Dr. David R. Williams of Harvard addresses the audience at Meharry on March 7 as part of the Robert Wood Johnson Center for Health Policy lecture series.

The gap between how healthy Americans could be … and how healthy we actually are … is stunningly wide and growing.

For the first time in our history, the United States is raising a generation of children who may live shorter, sicker lives than their parents. This fact has prompted The Robert Wood Johnson Foundation (RWJ) to open a national dialogue to look at important health questions for America at this time in history:

• Why are some Americans so much healthier than others?
• What can be done to create opportunities for all Americans to live long and healthy lives?

In 2008, the RWJ Foundation established the Commission to Build a Healthier America, enlisting national leaders in business, labor, education, community development, healthcare services, philanthropy, media, research and public policy to join together to advance the nation’s health by finding solutions that extend beyond the traditional medical care system and to explore the causes of the disparity between perceived health and reality.

The Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College has designed a health policy seminar series, “National Scholars’ Current Issues in Health Policy” for 2011 as part of the exploration of the national healthcare crisis.

The lectures and discussions have taken place on the Meharry campus starting Jan. 5 and running through May 2 and feature nationally renowned health policy and social science research scholars from around the country. The topics have been designed to open discussions on relevant and provocative issues in the areas of health policy, health services research and health disparities research.

As part of the series, David R. Williams, PhD, the Florence and Laura Norman Professor of Public Health at the Harvard School of Public Health and professor of African and African American Studies and of Sociology at Harvard University, spoke at Compton Nelson Hall on the Meharry campus on March 7. Author of more than 260 scholarly papers in scientific journals, Williams ranked as the ‘Most Cited Black Scholar’ in the Social Sciences in 2008. Currently he is a member of the National Advisory Council for the National Human Genome Research Institute and the director of the Lung Cancer Disparities Center at Harvard.

Williams is interested in social influences on health and has, over his career, examined the trends and determinants of socioeconomic and racial differences in health, looking at the ways in which racism could impact health, as well as the effects of religious involvement on health.

Williams said he has visited Nashville many times because the city stands out as a leader on the national healthcare scene. “However,” he added, “America faces a healthcare crisis whose answers lie outside healthcare itself. Where we live and work and learn and worship has more to do with our health than healthcare itself.”

He continued, “The question is what makes us sick and what makes us heal.

Wherever our homes and our communities are is where the action is if we are to answer to that question.”

He pointed out two economists from the President’s Council of Economic Advisors, in calculating the shortfalls in our nation’s health by education, have determined that education is the number one predictor of health.

A college education is a better predictor of good health than any other factor. “The U. S. economy would save $1 trillion in healthcare costs if all citizens had access to a college education,” he said. “Fixing health problems are in our economic interest. None of the problems we are experiencing are biologically inevitable — they reflect a choice we have made as a society.

“We must begin a dialogue to look at the disparities in health to determine the shape of the elephant we are dealing with before we can really confront the problem,” he said.

Williams continued, “More than half of white Americans, Latin Americans, and African Americans are not even aware that there are dramatic health disparities, such as the fact that African Americans have higher death rates in 12 of the 15 leading causes of death in the United States than do white Americans. Minorities get sick younger, have more severe illnesses, and die younger than whites.”

Williams pointed out that a study of ‘excess deaths’ nationally from the period 1940 to 1998 by a Vanderbilt sociologist determined that there were 96,800 African American deaths from healthcare causes beyond the statistical average.

“That works out to 165 deaths a day — the equivalent of a fully loaded jet crashing into a field after takeoff from the Nashville Airport every day for almost 60 years!

“You know that as a country we wouldn’t stand for that,” he added emphatically.

“We must begin the conversation. We have a clear record that as a society we have failed … not because we haven’t tried — with less than 6 percent of the world’s population, we consume one half of the money spent on health.”

Based on that statistic, he added, “We cannot just do more of what we have been doing. The problem is multi factorial—and we must identify the spiders spinning the web. We do know that the American way of life is dangerous to your health —the health of the immigrant population declines over the length of time of stay in this country.”

Socioeconomic status is a more powerful predictor of health than genetics or even cigarette smoking. The life expectancy of whites with college education is five years longer than that of any other racial group.

Williams pointed to some innovative programs that are working to reduce the difference in factors of the effects of socioeconomic status on health. “We must come up with homegrown, American solutions in health education and outreach interventions by developing strategies to reduce differences in outcomes,” he said. “Heath policy is more than what goes on in the doctors’ office,” he noted. “The issues are outside of medicine.”

He continued, “The question is political will. We know how to do it — by developing strategies to implement and improve health. There are economic reasons as well as moral ones — omission in healthcare availability costs the U.S. $1 trillion a year.”

Williams concluded, “Racial disparities in the health of people in the United States are large, pervasive and persistent. We can’t afford not to face them.”

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