By Clara and Justin Hamel
Over the last few weeks, we’ve been exploring a troubling contradiction in American healthcare. We spend more than any other nation on health care, yet Americans continue to struggle with rising rates of chronic illness and poor health outcomes. In fact, a 2024 OECD (Organisation for Economic Co-operation and Development) comparison of 10 wealthy nations found that the United States spent considerably more on health care while having the poorest overall health outcomes, including the highest rate of preventable and treatable deaths. These are startling statistics that we should all be paying attention to.
Last week, we asked a lot of questions and explored how the places where we spend the most time can be changed and designed to better support our health. However, improving our environments is only part of the conversation. So, let’s ask one more question: What are other countries with lower healthcare costs, lower rates of disease and fewer premature deaths doing differently?
It is important to remember, though, that we don’t have to recreate another country’s healthcare system. Healthcare policy and practice is complicated, and there is no country doing everything perfectly, but there are certainly countries with better outcomes.
For example, every citizen in Denmark is registered with a specific primary care physician, and the family doctor serves as the first point of contact for most health concerns. This creates continuity, allows physicians to identify problems earlier, and helps coordinate care before patients develop chronic illness. To expand on this, in the countries with better health outcomes, more than 90% of adults reported having a regular primary care doctor, while the United States was among the countries with the lowest rates. Americans were also the least likely to have a longstanding relationship with a primary care provider. Let’s be clear, the difference does not lie in simply visiting a primary care doctor more often, but in making primary care easier to access, with more continuity, and using an ongoing relationship not only to treat illness, but also to identify risks earlier and to help prevent disease before it develops or progresses.
In Japan, healthy habits are emphasized and introduced early. Nutritional education, known as Shokuiku, is incorporated into schools, and school lunches are seen as an opportunity to teach children about balanced nutrition and healthy habits. Japan’s School Lunch Act actually identifies nutrition and healthy eating habits as goals of the school lunch program.
Another great example can be found in the Netherlands, where movement is integrated into daily life. Walking and cycling are standard forms of transportation, and communities are set up for pedestrians and cyclists to navigate with ease. This promotes physical activity naturally throughout the day. As a result, Netherlands also reports higher levels of physical activity than the average OECD countries as well as lower rates of mortality from preventable and treatable disease.
Finland places considerable emphasis on prevention. Preventive services and screening are integrated into its health system; for example, recent OECD data show breast-cancer screening participation well above the OECD average. Finland also has lower preventable and treatable mortality than the OECD average.
These countries are very different from one another, and none provides a perfect model. Yet there is a common thread. None of these nations treat health as if it is something that happens solely inside a doctor’s office after illness starts. It points to a common theme: To improve our health outcomes, we need to move beyond merely treating disease and begin creating the conditions that help prevent it in the first place.
*Dr. Justin Hamel and Clara Hamel have a combined over 30 years of experience in health fields. Reach them at 1° Performance & Longevity, located at 46 N. Central Park Plz., Suite 101, in Jacksonville, on Facebook or by phone at 217-243-6358.
