Beyond Medicine

In Beyond Medicine, Paul V. Dutton provides a penetrating historical analysis of why countless studies show that Americans are far less healthy than their European counterparts.

Dutton argues that Europeans are healthier than Americans because beginning in the late nineteenth century European nations began construction of health systems that focused not only on medical care but the broad social determinants of health: where and how we live, work, play, and age. European leaders also created social safety nets that became integral to national economic policy. In contrast, US leaders often viewed investments to improve the social determinants of health and safety-net programs as a competing priority to economic growth.

Beyond Medicine compares the US to three European social democracies—France, Germany, and Sweden—in order to explain how, in differing ways, each protects the health of infants and children, working-age adults, and the elderly. Unlike most comparative health system analyses, Dutton draws on history to find answers to our most nettlesome health policy questions.

Paul V. Dutton is Professor of History and Adjunct Professor of Health Sciences at Northern Arizona University. He is the author of Differential Diagnoses and Origins of the French Welfare State.

[A] rich and satisfying read. Paul Dutton conveys his personal connection to four health systems, with well-referenced and convincing descriptions and analyses of three areas of health systems.

Paul Dutton provides an insightful read that every American should take time to review.

Jacob S. Hacker, Yale University:

In Beyond Medicine, Paul Dutton provides a compelling, panoramic, and deeply researched comparison of efforts to improve health and well-being in France, Germany, Sweden, and the United States. His message: Americans are less healthy not because American medicine falls short, but because US public policies fail to support human flourishing. In light of the COVID-19 pandemic, no message could be more important.

Victor G. Rodwin, New York University, coauthor of Health Care in World Cities:

Paul V. Dutton's refreshingly well-written book is full of insights into how and why France, Germany, and Sweden have been more successful than the United States in implementing national policies that promote the health of mothers, children, and working and retired adults. All those who study or work in the field of health policy and management should read this book.

Julia Lynch, University of Pennsylvania, author of Regimes of Inequality :

Beyond Medicine is an engaging book that connects the dots between government policy, social determinants, and health outcomes. It goes a long way towards helping members of the public and policy experts alike understand the inarguable importance of health policy.