Since WWII, Americans have been sold the idea that more health care is better. But comparisons of the U.S. with other comparable nations teach us otherwise. While we spend more per person on health care than any other nation—a total of over $3 trillion per year—we rank last or next to the last in key indicators of health and quality of health care. We know that medical errors are the third leading cause of death in this country, evidence that our health care system is not safe. And we are overscreening and overtreating and mistreating and misdiagnosing health problems. About one-third of all healthcare spending is because of unnecessary, inefficient and ineffective care, as well as outright fraud. If we could reduce this waste and give it to communities to promote health and wellness, we wouldn’t need as much acute care.
There is a growing movement in the U.S. to move our attention and resources upstream, meaning to efforts that will promote healthy individuals, families and communities so that they can avoid preventable, costly health problems. One of the leading organizations behind this movement is the Robert Wood Johnson Foundation (RWJF) through an initiative called Culture of Health. The focus is on what works to build healthier communities.
But where does one start in trying to build healthier communities for the individuals and families who live and work there?
One place to start is understanding whether your community is healthy or not. Some years ago, David Kindig initiated a project at the University of Wisconsin called County Health Rankings and Roadmaps that provides county-level data on key health indicators and ranks counties in a state based upon a composite score. You can go to the website and look up your county and see what the major health problems are and which of these are contributing to a poorer state of health in your community. The website also provides background on the indicators, resources that speak to addressing specific health issues, and examples of successful local initiatives that communities have launched to address key health problems. The Action Model shown above provides a guide for communities to think about doing the work of building a healthier place to live, work and play. In addition, the RWJF has funded the University of Wisconsin to help counties to interpret their data and be coached in developing initiatives that can prevent leading health problems.
On September 27, I interviewed Jerry Spegman, a Community Coach at the County Health Rankings & Roadmaps initiative at the University of Wisconsin, on my radio program, HealthCetera in the Catskills, to talk about the health indicators for Delaware County. HealthCetera in the Catskills airs on WIOX Radio in Roxbury, NY, located in Delaware County. Our discussion could be used to spur conversations about how to improve health in your own community.
Image source: County Health Rankings Action Model