PHA Leaders’ Circle: Interconnectedness and Tradeoff Considerations Abound in COVID-19 Response
By: Mary Jane Osmick MD and Jaan Sidorov MD
March 26, 2020
As the unprecedented coronavirus pandemic continues to evolve, the Population Health Alliance has been closely following the growing reports of and debate about the reopening the US economy. Choosing the right timing to take this action requires a medical, public health and scientific understanding of how to equitably and ethically care for, prevent, or slow the spread of the virus for all our citizens while protecting our front-line workers on whom we depend. Yet, at the same time, we also need to find a way to navigate the choppy waters of US economic stability. This navigation requires a well-defined and clearly stated data-driven strategy that provides all Americans the required knowledge and hope to overcome the pandemic and return to economic prosperity.
There is ample research evidence to suggest strong links between overall health, chronic illness, mortality and economic instability. Based on PHA’s national leadership role on health equity and social determinants of health, we find the latter a critical consideration. Nearly half of the US population can ill-afford job and wage loss, having little or no ability to absorb even a small catastrophe. Now, families are being pushed into precarious economic situations, asked to social distance, school children at home, work remotely or not at all – at no fault of their own. The anticipated financial blows from the pandemic can and will lead to significant housing instability, food insecurity, loss of personal safety and access to necessary health care and other social determinants, all of which are amplified by the anxiety and stress of an unpredictable collective future.
For your consideration, we offer a timely and nuanced discussion of this topic in a paper by McKinsey & Company entitled “Safeguarding our lives and our livelihoods: The imperative of our time”. Find the article and exhibits at this link.
Above Chart is Exhibit 2 from “Safeguarding our Lives and our Livelihoods: The Imperative of our Time” ©1996-2020McKinsey&Company
In the paper, authors Sven Smit, Martin Hirt, Kevin Buehler, Susan Lund, Ezra Greenberg, and Arvind Govindarajan note the significant trade-offs that must be made if we choose an “either-or” approach – that is, addressing the viral pandemic OR opening the economy. Instead, the authors suggest a data-driven and historically-supported middle-of-the-road way forward that allows for mitigation of the lingering health effects of the pandemic, while at the same time, avoiding lasting damage to the US economy. In other words, a strategy that works in parallel to successfully achieve both goals – caring equitably for the population while protecting our economic futures.
We recognize and applaud the U.S. House of Representatives, Senate and White House and Senate for their bipartisanship in issuing $2 trillion to support those in need. We also applaud the courageous State Governors and their teams for their cool-headedness, tenacity and unrelenting courage in doing what is necessary at a local level to increase healthcare resources and do what it takes to limit spread of the virus. Countless small and large employers across the U.S. deserve credit for also finding creative ways to keep working, retooling to produce what is needed and continuing to keep their employees working. Finally, the American people should be recognized for our willingness to hear and respond to the efforts of our leaders to respond collectively and protect one another.
We do not know precisely when and how well this will work in the weeks and months ahead, however, we trust that we will overcome this deadly public menace.
Our colleagues at McKinsey & Company suggest the we need to save lives without destroying livelihoods. As members of the Population Health Alliance community, we look forward to working with our political leaders to advance a solution that truly uses an informed and practical approach to the challenges ahead – one that addresses a win-win for the country and our people. We know that the member companies of the PHA stand ready to support continued public health and economic efforts that will lead to a successful outcome to the pandemic.
For Further Reading on The Interconnectedness of Health and the Economy:
- Health and Economic Growth: Reconciling the Micro and Macro Evidence by Bloom DE, et al. NBER Working Paper No. 26003, June 2019.
- How the Economy Affects Health by Frakt AB. JAMA, March 2018
- 3 Examples of How Economics Affects Health and Health Care by The Dartmouth Institute for Health Policy and Clinical Practice, April 2017
- Impact of the Economy on Health Care by Health Care Financing & Organization, August 2009
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Mary Jane Osmick MD, Principal at Mary Jane Osmick MD Consulting, LLC is a member of PHA’s Board of Directors, a lead author on PHA’s digital textbook: Social Determinants of Health and Health Disparities: Taking Action and presenter of several webinars on the subject of SDOH in Population Health Management Strategies
Jaan Sidorov MD, CEO & President at PA Clinical Network is PHA’s President and Chair of PHA’s Provider Engagement Initiative.
Rose Maljanian, Chairman Emeritus at PHA and Chairman & CEO at HealthCAWS invites thought leadership on pressing topics to our PHA community to join in on our Leadership Circle.