The US health care system can do a better job of providing patient care while moderating the rate of increase in cost, but it can do little about improving overall population health. This is because health care delivery accounts for only 10% of preventable deaths, with the remainder attributable to personal behaviors, social and environmental determinants, and genetic predisposition.1 As currently constituted, the health care delivery system has little direct control over these other factors. However, consensus is developing that truly controlling health care costs and improving the overall health of the American people will require a much closer partnership, permeable boundaries, and increased interdependence among the health care delivery system, the public health sector, and the community development and social service sectors.
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