A Healthier Tomorrow – Why We are Healthy

Imagine a Healthier Tomorrow

By Alison Page, CEO Western Wisconsin Health

Last month’s column ended with the following statement: ‘The most striking fact to date is the fact that people of color are dying of COVID-19 at a much higher rate than white people. Why? The reality is that we know the answer to this question and we know how to fix the problem. The question is, will we, as a country, have the will ….?’ I received a few inquiries wanting to know the answer to the question and more specific ideas on how to fix the problem. We will get started with some basic information this month and continue next month.

The fact is, there is enormous disparity in the health of the citizens of our country. This is not just about COVID-19, t is about all aspects of health. To set the stage for this discussion, I am returning to the first column I wrote in January of 2018. It outlines the social determinants of health. It is important to understand these as we determine how we can best address the disparity in health in our country.

Have you ever closed your eyes and imagined what your life would be like if you were as healthy as you could possibly be? Can you imagine what our children’s lives would look like if they were as healthy as they could possibly be? Can you imagine what a community looks like that supports the health of everyone who lives there? What would this look like….imagine.

Well, as it turns out, some people have done more than imagine what this looks like. They have, in fact, studied it. The University of Wisconsin and the Robert Wood Johnson Foundation have studied and identified the things that really matter in terms of impacting the health of individuals and communities. For purposes of the study, they defined “health” as being a combination of length of life (50%) and quality of life (50%). Then, they looked at all the factors that contribute to a person’s health and identified the factors that have the greatest impact. The study showed that the factors impacting health (the determinants of heath) fall into four categories.

Category 1 – Health Behaviors account for 30% of the things that impact the overall health of a person. The key behaviors that impact health include tobacco use, diet and exercise, alcohol and drug use, and sexual activity.

Category 2 – Access to good quality Clinical Care accounts for 20% of the impact on health.

Category 3 – Social and Economic Factors account for 40% of the impact on a person’s health. Things like education, employment, income, family and social support, and community safety greatly impact the likelihood of a person living a long and healthy life.

Category 4 – A person’s Physical Environment accounts for about 10% of the impact on his/her health. Specific factors in this category include the quality of air and water in the person’s environment, and access to housing and transit.

When we consider these four categories, we can start to understand why it is possible that 33% of people hospitalized in the US with COVID-19 are African American, even though African Americans make up only 13% of the population. The social determinants of health are real, and they matter.

We can do a lot to address these factors and impact the health and wellbeing of our citizens at the community level. But, our state and federal policies matter; they must support and align with efforts we know will make a difference for the future health of our citizens.

Health care organizations can provide access to excellent medical care to manage emergent situations, acute care needs and chronic disease. But, it is not enough. If we are going to truly impact the overall health of the citizens of the United States, we need engage communities, businesses, and government agencies to shape the future. Together, we can Build a Healthier Tomorrow.

I believe it was Teddy Roosevelt who said, “Do what you can, with what you have, where you are.” We cannot wave a magic wand and have the stars align to recreate our communities into perfect places that encompass and optimize all the determinants of health. We cannot immediately change state and federal laws that impact social and environmental policies. But, we can start. We start by doing what we can, with what we have, where we are.