In traveling the country I love to brag on Nashville as the “Silicon Valley” of health services. And that’s not an affectionate epithet — it’s true.
The Nashville health-care industry contributes $30 billion locally and $70 billion globally. With this amount of health-care dollars in Nashville, and with Nashville as a rising “it” city, one would expect to see a reflection in the health of Nashville. But this is simply not the case.
Currently, Tennessee holds the ignoble distinction of being one of the unhealthiest states in the union: 42nd out of 50. And Nashville/Davidson County specifically ranks 13th out of Tennessee’s 95 counties, according to the Robert Wood Johnson Foundation Healthy County Rankings.
Davidson County is also not competing with our peer cities. Compared with Austin, Texas; Charlotte, North Carolina; Cincinnati, Ohio; and Raleigh-Durham, North Carolina, Nashville ranks fourth among the five, according to researchers at the University of Wisconsin. Specifically, Nashville has the worst rates of obesity, children living in poverty, children living in single-parent homes, premature death, injury deaths and violent crime of all five cities.
Poor health carries a cost, and the price of inaction over the next decade will cost us at least $10 billion.
We absolutely have to do something about this.
In taking a closer look at the $70 billion in health-care dollars coming out of Nashville, we see that it comes from the work product of more than 250 health-care companies operating in Nashville and working on a multistate, national and international basis. Nashville is also home to more than 300 additional professional service firms (e.g. accounting, architecture, finance, legal) working in the “peri health care” space. Of these corporations, more than 260 of them are members of the Nashville Health Care Council, which is also something unique. This nonprofit organization holds together a coalition of the most powerful names in health care.
We are sitting on a powerhouse of health-care resources and dollars. So how did this happen to us?
We know that health care does not equal health, and 80 percent of how healthy we are depends on social determinants like local environment, education, diet and culture. For example, 72 percent of Davidson County Metro public schoolchildren suffer from economic disadvantages. We may be succeeding in these large business arenas, but the well-being of our population is not following.
If we consider actual health-care dollars spent on avoidable illness and loss of productivity of our workforce — either because they are sick or are caring for an ill loved one — the price of an unhealthy community over the next decade will cost us at least $10 billion, and maybe as much as $20 billion. It will be more expensive to live and raise families here, and more expensive for employers to build here or even continue to stay here. Inaction will result in lost jobs over time, a stagnation of our economic market, rising unemployment and a rising cost of health care for our population.
If we want to build a thriving and successful city and state, this has to change, because the health of our workforce and citizenry are paramount to the success of the region.
The good news is there is something we can do.
Already in Nashville there are public health champions doing incredible work every day. But our city is large and our problems complicated. No one organization working alone or even with a few others is capable of the scale of change we need to reset the trajectory of our city. But together we can do this work. We must organize as a citywide collaborative, leveraging the relationships we already have and the dollars we know are here. This way we can attack the problems from multiple angles, focus resources on the neediest areas and, in making these changes, save the city millions of dollars over the next decade.
In my opinion, this is the most important thing we can do for our city and our state right now and for the next 10 years. If we truly want to ensure Nashville stays an “it” city for years to come, and more importantly remains the place we all love and want to raise our families, we have no choice.
William H. Frist, M.D is a nationally acclaimed heart and lung transplant surgeon, former U.S. Senate majority leader, and chairman of the executive board of the health service private equity firm Cressey & Company.
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