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Well: What We Need to Talk About When We Talk About Health
"A deeply affecting work from one of the important and innovative voices in American health and medicine." -- Arianna Huffington
In Well, physician Sandro Galea examines what Americans miss when they fixate on healthcare: health.
Americans spend more money on health than people anywhere else in the world. And what do they get for it? Statistically, not much. Americans today live shorter, less healthy lives than citizens of other rich countries, and these trends show no signs of letting up.
The problem, Sandro Galea argues, is that Americans focus on the wrong things when they think about health. Our national understanding of what constitutes "being well" is centered on medicine -- the lifestyles we adopt to stay healthy, and the insurance plans and prescriptions we fall back on when we're not. While all these things are important, they've not proven to be the difference between healthy and unhealthy on the large scale.
Well is a radical examination of the subtle and not-so-subtle factors that determine who gets to be healthy in America. Galea shows how the country's failing health is a product of American history and character -- and how refocusing on our national health can usher enlightenment across American life and politics.
In Well, physician Sandro Galea examines what Americans miss when they fixate on healthcare: health.
Americans spend more money on health than people anywhere else in the world. And what do they get for it? Statistically, not much. Americans today live shorter, less healthy lives than citizens of other rich countries, and these trends show no signs of letting up.
The problem, Sandro Galea argues, is that Americans focus on the wrong things when they think about health. Our national understanding of what constitutes "being well" is centered on medicine -- the lifestyles we adopt to stay healthy, and the insurance plans and prescriptions we fall back on when we're not. While all these things are important, they've not proven to be the difference between healthy and unhealthy on the large scale.
Well is a radical examination of the subtle and not-so-subtle factors that determine who gets to be healthy in America. Galea shows how the country's failing health is a product of American history and character -- and how refocusing on our national health can usher enlightenment across American life and politics.
297 pages, Kindle Edition
Published April 1, 2019
99 people are currently reading
1180 people want to read
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Displaying 1 - 30 of 70 reviews
April 30, 2019
A different take on health and wellness in the United States. Though we spend more than any other wealthy country on healthcare, exercise equipment, gym memberships and prescriptions, our life expectancy is less. The author talks about the external factors that influence health from politics, environment, our jobs, our location and the food we eat. The premise is that if one can change these factors, our health will improve without excess doctor visits, and costly prescriptions. We are focusing on the wrong things, and our lives are suffering.
Well presented, well written, and gives one a few different ways to focus on our health and we'll being.
ARC from Edelweiss.
Well presented, well written, and gives one a few different ways to focus on our health and we'll being.
ARC from Edelweiss.
September 29, 2021
Public health is difficult to teach in America because the paradigm throughout the culture for understanding health is based on the biomedical model of disease. As a result, basic public health concepts such as "prevention" or "social determinants" are misunderstood by many people. For example, if the meaning of prevention is to do something before people get sick to keep them from being sick, then calling Narcan kits "overdose prevention" is bizarrely upside down, since the point of Narcan is to administer it to someone who has already had an overdose. This is just one instance I saw in the news the other day. I mention all this because I sympathize with the author trying to explain public health to the general public. The gimmicks he uses (poetry, hypotheticals, etc.) generally didn't work for me, but maybe they do help to get the message across for nonscientist audiences that are not very interested in data and are exploring the topic.
August 7, 2019
I picked up Well because my summer english assignment was to read a book about a social issue. i would say the health of our country is definitely pretty relevant to our society today, especially when we get into debates over healthcare. while i’ve been fortunate to be healthy so far in my life, I’m glad to have read Sandro Galea’s book. He encourages readers to stop looking at health as the absence of illness. or as something purely individual. he dares to question our current system of healthcare: whose purpose is to treat illness, rather than prevent it. he argues that health is as much about social, and economic influences, as it is genetics. he talks about how our current healthcare system focuses so much on extending life when people have reached their end, but Galea believes that instead of trying to fight human mortality, shouldn’t we be trying to improve our lives in order to be as fulfilled as possible with the life we have, so that we aren’t afraid to die? With that said, Galea’s book is making me embrace health, and life in a new way. it is truly eye opening.
October 18, 2020
Sandro Galea's Well~~
What do we talk about when we Americans talk about healthcare? Treatment for our illnesses, that's what. Dr. Sandro Galea argues in his 2020 book Well: What We Have to Talk About When We Talk About Health that we don't talk about keeping healthy or preventing illness. I completely agree. America's healthcare is much more costly and less efficient than other advanced countries with our life expectancy declining and more birth complications and deaths.
Galea observes that we assume health is an individual's responsibility. They should work harder on eating a better, more controlled diet and get more exercise and sleep, but the health industry doesn't help us with making good food available or accessible.
The government too doesn't help out by subsidizing fresh produce, keeping the poor stuck in crime-ridden areas with only convenience stores, and not providing a living wage or insurance for all.
Health, Galea explains, is a result of favorable economic, social, and environmental conditions.
We need to be able to buy good food and get it for our children in school, plus live in a safe place with social opportunities and support, plus breathe clean air and drink clean water and play in toxic-free parks with trees.
The disconnect partly stems from America's obsession with the idea of rugged individualism, the idea of being cowboys taming the wild west, you know?
But Galea notes that the west was only flooded with nervous Americans coming over because of President Lincoln's Homestead Act that guaranteed them free land. Then the government cleared the land of their inhabitants, the hostile Native Americans defending their homes. Americans have always needed the government to help them live out the American dream and it certainly hasn't changed, but now corporations have been given more rights than people.
He discusses how a US Supreme Court Justice, Lewis Powell, who was not a judge or constitutional lawyer, began in 1971 to influence the court and government to favor corporations.
It's an absorbing, somewhat troubling, book. I don't know if we've reached the tipping point that helps us to see we're on the wrong track and heading for disrailment with all this government inaction, but I'm really hoping for a blue tsunami this November. I hope you are too
What do we talk about when we Americans talk about healthcare? Treatment for our illnesses, that's what. Dr. Sandro Galea argues in his 2020 book Well: What We Have to Talk About When We Talk About Health that we don't talk about keeping healthy or preventing illness. I completely agree. America's healthcare is much more costly and less efficient than other advanced countries with our life expectancy declining and more birth complications and deaths.
Galea observes that we assume health is an individual's responsibility. They should work harder on eating a better, more controlled diet and get more exercise and sleep, but the health industry doesn't help us with making good food available or accessible.
The government too doesn't help out by subsidizing fresh produce, keeping the poor stuck in crime-ridden areas with only convenience stores, and not providing a living wage or insurance for all.
Health, Galea explains, is a result of favorable economic, social, and environmental conditions.
We need to be able to buy good food and get it for our children in school, plus live in a safe place with social opportunities and support, plus breathe clean air and drink clean water and play in toxic-free parks with trees.
The disconnect partly stems from America's obsession with the idea of rugged individualism, the idea of being cowboys taming the wild west, you know?
But Galea notes that the west was only flooded with nervous Americans coming over because of President Lincoln's Homestead Act that guaranteed them free land. Then the government cleared the land of their inhabitants, the hostile Native Americans defending their homes. Americans have always needed the government to help them live out the American dream and it certainly hasn't changed, but now corporations have been given more rights than people.
He discusses how a US Supreme Court Justice, Lewis Powell, who was not a judge or constitutional lawyer, began in 1971 to influence the court and government to favor corporations.
It's an absorbing, somewhat troubling, book. I don't know if we've reached the tipping point that helps us to see we're on the wrong track and heading for disrailment with all this government inaction, but I'm really hoping for a blue tsunami this November. I hope you are too
June 12, 2019
Important and impactful, but slightly redundant and pedantic. A quick read. Not sure I took any action items away, but it reinforces my views on the need for investment in health, not just healthcare.
April 22, 2022
Americans confuse health and healthcare, and Dr. Galea makes a clear argument that when health continues to be viewed as the individual's responsibility, the health of all will suffer. Our country desperately needs deeper understanding of the upstream causes of poor health outcomes that will lead to societal and political reforms to protect the environmental and economic factors that influence health.
August 30, 2019
Although I generally agree with the overall message, I found this book to be largely redundant, making the same point repeatedly in slightly different ways.
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November 26, 2025Read this for a public health class, super interesting and seems like a good book for those who haven’t studied public health because of how well concepts are explained and how Galea brings in different narratives to demonstrate his points. Quick and enjoyable, I recommend.
April 13, 2023
Like maybe it would’ve been better if I wasn’t forced to read it against my will. Very applicable to my major though so maybe I should have liked it. Shrug emoji
May 30, 2023
Read for class… the message was good and informative but definitely could have been done in less than 10 pages.
This felt like maddie trying to write a paper where she keeps saying the same thing with different words in order to reach word count
This felt like maddie trying to write a paper where she keeps saying the same thing with different words in order to reach word count
December 5, 2021
I read this book because I started an MPH program at BU’s school of public health, and it is written by the dean.
I gave it 4 stars because it was an easy but engaging read. If you are familiar with Sandro Galea, some of the stories and analogies used in the book can be a little repetitive because he uses them regularly in his speeches.
Generally speaking, I enjoy Galea’s open writing and speech style. His book includes chapters on money, politics, and power, but also chapters about compassion, empathy, hate, and love. This emotional approach is bold in a field that generally relies on scientific studies and statistics to make recommendations.
I would recommend this book for anyone interested in public health that would like some context from a humanist perspective.
I gave it 4 stars because it was an easy but engaging read. If you are familiar with Sandro Galea, some of the stories and analogies used in the book can be a little repetitive because he uses them regularly in his speeches.
Generally speaking, I enjoy Galea’s open writing and speech style. His book includes chapters on money, politics, and power, but also chapters about compassion, empathy, hate, and love. This emotional approach is bold in a field that generally relies on scientific studies and statistics to make recommendations.
I would recommend this book for anyone interested in public health that would like some context from a humanist perspective.
January 10, 2021
This is a good book on a really important subject. Galea argues that our focus on "healthcare" as opposed to health has caused us to under-invest in the kinds of public goods that really improve well-being. Improving public health means ensuring that everyone is able to breathe clean air, eat healthy food, live an active lifestyle etc. As a society, we place too much emphasis on individual choice, and not on addressing the underlying societal inequities and injustices that preclude many individuals from maximizing health. We focus only on helping people once they are sick, often at great expense, rather than keeping people healthy and we prioritize living for a long time as opposed to living well. Galea makes a compelling case for why we need to change our mindsets and these practices.
While the subject and argument are compelling, the book would have benefitted from better editing. It's redundant, and way longer than it needs to be. The various literary and pop culture references are silly and distracting. Instead, I was looking for deeper analysis and more data.
While the subject and argument are compelling, the book would have benefitted from better editing. It's redundant, and way longer than it needs to be. The various literary and pop culture references are silly and distracting. Instead, I was looking for deeper analysis and more data.
January 18, 2020
It’s okay. Perhaps it’s the philosophy major in me, but Galea’s book suffers from a fundamental flaw: he doesn’t do enough (if any) exploration into the other side of his arguments. I agree with him on a lot of points, but I also disagree on some major ones. He didn’t change where I stand on any issues, and I like to be challenged by a book. Most importantly, he completely overlooks mental health, which I argue is THE most important aspect of public health because it affects ALL other areas. Maybe it’s because if he had, a lot of his arguments wouldn’t have been as strong. I’ll still give it three stars because I enjoyed the history lesson, and it ends on a (somewhat) optimistic note for the future.
October 14, 2020
This was one of the best books I've read all year! I may be a bit biased as I do volunteer work on this subject but I felt that the author did a great job of incorporating lots of examples and evidence based data to make this book relatable to a wide audience. I was part of a book club where the author attended one of our meetings and it was fascinating to hear his perspective and expertise on the subject. I feel like it's a book that everyone should read so that we can begin deeper conversations about how communities can work together to support healthy living opportunities for ALL.
December 5, 2019
Sandro Galea is a rockstar in the field of public health. This book is a meditation on the factors that influence health. Galea makes so many very important points. The frustrating thing is that it is not clear what one person can do to change any of this, other than being aware of this and voting accordingly and supporting policies that will holistically improve health.
Some points made in the book:
Our health is shaped by the conditions around us- the combination of place, time, money, power and connections. The American health system focuses on treating illness rather than preventing it.
The past: It is cruel to look at someone’s health issues without taking their past and the socioeconomic conditions that characterized their history. US welfare programs are written and updated in a way that assumes laziness among those who dare to use them. Health and disease unfold over time.
Money: There are few relationships stronger than the link between money and health. Eg. one could purchase exemptions from the draft during the Civil War; income tax credits for families with children linked to positive health outcomes. Money can buy healthcare but also access to conditions that are conducive to health. American culture equates material success with personal virtue. In fact, most wealth is inherited.
Power: Gun laws in the US lag behind because public preference and common sense have been blocked by power. Power shapes health overtly and covertly- policies like zoning laws, ag subsidies, environmental regulations, and cultural shaping of beliefs and desires. Power in itself is neither good nor bad but is a tool that can improve or undermine health depending on the intentions of the person using it.
Politics: Policies shape health
Place: infrastructure, safety, food access, transportation options, social environment. zipcode is a better predictor of health than the genetic code.
People: social contagion, loneliness
Love and Hate: Trauma, exclusion
Compassion: enlightened self-interest- helping others is ultimately helping one’s self. Compassion urges us to correct problems that don’t seem to affect us directly. Empathy (thoughts and prayers) are not enough.
Knowledge: we live in an age where scientific knowledge is politicized. When it comes to health, there is no alternative to facts.
Humility: Health is greater than the sum of its parts.
Freedom: There are people who interpret freedom as a license to do everything they wish, even if it harms others. There is a tension between maximising individual freedoms and protecting the rights of citizens.
Choice: Daily decision, life choices. Much of our conversation about health has to do with lifestyle, making choices for better health. But the range of choices depends on context, shaped by factors beyond our immediate control or even awareness. There are inherent limits to personal choice.
Luck: Our circumstances are deeply influenced by chance, which country we were born in, which family we were born into. If these are in our favor, we are the beneficiaries of tremendous, unearned luck. But we can bring about a world in which luck and opportunity are more broadly accessible.
The Many: Our individual health is inextricably linked to the collective health. In the US, the vast majority of health spending is on medical services like doctors and medicines and it is misallocated because SES, environmental factors and behavioral factors are ignored.
The Few: We scapegoat the marginalized few, consigning them to poor health and stigma and even blaming them for their own sickness.
The public good: Health is a public good and not a commodity.
Fairness and justice: The societal forces that land individuals on the right or wrong side of unfair are also responsible for creating health.
Pain and pleasure: Public health is sometimes seen as the enemy of pleasure, warning again indulgence. But public health informs a different, more expansive notion of pleasure of moderation, sustainability, health and a longer, fuller life.
Change the conversation, apply our desire to be healthy to change the broader conditions that determine health.
Some points made in the book:
Our health is shaped by the conditions around us- the combination of place, time, money, power and connections. The American health system focuses on treating illness rather than preventing it.
The past: It is cruel to look at someone’s health issues without taking their past and the socioeconomic conditions that characterized their history. US welfare programs are written and updated in a way that assumes laziness among those who dare to use them. Health and disease unfold over time.
Money: There are few relationships stronger than the link between money and health. Eg. one could purchase exemptions from the draft during the Civil War; income tax credits for families with children linked to positive health outcomes. Money can buy healthcare but also access to conditions that are conducive to health. American culture equates material success with personal virtue. In fact, most wealth is inherited.
Power: Gun laws in the US lag behind because public preference and common sense have been blocked by power. Power shapes health overtly and covertly- policies like zoning laws, ag subsidies, environmental regulations, and cultural shaping of beliefs and desires. Power in itself is neither good nor bad but is a tool that can improve or undermine health depending on the intentions of the person using it.
Politics: Policies shape health
Place: infrastructure, safety, food access, transportation options, social environment. zipcode is a better predictor of health than the genetic code.
People: social contagion, loneliness
Love and Hate: Trauma, exclusion
Compassion: enlightened self-interest- helping others is ultimately helping one’s self. Compassion urges us to correct problems that don’t seem to affect us directly. Empathy (thoughts and prayers) are not enough.
Knowledge: we live in an age where scientific knowledge is politicized. When it comes to health, there is no alternative to facts.
Humility: Health is greater than the sum of its parts.
Freedom: There are people who interpret freedom as a license to do everything they wish, even if it harms others. There is a tension between maximising individual freedoms and protecting the rights of citizens.
Choice: Daily decision, life choices. Much of our conversation about health has to do with lifestyle, making choices for better health. But the range of choices depends on context, shaped by factors beyond our immediate control or even awareness. There are inherent limits to personal choice.
Luck: Our circumstances are deeply influenced by chance, which country we were born in, which family we were born into. If these are in our favor, we are the beneficiaries of tremendous, unearned luck. But we can bring about a world in which luck and opportunity are more broadly accessible.
The Many: Our individual health is inextricably linked to the collective health. In the US, the vast majority of health spending is on medical services like doctors and medicines and it is misallocated because SES, environmental factors and behavioral factors are ignored.
The Few: We scapegoat the marginalized few, consigning them to poor health and stigma and even blaming them for their own sickness.
The public good: Health is a public good and not a commodity.
Fairness and justice: The societal forces that land individuals on the right or wrong side of unfair are also responsible for creating health.
Pain and pleasure: Public health is sometimes seen as the enemy of pleasure, warning again indulgence. But public health informs a different, more expansive notion of pleasure of moderation, sustainability, health and a longer, fuller life.
Change the conversation, apply our desire to be healthy to change the broader conditions that determine health.
April 28, 2022
essential reading for anyone invested in health, public health, or healthcare.
Basically this book creates the argument that "Americans conflate health and healthcare: we invest almost solely in the latter at the expense of the former, ignoring the context that actually decides our health in favor of hoping and procuring the cutting edge of medical science. And when we stop thinking about the treatment of disease to think about health itself, we think mostly about our lifestyle, buoyed by the notion that if we make good decisions, we will be healthy. This has led us to emphasize individual choices about personal behavior like diet and exercise, creating the illusion that modifying these choices will be enough to improve our health, when, in reality, our lifestyle is almost entirely shaped by the social, economic, and environmental forces .."
This is a reframing of health and how to achieve it. A paper is referenced early in the book that claimed in its research that healthcare determines on 6% of the experience of health that a person experiences, and essentially healthcare is the primary modality of health investment and discussion in the US. Not to mention that the US spends more on healthcare than anywhere else in the world, but we have poorer health than we did 20 years ago, and poorer health than many many countries.
This book is a roadmap for changing the way we think about improving health outcomes that center health, and include the basics, justice, inclusion, lgbtq rights, civil rights, environmental justice, afordable housing, economic security, joy, community, accessibility and more.
Basically this book creates the argument that "Americans conflate health and healthcare: we invest almost solely in the latter at the expense of the former, ignoring the context that actually decides our health in favor of hoping and procuring the cutting edge of medical science. And when we stop thinking about the treatment of disease to think about health itself, we think mostly about our lifestyle, buoyed by the notion that if we make good decisions, we will be healthy. This has led us to emphasize individual choices about personal behavior like diet and exercise, creating the illusion that modifying these choices will be enough to improve our health, when, in reality, our lifestyle is almost entirely shaped by the social, economic, and environmental forces .."
This is a reframing of health and how to achieve it. A paper is referenced early in the book that claimed in its research that healthcare determines on 6% of the experience of health that a person experiences, and essentially healthcare is the primary modality of health investment and discussion in the US. Not to mention that the US spends more on healthcare than anywhere else in the world, but we have poorer health than we did 20 years ago, and poorer health than many many countries.
This book is a roadmap for changing the way we think about improving health outcomes that center health, and include the basics, justice, inclusion, lgbtq rights, civil rights, environmental justice, afordable housing, economic security, joy, community, accessibility and more.
January 5, 2021
Dr. Galea is a voice of contemporary public health that aligns very much with what drew me to public health in the first place. In Well: What We Need to Talk about When We Talk about Health, Dr. Galea talks about how it is time to shift our thinking when it comes to health in America. As it turns out, the conversations about health in America aren't even about health, so to speak; they're about healthcare - medicine and hospitals. Of course, this is important, but it fails to recognize the complexity of the human species and the way we interact with the places and spaces around us. Social and political determinants of health show us this.
What I appreciated about this book, given the fact that I am an early career public health professional, it is that Dr. Galea speaks about matters such as love and hate, freedom (and what this really means), values, compassion, humility, fairness and justice, and death as much as he speaks about money, power, place, and others. Often, these former matters are rarely spoken about.
I recommend this to anyone interested in the field of public health, trying to explain public health to anyone who asks "so what is public health?", or just wanting to know a little more about how we interact with this world, specifically the United States.
What I appreciated about this book, given the fact that I am an early career public health professional, it is that Dr. Galea speaks about matters such as love and hate, freedom (and what this really means), values, compassion, humility, fairness and justice, and death as much as he speaks about money, power, place, and others. Often, these former matters are rarely spoken about.
I recommend this to anyone interested in the field of public health, trying to explain public health to anyone who asks "so what is public health?", or just wanting to know a little more about how we interact with this world, specifically the United States.
June 3, 2020
Very interesting commentary into the United State's healthcare and how we treat health as a commodity that can be bought, which leads to the richer being "healthier." However, health is decided more, or at least equally, by our conditions than our choices. The United States has a long-standing attitude that bad health is directly tied to your personal bad decisions but we totally ignore the conditions in which a person lives and how those can negatively affect lifelong health. The vast majority of money in the US spent on 'health' is for treatment after we're already sick instead of focusing on prevention. This is such a shame as prevention could ultimately do more good for a larger number of people by removing pollutants, etc.
I do wish this book included action points. Instead it went in cycles of stating how "the US utilizes this system/mindset and we need a complete attitude shift to change it" which isn't helpful for any individual looking to increase their health or help better the health of others. HOW can we start creating this attitude change to increase national health to the level of other first-world countries?
I do wish this book included action points. Instead it went in cycles of stating how "the US utilizes this system/mindset and we need a complete attitude shift to change it" which isn't helpful for any individual looking to increase their health or help better the health of others. HOW can we start creating this attitude change to increase national health to the level of other first-world countries?
May 19, 2019
This is a must read for everyone. It discusses the role of luck, with where, when, how you're born. It discusses how our environment shapes our health and not individual choices. It discusses the importance of caring for the needs of the many vs. the needs of the few. It explains how changing life situations, pour housing, poor water, poor access to fresh food, walkable spaces, across to reliable transportation, community, education, child care, living wages, and clean air are all necessary to help us live a healthy life and die healthy. Rather than just waiting until disease happens and relying on doctors, equipment, procedures and pharmaceuticals to prolong our poor health until we die. Dying is not a bad word. It is part of life. We need conversations and policies that shift the focus from reactive to proactive. This is what saves health care dollars in the long run and contributes to a more balanced, contributing society. We all need each other. No man is an island.
December 10, 2019
Well by Sandro Galea is marvelous in its simplicity. It utilizes a statement put forth by Benjamin Franklin; an ounce of prevention is worth a pound of cure.
Galea’s main argument is that we throw money at problems but don’t get much out of it. The United States has the highest health spending in the developed world and one of the lowest life expectancies. Galea argues that this is because we focus on the wrong things when we think of health. Americans are supposed to be rugged individuals who pull themselves up by their own bootstraps. This totally ignores the entire socioeconomic situation in America. Most people who are born to poor parents become poor themselves.
This book is very good. I would go so far as to say it is life-changing. Through twenty chapters of various focuses, the author explains the different problems with our healthcare system. The only real problem is that the book repeats itself a great deal. On the other hand, the book is a very quick read.
Galea’s main argument is that we throw money at problems but don’t get much out of it. The United States has the highest health spending in the developed world and one of the lowest life expectancies. Galea argues that this is because we focus on the wrong things when we think of health. Americans are supposed to be rugged individuals who pull themselves up by their own bootstraps. This totally ignores the entire socioeconomic situation in America. Most people who are born to poor parents become poor themselves.
This book is very good. I would go so far as to say it is life-changing. Through twenty chapters of various focuses, the author explains the different problems with our healthcare system. The only real problem is that the book repeats itself a great deal. On the other hand, the book is a very quick read.
May 26, 2022
This book addresses health and wellbeing from a public health perspective, focusing on prevention, upstream influences, and the social determinants of health (the environmental factors that have the greatest effect on our health). While it touches on the many dimensions of public health, I appreciate that he identifies compassion as its cornerstone in the quest for a healthier world for all. Since I am a public health student, many of these topics were a review for me. This book might be a better fit for someone new to the field of public health.
-Public health as motivated by “agape” – the unconditional love for humanity…an active love that seeks to do good and improve conditions for all; and compassion – “sympathetic consciousness of others’ distress together with a desire to alleviate it”
-“As the United States spends more than any country in the world on health, we have at the same time underinvested in the social services that actually create a foundation for health.”
-Public health as motivated by “agape” – the unconditional love for humanity…an active love that seeks to do good and improve conditions for all; and compassion – “sympathetic consciousness of others’ distress together with a desire to alleviate it”
-“As the United States spends more than any country in the world on health, we have at the same time underinvested in the social services that actually create a foundation for health.”
October 8, 2025
Dr. Galea effectively highlights what the US is doing wrong regarding health and health policies. It's definitely an eye opener. However, I found myself frustrated as he never gives any solutions to these problems, just that health policies should be different, and a general direction for what that should be. The author is aware of this and didn't want to write a full textbook on policy, but it's frustrating nonetheless. He also never mentions why our culture is resistant to certain policies, and only looked at the cultural views on health in general. This was frustrating because he would bring up specific issues and only explain his side of the argument, and we would get little to no context of why there was opposition to the idea in the first place. I think Dr. Galea presents his case very well, however I can only see it further educating people that agree with him, and doing nothing to convince those who are opposed to his ideas.
June 30, 2019
3 1/2 STARS
This book is more of an outline or overview of what needs to change when we think about health.
Even though the U.S. spends significantly more on healthcare, we have poorer outcomes than other wealthy nations.
This gives a framework for the changes that need to take place in our society in regards to environment, community, and politics. It deals with the difference between health and healthcare.
A staggering statistic found toward the end of the book:
As a country that thinks about treatments before it thinks about disease, America’s healthcare expenditures paint a picture of a culture that is more focused on living longer than on living well. For example in 2014, Medicare spent much more caring for the health of people who passed away that year ($34,000 per person) than it did for ALL other Medicare recipients (about $9,000 per person).
This book is more of an outline or overview of what needs to change when we think about health.
Even though the U.S. spends significantly more on healthcare, we have poorer outcomes than other wealthy nations.
This gives a framework for the changes that need to take place in our society in regards to environment, community, and politics. It deals with the difference between health and healthcare.
A staggering statistic found toward the end of the book:
As a country that thinks about treatments before it thinks about disease, America’s healthcare expenditures paint a picture of a culture that is more focused on living longer than on living well. For example in 2014, Medicare spent much more caring for the health of people who passed away that year ($34,000 per person) than it did for ALL other Medicare recipients (about $9,000 per person).
March 5, 2023
Too much of an external locus and blaming your health on politics and society. I understand how health is affected by where you are located, but you can make the best with what you have. This book makes you feel that it's okay to blame your downfalls on everything around you even when your own actions can change things.
I did agree with his views on how healthcare needs changes, but every chapter he beat the same dead horse with his examples. It became redundant.
His hypothetical examples were also on opposite ends of the spectrum to where it felt exaggerated and couldn't be taken seriously.
I did agree with his views on how healthcare needs changes, but every chapter he beat the same dead horse with his examples. It became redundant.
His hypothetical examples were also on opposite ends of the spectrum to where it felt exaggerated and couldn't be taken seriously.
This entire review has been hidden because of spoilers.
June 16, 2023
While there are some important topics discussed and outlined in this book, I was overall disappointed. I am an individual who votes on the issues, regardless of party affiliation. Healthcare etc. in the US is an issue that needs everyone's attention. The author consistently blames a certain political party for the majority of our healthcare issues. As well, the author seems to undermine the power of free-agency and personal choice and responsibility and indicates that political parties, society, etc. are the reason why many Americans are sick, obese etc.
July 10, 2021
I'm only in the first chapter of Heather McGhee's brilliant The Sum of Us and can't stop thinking about how inadequate this book is in comparison. For one thing, Galea's praise of The Homestead Act as an example of public investment in health, with only one paranthetical sentence about how it impacted the Indigenous people whose stolen land was being given away for free and nothing at all about how it completely excluded Black people.
I'm a big fan of a lot of Galea's work in the public health literature but this book is like a series of essays he could have sat down and written in a day. It's a shame because a more diligent argument could have been a lot more impactful.
I'm a big fan of a lot of Galea's work in the public health literature but this book is like a series of essays he could have sat down and written in a day. It's a shame because a more diligent argument could have been a lot more impactful.
September 28, 2022
Galea delves into how we need to look at health from a proactive equity lens related to the social determinants of health such as access to education, medicine, connected communities etc. Diverting greater attention to overall population health and a quality filled life rather than the individual reactive healthcare will lead to a healthier population of Americans. The book does have a political lean, but is important subject matter on the root causes between health and our environment.
July 23, 2023
As a researcher who spends much of my time wading through the complex structural determinants of health, I found this to be a well-presented summary of the field. Galea weaves research with anecdotes to describe how broad environmental factors, far beyond the health care system, affect health. The examples are sometimes simplistic, but I think Well is an admirable effort in summarising the determinants of health to a public audience.
November 1, 2023
A lucid, well thought out, and easy to read explanation of America’s exceptionally poor public health system. What I thought was going to be a simple critique of healthcare turned out to be a much more rich and expansive commentary on America’s ideological approach to health and life itself - and therein finding the key to what we need to change in order to become a truly healthy nation. A fantastic expose by a leading public health expert!
October 19, 2019
A holistic approach for health written by a doctor, and a professor of public school of health. Introduction highlights the size and importance of the health problems in USA. And in the rest, the author does a great job of articulating all social, economical and political reasons leading into poor health. I was able to feel the author's passion in his work and I enjoyed reading this book.
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