Strong medicine for a healthier America: introduction.

s p n s c n l a here is more to health than health care. Where we live, work, learn, and play can affect our health more than what happens in the physician’s offıce. et, ask our national leaders “What determines health?” nd you’ll hear about access to health care. As vital as ealth care and healthcare reform are, they are just part of he answer. Over the past few years, more and more ttention has focused on the social factors that are imporant determinants of how healthy we are. Examining hese factors—the relationships between how we live our ives and the economic, social, and physical environents that surround us—reveals just how connected our ealth is with how we live, where we live, and the world nto which we were born. While medical care is vital to treat disease once diagosed, it turns out that prevention requires a much roader approach than themedicalmodel suggests. Some actors that affect health are within our control, butmany re not. Behaviors such as tobacco use, lack of exercise, nd unhealthy diet can result in poor health, and we each ave a responsibility to take care of our own health. owever, some of us face much greater barriers to ealthy behaviors than others, barriers that sometimes re too high to overcome even when the motivation is reat. What if there is no drug store where a smoker can ttain cessation therapy? No grocery store, so no fresh, ealthy food, and no sidewalks or parks to enable being hysically active? Where you live can predict your life expectancy. The Red ine between Union Station inWashington DC and Shady rove in Montgomery County, Maryland, spans 17 stops, 0 miles, and an estimated 9-year difference in life expectncy. Lifespan disparities are seen in conjunction with ifferences in income, education, and environment. The