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Fixin' Healthcare

Monday, July 25, 2005

Healthy Greenville

A healthy lifestyle consists of a few key behaviors that yield a large and growing list of benefits. Finland, first through the North Karelia Project and then through a nation-wide initiative, demonstrated that public health intervention prevents chronic disease and extends life expectancy. World Health Organization programs have made it possible for other countries to benefit from Finland's experience. In 1999 a community of interested parties that includes Mayo Clinic in Olmsted County, MN adapted Finland's experience and launched CardioVision 2020. CardioVision 2020 advocates personal commitment and community action as the most effective and least costly means to optimize health.

Subsequently, a consortium of Greenville, SC community organizations issued a challenge to CardioVision 2020 and Olmsted County on behalf of Greenville County to determine who can produce the most improvement in community health status by the year 2020. The challenge was accepted and CardioVision 2020 versus Healthy Greenville formally began in January 2004. The contrasts and commonalities will generate learning opportunities for any community that wishes to join the challenge. The members of the consortium are:

City of Greenville
Furman University
Greater Greenville Chamber of Commerce
Greenville Technical Education College
School District of Greenville County
The Greenville News

Healthy Greenville is a public health intervention project with the purpose of improving the health status of Greenville County citizens by altering health behavior. There are many broad and complex factors contributing to health status of populations but the message of Healthy Greenville is not complex. Everyone can grasp the message and it can be mastered to varying degree but only with personal commitment and community action. Motivation, inspiration and innovation will determine the degree to which the community masters the message but the message is constant. Practicing the message in everyday life will improve health. The message is:

1. Cease exposure to cigarette smoke.
2. Eat a balanced diet that includes five servings of vegetables and fruit daily, lean meat or
vegetable protein and low fat dairy, drink water, tea and lemonade and avoid sodas, and no
highly processed food.
3. Daily physical activity with a goal of walking 10,000 steps.

The objectives of the planning process are:

1. To stimulate and promote ideas that relate to the issue of health promotion and disease prevention.
2. To recruit the interest of all existing resources in the county.
3. To link and coordinate existing resources for the purpose of health promotion and disease prevention.
4. To establish and maintain a horizontal and decentralized functionality.
5. To avoid the development of unnecessary overhead and expenses.
6. To establish a seamless transition between planning and implementation.
7. To create a free flow of information so that all may learn from every effort.
8. To create momentum for a process that will never end.

Initial programs are designed to establish a base with children and young adults and link that base to health promotion initiated within corporations and other community organizations.

Healthy Greenville is a component of Healthy SC, a health challenge initiative with the mission to improve health status throughout the state - www.healthysc.gov

Friday, July 08, 2005

Pour A New Foundation

Health care is a large enterprise that touches everyone in one way or another. The health care system is loosely organized and difficult to manage. It has been impossible to reform. Growth is the only change the health care system has known. Yet, there are serious problems that confront health care in the United States. High cost, limited access and deteriorating health status relative to other industrialized countries top the list. Almost everyone can agree that reform is necessary but no plan of action has broad support.

Fear, hope, scientific progress, development of technology, higher education, professionalism, specialization, commercialism, competition and politics are among the factors that contribute to sustained momentum in health care. With so many vested interests, sometimes the obvious truths are overlooked or ignored. The usual result is a practical course of action that modifies the existing system to resolve specific problems. This is not an effective method for reform because the old problems often persist and new ones are created.

Changes in the health care system frequently do not lead to predictable results. The major groups directly involved or with a vital interest in health care are quite nimble in their response to gain advantage or preserve the status quo. The details may be different but the outcomes often circumvent intended reform.

Health care in the US is medical care and medical care is a highly specialized activity that functions best when treating illness and injury. Medical care has not been successful in addressing the lifestyles that cause most of the chronic diseases. It is not a matter of whether the country needs medical care but whether the country can afford so many sick people. Society needs optimum health status for the greatest number of people at the lowest cost.

American society has demonstrated an escalating trend to present a wide variety of personal and social problems to medical care described as sickness. The medical care enterprise has promoted this trend with aggressive marketing. It is difficult and expensive to distinguish between need and demand when problems are defined in the context of sickness.

Medical insurance functions as a financial tool to manage illness and injury. It has not been an effective mechanism to manage health risk and prevent health problems. The traditional role of insurance to share financial risk is indefensible in a population where unhealthy lifestyle is prevelant. It is unlikely that providing medical insurance to everyone could result in optimum health status for the greatest number of people at the lowest cost.

Hopefully, medical care reform will make the treatment of illness and injury more effective and efficient, but it is community action on health promotion and prevention that might result in optimum health status for the greatest number of people at the lowest cost. Good health depends upon healthy lifestyle and healthy lifestyle arises from communtiy commitment and personal responsibility.

Health lifestyle is not one thing; it is everything. Nutrition, nutritional supplements, physical activity, adequate sleep and management of stress determine health status. A healthy lifestyle requires public health measures that assure immunization status, clean environment, safe water and safe food supply. Spiritual lives, service to others and respect and courtesy for everyone are important components of healthy lifestyle.

Development of healthy life style for the community requires input from the community. There is urgent need for thoughtful deliberation and public debate regarding the development of programs for health promotion and prevention that apply equally to everyone and include incentives, rewards and penalties. The purpose is to formulate, evaluate, propose, promote and implement plans of action to improve health status.

The following questions are only a beginning.

Is American society oriented to health or sickness?
Does it make a difference whether society is oriented to health promotion and prevention or sickness?
Can a community develop, promote and sustain healthy lifestyle for everyone? If so, how?
What defines community?
Are people capable of the individual responsibility required for healthy lifestyle and preventive health care?
What incentives, rewards and penalties could work for health promotion and prevention?

Your responses will be summarized and used as the basis for additional articles to move the public dialogue forward.

There is no topic more important to America today than good health.