Fast Company – It’s surprising how little we have applied geography in shaping our knowledge of what determines health. We should start now. “…it’s surprising how little we have applied geography in shaping either our knowledge of what determines health, such as nearness to pollutants or access to care, or our strategies for achieving it, such as equitable allocation of resources or geographically targeted and tailored interventions. This has arguably been a significant mistake in analysis. But it is certainly a mistake in strategy. The classic “epidemiologic triad” consists of (1) agent of disease, (2) a susceptible host, and (3) the environment. Medical science has made great advances in identifying and addressing the first two—from antibiotics to genetics to advances in medical technology. We have made less progress on the third—a contextual cornucopia that includes the built environment, the social determinants of health, and local ambient conditions.

What we have learned is that 80% of our health outcomes are context-driven: physical environment (10%); health behaviors (30%); and social and economic factors (40%). Only the remaining 20% is determined by a person’s genome and microbiome (the symbiotic organisms—including billions of bacteria and other microbes—that make up an individual human being) and the clinical care they receive…”