Health is about far more than access to the most cutting-edge medicines; social determinants — conditions in the places where people live, learn, work and play — also have an enormous role in keeping both individuals and populations healthy. Yet, in the United States, spending on social services as a percentage of gross domestic product is below the average of other developed countries.

That may help explain the paradox of health care in the United States, where the world’s highest rate of medical spending has not translated into better outcomes. Writing in the Journal of the American Medical Association (JAMA), University of Pittsburgh Medical Center researchers suggest that recent government efforts, as well as more aggressive investment in social services, may help turn the tide.

“This broadening of the nation’s vision of health to include social well-being as well as medical care increases the likelihood of achieving better health outcomes for more people in the United States,” the JAMA article concludes.

Why It Matters: Efforts to solve issues of high health spending in the United States often focus on pitting one medical intervention against another, but the problem — and the solution — may require a more holistic view of not only the health care system, but also the social determinants of health. It also will require a broader understanding about how to pay for what matters most in improving health care outcomes.

This is no longer just an academic discussion. The JAMA article lays out the groundwork now in place to accelerate investments that are likely to have long-term benefits in both costs and spending.