Which systemic issue do you believe has the greatest impact on the United States overall health outcomes?

Answer Explanations

• Other (please specify)

  user-98212
  Misinformation and social media
• user-663996
  Lobby of Pharmaceutical and Food industries is too strong. This prevents enactment of laws that would improve health of Americans.
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-277129
  No universal healthcare
  No system to address social determinants of Health
  Substandard government policy
  Volatile political system
  Systematic racism 
  Constitutionally and culturally embedded gun laws
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-751315
  The US lags behind because it is almost unique in the failure to accept health care as a human right, not a privilege for the wealthy.  And poor education is at the base of the pyramid of inequity.
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-578886
  Until we decide that people should only have to work one full-time job to be able to meet their needs, we will never solve the problems that create our unhealthy society.
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-531244
  The health care system prioritizes specialty and acute care over primary, preventive, and mental health services. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-672218
  see above
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-247418
  The major risk factors for chronic disease are ones which we can directly control, but US citizens either don’t understand that or lack the resources to address them. Chronic disease prevalence differs markedly by race, education and income levels. Blacks and Native Americans suffer higher prevalence and much worse outcomes as do other races in lower income brackets. But the Trump administration seems to be fine with that which is appalling!
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-823481
  Income inequality and poverty are the most powerful determinants of poor health outcomes in the United States. Economic disadvantage shapes nearly every aspect of life—housing quality, education, diet, stress exposure, and healthcare access. People living in low-income communities experience higher rates of chronic disease, maternal and infant mortality, and mental-health disorders. Studies show that life expectancy in the poorest U.S. counties can be up to two decades shorter than in wealthier ones, highlighting how deeply social and economic inequities drive national health gaps.
  Healthcare access and affordability barriers remain a defining weakness of the U.S. system. Despite the world’s highest healthcare spending, millions of Americans face financial or logistical barriers that delay or prevent care. High out-of-pocket costs and uneven insurance coverage contribute to late diagnoses, uncontrolled chronic conditions, and preventable hospitalizations. These gaps translate into worse outcomes compared with other high-income nations, where universal access to primary and preventive care reduces avoidable deaths.
  Ultra-processed foods also have a profound impact on public health. They dominate the American diet, accounting for more than half of daily caloric intake, and are closely linked to obesity, diabetes, cardiovascular disease, and some cancers. These foods are inexpensive, heavily marketed, and widely available—particularly in low-income areas—creating a cycle of poor nutrition and metabolic disease. Addressing this structural problem in the U.S. food environment is essential to reversing the burden of diet-related illness and improving national health outcomes.
• Ultra Processed Foods Inadequate preventive care emphasis Other (please specify)

  user-223241
  Lack of trust in public health. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-868575
  Although there are concerns with environmental toxins and UPF; improvements in poverty and lack of access to health care would have an enormous impact on the overall health. The hysteria about UPFs is a distraction. Yes, people should limit intakes of UPF and get more exercise.
• Ultra Processed Foods

  user-234128
  Not just ultra-processed foods but garbage food in general... junk food, poor nutritional content because of producers going for cheap solutions. 
• Other (please specify)

  user-123942
  Extraterrestrial influence on health 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-47615
  Preventive care, such as vaccinations and regular cancer screenings, should be of paramount importance in healthcare, as it can prevent disease at its source. This would result in fewer patients and lower overall healthcare costs. However, high income inequality and the lack of a robust public health insurance system in the US prevent adequate disease management and may even result in chronic conditions.
• Healthcare access and affordability barriers Inadequate preventive care emphasis Overmedicalization

  user-510547
  Physical inactivity and ultra processed food have great impact, but individuals have choices to mitigated them
• Income inequality and poverty Physical Inactivity Overmedicalization

  user-451765
  I believe there are a lot of providers who are uninformed with poor training to support the care needs of the nations patient population - online education for nurse practitioners and 2-years of clinical training for physician assistants should be cause for our countries concerns
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-642568
  poor leadership
• Ultra Processed Foods

  user-566604
  Ultra processed foods could be a source of cancer and other healthy treats
• Physical Inactivity Inadequate preventive care emphasis Other (please specify)

  user-153764
  When looking at American diets the major outcomes of obesity are increased risk of diabetes, cardiovascular disease and cancers.
• Healthcare access and affordability barriers Income inequality and poverty Physical Inactivity

  user-745157
  Healthcare and income inequality are reinforcing factors. The poorest are often the sickest and get the worst healthcare. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-367398
   

  - The fragmentation and profit oriented of the USA system is the master problem. 
  
  

  - It is the broken engine that drives the high costs, denies access , focuses on sickness over wellness, and magnifies the health-damaging effects of socioeconomic disparity. 
  
  

  - Fixing this by moving towards a universal, integrated system with aligned incentives for keeping people healthy would be the single most powerful lever for improving the nation's overall health outcomes. 
  
  
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-956542
  Based on the breadth and depth of their impact on the population's health, the three systemic issues I believe have the greatest impact on the United States' overall health outcomes are:
  
  

  1. Healthcare access and affordability barriers
  2. Income inequality and poverty
  3. Inadequate preventive care emphasis

  
  Here is the reasoning for this selection:
  
  

  
  1. Healthcare Access and Affordability Barriers
  
  

  
  This is a direct and critical failure of the U.S. health system. When people cannot see a doctor due to cost, lack of insurance, or geographic barriers, they forgo routine care, delay diagnoses of serious conditions, and skip medications. This leads to worse management of chronic diseases (like diabetes and hypertension), more advanced stages of cancer at diagnosis, and more frequent use of expensive emergency rooms for preventable crises. It is a primary driver of medical debt and creates a significant chasm in health outcomes between the insured and uninsured/underinsured.
  
  

  
  2. Income Inequality and Poverty
  
  

  
  This is arguably the most powerful social determinant of health. Low income is strongly correlated with:
  
  

  • Food insecurity and poor nutrition, leading to obesity and diabetes.
  • Housing instability and poor-quality housing, which contribute to stress, asthma, and exposure to violence.
  • Less education, which limits health literacy and job opportunities.
  • Chronic stress from financial precarity, which has direct physiological effects (e.g., high cortisol levels) that increase the risk of heart disease, mental illness, and other conditions.
    Poverty creates a vicious cycle where poor health leads to an inability to work, which deepens poverty.

  
  3. Inadequate Preventive Care Emphasis
  
  

  
  The U.S. system is often described as a "sick-care" system rather than a "health-care" system. It is financially and structurally incentivized to treat illness after it occurs rather than to prevent it. This manifests as:
  
  

  • Payment models that reward procedures over patient counseling and lifestyle coaching.
  • Underutilization of proven, cost-effective screenings (e.g., for cancer, cardiovascular risk).
  • Lack of investment in public health campaigns and community-based wellness programs.
    A shift to a prevention-first model would drastically reduce the incidence and burden of the chronic diseases that are the leading causes of death and disability in the U.S.

  
  Why the others, while critical, are ranked slightly lower in terms of "greatest systemic impact":
  
  

  • Ultra-Processed Foods & Physical Inactivity: These are massive behavioral drivers of poor health, but they are heavily influenced by the systemic issues above. Poverty limits access to healthy food, and car-centric city design limits opportunities for physical activity. They are symptoms of a broader environment.
  • Environmental Toxins: This has a devastating impact on specific communities (environmental injustice) but is more geographically concentrated than the three selected, which affect a vast majority of the population in some way.
  • Overmedicalization: This is a significant problem that drives up costs and can cause patient harm, but its negative population-level health impact is likely smaller than the consequences of millions having no access to care at all.

  
  

  
  

  
  

  
  

  
  
  
• Income inequality and poverty Ultra Processed Foods Overmedicalization

  user-146840
   Ultra-processed foods are the mainstay of the American diet, contributing to childhood obesity, diabetes, and other chronic illnesses. 
   
  Poverty and Income Inequality: Socioeconomic differences exacerbate disparities in outcomes by influencing access to secure spaces, wholesome food, and high-quality healthcare. 
   
  Overmedicalization: Rather than addressing the underlying causes through prevention, lifestyle, and systemic changes, the United States frequently deploys expensive procedures to treat symptoms. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-540700
  Public health is the major contributor to improve overal health of citizens at population level, which is the topic of this investigation. Political decisions right now are undermining public health. Many of the data are no longer collected, for example due to budget cuts at CDC. Public health is very strong in providing adequate preventive care, so this is heavily undermined right now.
  Health care is privatised, so health care is monetised and needs to be profitable. This increases the cost of health care, and in addition, delivers a poorer quality health care to those that have a limited budget. Income inequality is thus contributing to poorer health of poor people. If poor people cannot be insured, they will often not be able to even pay the basic health care that other richt countries provide to all their citizens. Without affordable health insurance, poverty results in no access to affordable health care. Even those with a medium to low income already have difficulties to afford health insurance and health care.
  All other factors do contribute, but most are a consequence of income inequality. Ultra processed food is cheaper than healthy food. Poor people have jobs that exposes them more to toxins, and gives them less opportunity for physical activity. Lack of preventive care emphasis also does not stimulate the proper behaviour such as more physical activity. It is easier to give medication to individuals than to do the consistent efforts at a public health level to prevent health problems and avoid the need for medication.
• Income inequality and poverty Physical Inactivity Inadequate preventive care emphasis

  user-402166
  I believe addressing income inequality and poverty will have the greatest impact on health outcomes because the poorest Americans experience the worst health outcomes in the country. In places (other countries or within the U.S.) where there is greater economic equality and lower rates of poverty relative to the U.S. average, we see improved health outcomes. This environment of relative economic equity (though really it is more a function of reduced poverty) often produces greater accessibility to high-quality foods, physical activity, high-quality care, etc. Massachusetts, Utah, and Washington state are good examples of this. 
• Healthcare access and affordability barriers Income inequality and poverty Physical Inactivity

  user-267787
  I believe all are important but improved access to healthcare and education about diet and exercise is important but improving access and prioritizing exercise is important for everyone. Income inequity puts those with lower income at increased risk for eating unhealthy foods, decreased time for exercise and less access to healthcare. This leads to medical increased chronic medical conditions by income. 
• Income inequality and poverty Ultra Processed Foods Physical Inactivity

  user-933382
  Advertising and fast food lobbyists support all three of these 
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-520432
  All of the listed factors contribute in part but there is robust evidence that the high cost of healthcare, together with poor diet and poverty linked to income inequality are the primary causes.
• Income inequality and poverty Physical Inactivity Other (please specify)

  user-449711
  Alcohol, tobacco and firearms 
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-884738
  Not taking the ongoing SARS-CoV-2 pandemic seriously
• Inadequate preventive care emphasis

  user-476126
  It is a toss up between inadequate preventive care and healthcare access as these two are related. The two leading causes of death in the United States are cancers and cardiovascular disease, and although a number of the choices above may be related to these diseases, diet, exercise, not smoking, and not drinking are prominent mechanisms to minimize death rates. 
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-72077
  The underlying factors that drive health outcomes in the US are primarily based in deeply entrenched systems of power that disadvantage those with historically minoritized,  underrepresented, and underserved identities. Income inequality, poverty, healthcare access, environmental factors, etc. represent downstream social determinants that are created and perpetuated by systemic racism and sexism.
• Income inequality and poverty Inadequate preventive care emphasis

  user-919787
  There is inadequate preventive care  and inadequate health insurance care as a result of many populations having an overburdened health challenges, especially disadvantaged communities. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-784583
  If sick people can’t obtain health care the gap will only grow.
• Income inequality and poverty Ultra Processed Foods Physical Inactivity

  user-158538
  While the United States is often perceived as a wealthy nation, the reality is that deep income inequality undermines the health of large segments of its population. The widening economic gap drives multiple downstream effects: households with limited income often rely on ultra-processed, inexpensive foods, experience higher chronic stress, and work long hours in jobs that leave little opportunity for physical activity or self-care. These conditions collectively contribute to rising obesity and chronic disease rates.
  
  

  Compounding the problem are barriers to healthcare access and affordability, which discourage early medical intervention and preventive care. The result is a self-perpetuating cycle in which economic hardship fuels poor lifestyle choices, poor health reduces productivity, and limited healthcare access prevents recovery. This dynamic helps explain why, despite its wealth and advanced medical technology, the United States continues to lag behind its peers in key public health metrics such as life expectancy and chronic disease burden.
  
  
• Other (please specify)

  user-940530
  Yes, all these things are bad, but the main issue is a lack of education. People who eat poorly and are physically inactive are not educated on the ill health effects of this lifestyle. At best, they often turn to supplements in a vain attempt to overcome an unhealthy lifestyle. The fact that so many children can't read or write compounds the problem, but ultimately there needs to be major knowledge translation to elementary and high school students. They should be taught from kindergarten (and every year thereafter) about the benefits of a healthy diet/exercise and costs of poor diet and lifestyle. This should be reinforced by healthy food choices in school lunch programs. There are a number of model schools in the US where lunches only include healthy food options and drinks are limited to water or milk. This needs to be combined with physical activity. In addition, they can be taught about the adverse effects of smoking/vaping, illicit drugs, social media, lack of sleep, etc. An added bonus is if you teach children about the benefits of a healthy lifestyle, they will pass this information on to their families. 
• Other (please specify)

  user-745678
  Commercial interests compete with better interests of health promotion and disease prevention
• Income inequality and poverty Inadequate preventive care emphasis

  user-97011
  Societies that higher life expectancies focus more on preventing the occurrence of a disease. Moreover, it's also important for the US to consider addressing the issue on poverty.
• Income inequality and poverty Physical Inactivity Other (please specify)

  user-321504
  Inadequate public and community health in many parts of the country.  I judge that includes inadequate healthcare access and preventive care emphasis.
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-229823
  The Make America Healthy Again (MAHA) report highlights that the growing health gap in the United States stems from a combination of systemic and lifestyle factors, including poor diet, exposure to environmental toxins, sedentary behavior, and the overmedicalization of healthcare. These factors, reinforced by deep structural inequities, have collectively contributed to the rising burden of chronic diseases and declining public health outcomes. Among the most critical determinants identified are healthcare access and affordability, income inequality, and the pervasive consumption of ultra-processed foods.
  
  1. Healthcare access and affordability barriers: The U.S. healthcare system is among the most expensive in the world, yet millions remain uninsured or underinsured. High medical costs discourage early diagnosis and preventive care, resulting in poorer long-term outcomes and higher mortality rates than those observed in other developed nations. Furthermore, periodic government shutdowns exacerbate these challenges by suspending essential public health services, nutrition assistance, and medical research activities, leaving vulnerable populations without consistent care or support.
  
  2. Income inequality and poverty: Economic disparities magnify poor health outcomes by limiting access to nutritious foods, safe environments, and preventive healthcare. The MAHA report underscores that such inequalities erode national resilience and perpetuate intergenerational cycles of disease and disadvantage. Reducing this gap requires addressing not only income disparities but also the broader social determinants of health that influence lifestyle and opportunity.
  
  3. Ultra-processed foods: Nearly 70% of American children’s calories now come from industrially processed foods high in sugar, unhealthy fats, and chemical additives. The report directly associates this dietary pattern with rising rates of obesity, diabetes, and metabolic disorders. It calls for a nationwide shift toward whole, farm-based nutrition, emphasizing locally sourced and minimally processed foods as a foundation for restoring public health and preventing chronic disease.
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-725842
  My response is based on an understanding of the United States’ child-health gap in comparison to top-performing developed nations identified by WHO as global leaders in child health, such as Norway, Sweden, Finland, Denmark, Japan, Switzerland, and Iceland. This gap appears to be driven by three interacting, system-level forces.
  
  

  1. First, healthcare access and affordability barriers delay prevention and early treatment, worsening chronic disease control compared with the universal and equitable health systems common in these nations. 
  2. Second, income inequality and poverty amplify risk by influencing where families live, what food they can afford, their stress levels, and their ability to use preventive services, factors that Scandinavian social safety nets effectively mitigate. 
  3. Third, the dominance of ultra-processed foods (UPFs) in American diets, particularly among children, drives obesity, diabetes, and related conditions; in contrast, peer nations generally maintain lower UPF consumption and stronger nutrition standards.

  Addressing these three levers: access, equity, and diet quality, together offers the greatest population-level impact and best reflects how healthier developed nations achieve superior child health outcomes. This reasoning aligns with the MAHA report’s identification of poor diet (e.g., UPFs) and weak preventive measures as primary drivers of the U.S. childhood chronic disease burden. While physical inactivity, environmental toxins, and over-medicalization also contribute, their population-level effects are magnified, and more effectively reduced, when access, inequality, and dietary quality are addressed first.
  
  
• Ultra Processed Foods Physical Inactivity Environmental Toxins

  user-728758
  Nature of their work
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-206197
  If you forced me to name a “runner-up,” it would be inadequate preventive care emphasis, but in truth, that is more of a symptom of the first two issues than a separate cause. This is because when life is financially unstable and care is expensive, prevention always takes a back seat.
  
  
• Healthcare access and affordability barriers Income inequality and poverty Other (please specify)

  user-253845
  Other: Digital literacy and technology use, including excessive screen time (driven by social media on mobile devices with AI algorithms) that undermines productivity, well-being, physical activity, and social connection.  Guardrails and needed for all to prevent unhealthy use (especially for children), and to prevent polarization of ideologies that break down social cohesion and public trust. 
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-821097
  The three systemic issues with the greatest impact on the United States' overall health outcomes are:

  1. Healthcare Access and Affordability Barriers: Many Americans lack adequate health insurance or face high out-of-pocket costs, leading to delayed care, untreated conditions, and poorer health outcomes.
  2. Income Inequality and Poverty: Socioeconomic disparities significantly affect access to healthy food, safe environments, education, and healthcare, perpetuating poor health in marginalized communities.
  3. Ultra-Processed Foods: The widespread consumption of cheap, calorie-dense, and nutrient-poor foods contributes to obesity, diabetes, and heart disease, which are major drivers of poor health outcomes in the U.S.
• Healthcare access and affordability barriers Inadequate preventive care emphasis Overmedicalization

  user-272301
  The context is income inequality. 
• Income inequality and poverty Ultra Processed Foods Environmental Toxins

  user-914188
  The US has significant inequalities around wealth and these are much more pronounced compared to other developed nations - indeed I have seen the social inequalities of the US described as comparable to developing nations. These inequalities underlie much of the poor health outcomes and why averages e.g., life expectancies are down. These outcomes could be improved by having more robust social security similar to EU nations. Beyond this, diet and toxins in the diet and environment also sets the US apart from other developed nations where food quality and regulation of toxins are higher on the agenda with cheapness of food being a lower priority. The drive for cheap ultra-processed food ties in with the wealth disparities. 
• Healthcare access and affordability barriers Physical Inactivity Inadequate preventive care emphasis

  user-496928
  Equitable access to healthcare services is a basic human right essential for system quality. Therefore, population health- based programs to assess social and behavioral determinants of health in order to establish programs that meet the population demands and tailored to their needs. 
• Healthcare access and affordability barriers Physical Inactivity Inadequate preventive care emphasis

  user-279844
  Preventive care must be put in place since the very beginning of every US citizen life. Much can be done about that and despicably, it has not been done yet ! Precision medicine and precision safety of medicines (see for instance De Pretis, F., van Gils, M., & Forsberg, M. M. (2022). A smart hospital-driven approach to precision pharmacovigilance. Trends in Pharmacological Sciences, 43(6), 473–481. URL: http://dx.doi.org/10.1016/j.tips.2022.03.009) shall be what should be guiding such a change.
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-657460
  Healthcare disparities drive limitations on access/affordability, as does income inequality. Lack of access contributes to inadequate preventive care emphasis, but, even for Americans who have healthcare access and engage, I believe that healthcare professionals are forced to focus on active medical issues and either fail or lack the time to educate patients on preventive health care.
• Healthcare access and affordability barriers Inadequate preventive care emphasis Other (please specify)

  user-543438
  The number one problem currently in this country is un- / under-vaccination. This creates a more unstable population health status. Followed by Healthcare Access and Affordability, and inadequate preventive care emphasis.
• Healthcare access and affordability barriers Ultra Processed Foods Inadequate preventive care emphasis

  user-839240
  Access to healthcare is a major factor as not all Americans have access to Medicaid and may not be able to afford the level of care that they need, futher more ultra processed foods appear to be readily available and cheaper than quality food and so majority gravitate towards cheaper alternatives especially in the current economy.  There must be more emphasis at every opportunity in educating the public on the importance of preventive care, this is cheaper and better than living an unhealthy lifestyle and will increase ife expectancy.
• Healthcare access and affordability barriers Physical Inactivity Other (please specify)

  user-37600
  Heartless vultures of the private insurance industry.
• Physical Inactivity Inadequate preventive care emphasis Other (please specify)

  user-271773
  Emphasis on preventive care should include increased funding to nutrition research and to development of a cross-agency (particularly across HHS and Dept of Agriculture) regulatory structure to improve access to effective and affordable nutrition. 
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-869302
  Access to healthcare is everything. In the US, employers often serve as gatekeepers for insurance. Without a reliable job that includes health benefits, people are often on their own to navigate an array of confusing and expensive options.
• Ultra Processed Foods Physical Inactivity Overmedicalization

  user-910913
  All thicked mostly have direct effects on health
• Other (please specify)

  user-426175
   Universal healthcare coverage and free but mandatory screening would help 
• Healthcare access and affordability barriers Income inequality and poverty Physical Inactivity

  user-606148
  We aren’t doing in policy what the science tells us the barriers are
• Healthcare access and affordability barriers Physical Inactivity Inadequate preventive care emphasis

  user-53122
  With ~50% of adults being not only overweight but obese, due large portion sizes, poor quality food, and lack of physical activity, it seems inevitable that poor health and lower life expectancy will result 
• Income inequality and poverty Physical Inactivity Environmental Toxins

  user-709065
  The role of the anti-aging gene Sirtuin 1 is critical to the chronic disease epidemic and health outcomes in the US. The  use of Sirtuin 1 activators versus inhibitors will improve  NAFLD, diabetes and neurodegenerative diseases.
  RELEVANT REFERENCES:
  1.               Nutrition Therapy Regulates Caffeine Metabolism with Relevance to NAFLD and Induction of Type 3 Diabetes. J Diabetes Metab Disord. 2017; 4: 019.
  2.               Anti-Aging Genes Improve Appetite Regulation and Reverse Cell Senescence and Apoptosis in Global Populations. Advances in Aging Research, 2016, 5, 9-26
  3.               Single Gene Inactivation with Implications to Diabetes and Multiple Organ Dysfunction Syndrome. J Clin Epigenet. 2017; Vol. 3 No. 3:24.
  4.               Increased Risk for Obesity and Diabetes with Neurodegeneration in Developing Countries. Top 10 Contribution on Genetics. Chapter 1, EBook. 2018. www.avid.science.com
  5.               Insulin Therapy and Autoimmune Disease with Relevance to Nonalcoholic Fatty Liver Disease. Non Alcoholic Fatty Liver Disease. An Update. IntechOpen. 2018. 
  6.              COVID-19 Infection and Anti-Aging Gene Inactivation. Acta Scientific Nutritional Health 4.5 (2020): 01-02.
• Physical Inactivity Environmental Toxins Overmedicalization

  user-361025
  these are commonly incriminated factors for increasing non-transmissible diseases
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-640046
  Affordable access to basic healthcare, regardless of income or lack of income, employment or unemployment, fortune or misfortune, should be a basic right in any developed nation that cares for the well-being of its citizens. The USA seems to be an outlier compared with the large majority of developed nations. Of course, national health funded by the state does have some challenges, but they are exaggerated by the USA media and GOP.
• Overmedicalization

  user-558408
  Overmedicalization is the defining systemic flaw in the U.S. health system: it inflates costs, harms patients, and undermines genuine health improvement by medicalizing what are fundamentally social and behavioral issues. Until the US reorients its incentives from treating disease to promoting health, it will continue to spend more and live less.
• Healthcare access and affordability barriers Income inequality and poverty Ultra Processed Foods

  user-231028
  Access to care is a great determinant of health. Accessibility should be looked into and food consumption should be monitored 
• Healthcare access and affordability barriers Income inequality and poverty Physical Inactivity

  user-445218
  If you cannot access treatment, you could easily become incapacitated or die.
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-511592
  in addition to inaccessibility, growing vaccine helsitancy has a big impact
• Ultra Processed Foods Physical Inactivity Overmedicalization

  user-708958
  According to my knowledges treatment of diseases especially oncological and cardiovascular ones - the maine cause of mortality - is on a very high level. Although incidence of such diseases remains high due to population usually skips lyfe style modifying interventions.
• Healthcare access and affordability barriers Income inequality and poverty Inadequate preventive care emphasis

  user-274801
  Preventive care also includes, but is not limited to, access to information on ultra-processed foods, environmental toxins, and physical inactivity. These three themes could be part of a program.
• Healthcare access and affordability barriers Income inequality and poverty Overmedicalization

  user-679764
  Income inequality and racism prevent good health for more than 40% of Amercans.