Opening Keynote: Changing the Narrative: Achieving Health Equity by Creating a New Social Contract
In 2013 when Forbes magazine listed the top ten healthcare quotes for 2013, the number one quote was attributed to me:“When it comes to health, your zip code matters more than your genetic code.” This brief presentation will address some of the data and evidence behind that quote by exploring the strength of the relationship between life expectancy and neighborhood. Using hundreds of thousands of death certificates, GIS mapping and other simple data analyses, a profile of life expectancy by neighborhood in seven different cities and regions will be presented. The implications for US health spending and population health management will be discussed and a model for understanding the social determinants of health will be presented. The role of narrative change in shaping health policy and re-creating our social contract will be described.