Aligning US Spending Priorities Using the Health Impact Pyramid Lens

Thomas Frieden’s “health impact pyramid” presents a hierarchy in which the wide base of the pyramid of socioeconomic factors at a population level has more impact on the health of the public than do individually focused interventions at the pyramid’s top.

From this pyramid perspective, the US spending priorities are misaligned, as expenses targeted at public health and socioeconomic factors are far outstripped by spending on individual health care services at the top of the pyramid. The nation’s ongoing debate on health care reform continues to focus on access to individual health care services, despite evidence demonstrating the health impacts of population-level efforts at the base of the pyramid and the synergistic health impacts of health and social service collaboration.


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