Conference Presentation, Panel
Public Health: The Key to Prosperity
Milken InstituteRyan Shadrick Wilson, Dr. Lynn Goldman, Harry Leiter, Carmen Nevarez, Dr. Winston Wong
- Childhood obesity rates are predicted to level off for the first time, though declines have not yet begun, driven by a post-millennial generation that expects healthy food, physical activity, and walkability in educational and workplace environments.
- Generational shifts toward virtual connectivity are anticipated to influence community and public health over the ensuing ten years, alongside a forecast that disparities must be addressed to achieve public health improvements comparable to early 20th-century leaps.
- Without intervention, society faces a "tsunami of illness and lower productivity" and macro threats from a future where many young people are obese, with life expectancy declines for working-class whites expected to continue due to drug overdoses, alcohol-related liver disease, and chronic conditions.
- Employers are expected to increasingly compete for retention through health benefits for hourly workers as unemployment drops, driven by an 18-month to two-year ROI horizon that discourages prevention investments not yielding immediate hospitalization or ER visit reductions.
- Current US healthcare payment incentives are misaligned for long-term prevention outside the public sector, with the system economically incentivized to generate revenue from expensive interventions rather than maintaining health.
- Investments in low-income neighborhoods are expected to raise overall community life expectancy, including in affluent areas, while "Balance Rewards" programs utilizing technology and incentives aim to achieve 70% annual participation compared to 20% in traditional programs.
- Behavioral changes at scale are expected via remote coaching and data-driven "identity circles" for social media targeting, alongside predictions that new congressional bills in the summer and fall will advance mental health parity.
- A global movement similar to the HIV/AIDS crusade is forecast as necessary to mainstream mental wellness, while military engagement with communities is suggested to build health-focused models for future recruitment.
- Self-insured employers may creatively design benefits to economically compel healthy behaviors like weight loss and exercise, and data-linked opt-in incentives could lead to insurance premiums based on "total wellness scores" incorporating credit and purchasing habits.
- Financial incentives for healthy behaviors carry a risk of acting as a regressive tax on lower-income populations who may be penalized for unhealthy behaviors or unable to afford penalties, while "populist health" concepts are proposed to help navigate chronic disease and mental health challenges.