Several months ago a doctor and I were discussing the challenges facing us in health care today. I have always been a big believer in the concept of “integrative healthcare” and the need to expand our definition of health as a society to fix the mess we’ve created. From a purely business and consumer perspective I had always wondered how we can expect to change the trajectory of increasing costs when all we are talking about is fixing the end-result (the diseases). My arguments didn’t go very far inside the system. The system is still focused on only addressing the end-result.
Yes, the system has created the idea of health coaching and health promotion but it’s all still very clinical from my perspective. Health care has not embraced them as critical elements to the solution. The incentives are in treatment- not in the other stuff. We’re identifying risks, then trying to get people enrolled in specific programs to address the risks. We’ve had moderate success. The new reform legislation includes rules and initiatives focused on prevention, health promotion, and community health but they remain a separate world from the developments in technology, telemedicine, pharmaceuticals, and all the rest that are more part of our “standard” sickness system. We have not yet integrated our culture and social well-being into the equation. We’re talking about it- but we have a long way to go.
The doctor turned me on to the work of Sir Michael Marmot. Professor Marmot is a professor of epidemiology at University College London. His work looks at the social aspects that can have a dramatic influence on the health of any population. His conclusions: the social (cultural) factors we encounter each day can influence how healthy or how “sick” we are. We’ve posted the World Health Organization’s Social Determinants of Health (of which Professor Marmot was a contributor) on our web site. You can get it by clicking here.
This report looked at nine different social influence's that have a dramatic impact on the health of a population. These included:
*Stress- which is largely influenced by the socioeconomic status and self-perception of an individual
*Early Life- which includes how we set the foundation and example for our children early in life.
*Social Exclusion- which evaluates the social connectedness we have in our lives
*Work- looking at the relationships and satisfaction in our work
*Unemployment- evaluating the effects our professional lives have on our health, and especially when a person is out of work
*Social Support- the culture of support and guidance available to a population
*Addiction- the impact drugs, alcohol, and tobacco have on health and well-being
*Food- The nutritional make-up of our lives
*Transport- which essentially equates to getting out of the cars and exercising by walking and looking at other means of transportation.
These factors have a dramatic influence on the health of any population. Employers are making some progress individually but the engagement rate of consumers in the “risk based” models being introduced today remain relatively low. Some of the social factors identified by the WHO report are dealt with indirectly but are certainly not part of the overall platform that is evolving in the health care system we have today.
Our culture is stressed, 71% are not enamored with their work, our unemployment rate is high, we’re overweight and don’t exercise, and the social support available is being reduced simply due to the economy. We are not a healthy population.
It’s time we start building these social factors into what we traditionally define as “health care.” Until we do, all the medical homes, baskets of care, and other new ideas in the world aren’t going to make a difference to the costs we will pay if we just keep getting sicker.
Yes, the system has created the idea of health coaching and health promotion but it’s all still very clinical from my perspective. Health care has not embraced them as critical elements to the solution. The incentives are in treatment- not in the other stuff. We’re identifying risks, then trying to get people enrolled in specific programs to address the risks. We’ve had moderate success. The new reform legislation includes rules and initiatives focused on prevention, health promotion, and community health but they remain a separate world from the developments in technology, telemedicine, pharmaceuticals, and all the rest that are more part of our “standard” sickness system. We have not yet integrated our culture and social well-being into the equation. We’re talking about it- but we have a long way to go.
The doctor turned me on to the work of Sir Michael Marmot. Professor Marmot is a professor of epidemiology at University College London. His work looks at the social aspects that can have a dramatic influence on the health of any population. His conclusions: the social (cultural) factors we encounter each day can influence how healthy or how “sick” we are. We’ve posted the World Health Organization’s Social Determinants of Health (of which Professor Marmot was a contributor) on our web site. You can get it by clicking here.
This report looked at nine different social influence's that have a dramatic impact on the health of a population. These included:
*Stress- which is largely influenced by the socioeconomic status and self-perception of an individual
*Early Life- which includes how we set the foundation and example for our children early in life.
*Social Exclusion- which evaluates the social connectedness we have in our lives
*Work- looking at the relationships and satisfaction in our work
*Unemployment- evaluating the effects our professional lives have on our health, and especially when a person is out of work
*Social Support- the culture of support and guidance available to a population
*Addiction- the impact drugs, alcohol, and tobacco have on health and well-being
*Food- The nutritional make-up of our lives
*Transport- which essentially equates to getting out of the cars and exercising by walking and looking at other means of transportation.
These factors have a dramatic influence on the health of any population. Employers are making some progress individually but the engagement rate of consumers in the “risk based” models being introduced today remain relatively low. Some of the social factors identified by the WHO report are dealt with indirectly but are certainly not part of the overall platform that is evolving in the health care system we have today.
Our culture is stressed, 71% are not enamored with their work, our unemployment rate is high, we’re overweight and don’t exercise, and the social support available is being reduced simply due to the economy. We are not a healthy population.
It’s time we start building these social factors into what we traditionally define as “health care.” Until we do, all the medical homes, baskets of care, and other new ideas in the world aren’t going to make a difference to the costs we will pay if we just keep getting sicker.
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