that some say supports an estimate of 50%.

    @afrakt

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