By Casey Williams, M.D.
Health systems have traditionally approached health communication on an individual basis, with care team members interacting with patients and their loved ones after an illness happened. There has been limited communication between health care systems and the larger communities in which they exist. Those in healthcare do heroic work in treating disease and extending life expectancy; however, it is now very clear that waiting for the population to become sick and then spending large amounts of resources to treat these illnesses doesn’t work.
The diseases that people carry over time (such as high blood pressure, diabetes, and heart disease) cause the most suffering and drive the cost of healthcare. Known as chronic diseases, they develop not in clinics and hospitals, but in community settings, where people work, play, live, and learn. While health systems are adept at keeping chronic diseases at bay, they do little to affect the root causes of the disease.
To address this problem, the University of Missouri Health System (UMHS) has created a program known as the Healthy Community Initiative. The goal of this initiative is to partner with Missouri communities in order to improve health outside of the healthcare system. The Initiative teams UMHS faculty and staff with others from around the University, such as the HCRC, with local community members and health officials to affect change in the community, through efforts such as improving the built environment to allow people to safely get out and exercise.
In the past, chronic disease has been seen as the result of an individual’s unhealthy behaviors over time. The four most prevalent actual causes of death are smoking, a lack of physical activity, consuming too much unhealthy food/drink, and drinking too much alcohol. We understand now that individuals are not entirely responsible themselves for getting sick with chronic diseases. While individual behavior can eventually lead to disease in a single person, group behaviors are often the result of physical, policy, and media environments that predispose everyone within them to make unhealthy choices.
The Healthy Community Initiative will undertake several steps to improve health within Mid-Missouri communities.
Step 1: Identify communities whose members are interested in improving health.
Step 2: Identify key stakeholders within these communities and form working partnerships with them. Within these partnerships, the community members will identify key areas where health can be affected, such as schools, workplaces, media environments, or policy environments. Campus-based staff will provide evidence-based expertise in strategies to change these environments as well as financial support, which will come from University, state-based, and national grants.
Step 3: To implement the environmental changes using the experience of the campus-based faculty and the knowledge and influence of the community stakeholders. Some examples of environmental changes shown to improve health include workplace wellness programs, enhanced school physical education programs, smoke-free ordinances, and changes to physical environments to promote fitness, such as walking trails and bike lanes.
Step 4: To measure the effect of the environmental changes on healthy behaviors and, ultimately, health outcomes.
This process won’t happen overnight and must come with the support of community members. These sorts of programs also nearly always meet with some resistance from some community members.
That is where health communication comes into play.
One major focus of the Healthy Community Initiative is to use proven health communication techniques to increase health literacy and healthy behaviors within a community. Communication can also work in favor of health and safety. For example, marketing campaigns have successfully reduced smoking rates and cancer screenings, and have increased immunizations. And it’s not only about marketing. Health communication can raise awareness and improve education about health.
Just as manufacturers use advertising to tout fast food, sugary soft drinks, alcohol and cigarettes, health systems can use the same channels to fight back. Forward-thinking health systems are now realizing what a powerful influence communication can be in increasing healthy behaviors in a population. Well-designed messages focused on single behaviors and directed to specific segments of the population can be critical to the success of health efforts such as the Healthy Community Initiative.
Ultimately, through the implementation all of these steps and techniques we believe that we can make a difference in the communities of Missouri and; if we can unlock a winning process, could lead to the improvement in the health of the country as a whole.