Mark Bertolini: Your zip code matters

Mark Bertolini of Aetna speaking at bswift's Idea Exchange conference in 2018

Aetna Chairman and CEO tells employers at bswift’s Idea Exchange that life expectancy is shaped more by where you live than how you live.

To fix our health care system, we need to address social determinants of health, explained Mark Bertolini , Aetna chairman and CEO, at bswift’s Idea Exchange. Idea Exchange brings together HR and benefits professionals for a multi-day event filled with keynotes and discussions around benefits administration and healthcare.

So, what exactly is a social determinant of health? It’s your neighborhood and it’s your workplace. It’s where you go to school and it’s what you do for fun. Essentially, the conditions into which you are born and in which you live shape your health and influence the decisions you make about your well-being and healthcare.

“60% of our life expectancy has nothing to do with the healthcare system. Your zip code matters more than your genetic code.”

Consider for a moment: if someone is struggling with health problems caused by poor diet, the most obvious thing to do is to simply say, “change your diet.” If it were that simple, a doctor could just “prescribe” his or her patient at least five servings of fruits and vegetables per day and send them on their way.

But what if they live in a neighborhood that doesn’t have access to a fresh market? Or, what if they do have access to a fresh market, but they can only afford to purchase processed food? The key is to look beyond just the surface and take an holistic approach to understanding an individual’s health.

“There are places everywhere where people living in adjoining zip codes can have a difference in life expectancy of 20 years,” Bertolini said.

Ultimately, the decisions we make about our health may not always be the decisions we wantto make. We often make certain choices that are heavily influenced by our environment.

“We need to create a system that looks forward to the 21st century.”

It’s easy to look back at the state of the healthcare system decades ago and question the rationale behind it. But think: what will people say years from now as they reflect on the system we have in place today?

“The consumer experience today is a total maze,” Bertolini said. “We really need to rethink our system.”

Bertolini suggested that the goal of healthcare providers should ultimately be three-fold:

  1. Identify the unmet need of the consumer: what about their health gets in the way of the life they want to lead?
  2. What are the consumer’s alternatives to the situation?
  3. What are the barriers preventing them from seeking these alternatives?

“It’s the customers that disrupt industries,” Bertolini explained. “We understand the people we care for based on social determinants and their community, and then, we build a supply chain for them.”

“The system today focuses on the 10% of what impacts death and life expectancy in the U.S.: clinical care. Unless we address the social determinants of health, we are not going to address this problem.”

Moving forward, Bertolini expressed that the focus of the system should be on creating personalized, on-demand solutions for each stage of an individual’s health journey. By developing a consumer-centric system in this way, he is confident that we can create health plans that both providers and consumers agree upon.

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