Going upstream to address Ohio’s biggest health challenges and cost drivers

In its report “For the Public’s Health: Investing in a Healthier Future,” the Institute of Medicine found that “it is no longer sufficient to expect that reforms in the medical care delivery system alone will improve the public’s health” and that investing in more upstream causes of ill health could significantly improve health outcomes in the United States.

Almost all U.S. health spending goes to “sick care” rather than to prevention, thereby missing opportunities to stop health problems before they become more burdensome and costly.  Studies have estimated that factors outside the traditional health care setting—behavior patterns, environmental issues and social circumstances—account for more than half of the causes of premature death.

This forum explored opportunities to improve the health of Ohioans by addressing the many factors that shape health beyond the doctor’s office.


  • Realigning Health with Care” — Dr. Heidi Behforouz, Associate Physician in the Division of Global Health Equity at Brigham and Women’s Hospital (BWH) and  Medical and Executive Director of the Prevention and Access to Care and Treatment (PACT) Project
  • Addressing Upstream Causes of Poor Health” — Rick Brush, Founder & CEO, Collective Health, and Executive Director, Health Initiative Coordinating Council (HICCup)

Additional resources