Giving Compass' Take:

• This JAMA forum post explores the concept of "wrong pockets" (when one sector benefits from the investment of another) as it applies to health. It may explain why some non-medical interventions are underfunded.

• What can we do to make sure there's more ROI for investors and stakeholders when it comes to certain healthcare gaps? Is there a better way to address non-medical needs in the system?

• Here's how partnerships and collaborations can improve healthcare access.

Every month about 30 researchers, policy makers, and practitioners from 4 different sectors — health, education, housing, and social services — meet at the Brookings Institution in Washington, DC. We discuss policy reforms that would boost collaboration between sectors to improve the health of households and communities. We are especially interested in “social determinants” — non-medical social factors affecting health.

The focus of a discussion might be children’s mental health, housing conditions, or aging. But whatever the topic, it is never long before someone raises an example of a “wrong pocket problem” undercutting the incentives for collaboration. A wrong pocket problem arises when one organization or sector is best placed to make an investment, but it is another sector — another pocket — that benefits from the investment. As any economist would point out, when a potential investor incurs the cost but cannot capture the generated value, there will be underinvestment.

This issue is important in health care because the research literature increasingly emphasizes the importance of non-medical factors in health. For instance, the absence of quality medical care appears to account for perhaps 20% of avoidable deaths and genetics another 20%. But social, behavioral, and environmental factors may account for as much as 60%.

The wrong pocket problem reduces optimal investment in non-medical factors that would improve health outcomes.

Read the full article about how "wrong pockets" hurt health by Stuart Butler, PhD at news@JAMA.