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June 24, 2020

Surgery and Population Health—Redesigning Surgical Quality for Greater Impact

Author Affiliations
  • 1Department of Surgery, University of Michigan, Ann Arbor
JAMA Surg. 2020;155(9):799-800. doi:10.1001/jamasurg.2020.0808

The US has a population health crisis. Most measures of overall health are worse in the US compared with any other high-income country. The US ranks lowest for 9 of the top 10 causes of premature mortality, including ischemic heart disease, drug use disorders, lung cancer, road injuries, self-harm, neonatal disorders, chronic obstructive pulmonary disease, interpersonal violence, and cirrhosis.1 Except for road injuries, these are all traditionally considered medical problems for which the cornerstone of management is prevention; therefore, surgeons are left out of the conversation about solutions. When considering the top risk factors driving death and disability (in order, high body mass index [calculated as weight in kilograms divided by height in meters squared], smoking, dietary risks, high fasting plasma glucose level, high blood pressure, drug use, and alcohol use), we are again faced with a list that falls heavy on primary care physicians and medical subspecialists.1

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