Inspiring Innovations that Disrupt The Status Quo---
A Response and View From the 74126
(Photo above, taken in our community gardenpark and orchard we are creating here; for the purposes of this post, it is a photo of a physician delivering innovative health care here in the 74126)
51 percent of health comes from lifestyle choices,
20 percent from genetics,
19 percent from the environment,
and only 10 percent from the health care delivery system (data from the presentation mentioned below)
And yet, of course, what is spent to effect change in health care in those areas is not anywhere near proportionate to what in fact makes the difference. We are stuck in an institutional, attractional model, that is maintanence rather than mission based. But, there are seeds of new endeavors underway to try to re-orient us (connected issue but also separate from this are the issues of the health care insurance and coverage of uninsured in our country; won’t get into that here; but if Governor Fallin is serious about looking beyond the box and trying innovative local plans to improve health outcomes that do not involve insurance coverage, then she should pay attention to what is said here and what is going on in these new seedbeds of innovation). Of course, good things are happening and health is being improved through the current institutions, but it is out of whack when it comes to comparing outcomes and costs.
Related to this is that very important truth that there are big differences in values and approaches and “class” perspectives among the very residents here, and these are big determinants on how residents trust, or not, the health care system now in place, and what they think of regarding their own health options and their willingness or reluctance to go to a doctor for what is generally considered preventive care or primary care, even if they, for example, lived next door to a 24/7 facility; there are differences if it is a walk-in anytime clinic as opposed to one where you have to make an appointment first, an act itself that is viewed as a barrier and difficulty for some. We have here differences of those who grew up middle class with its values and even though they are now poor, and perhaps new to the area, still have middle class attitudes toward themselves and their options; we have those who are multi-generationally in poverty who have different stances and responses; and we have those who are or were working class and who have assets that are above poverty line. So, any health care approach that considers people to be representative, even among their own neighborhood, will end up misconnecting; treatment for someone will vary due to culture and geography and economic condition, and will vary in a zipcode like ours as well. So, the bottom line here is that health care professionals, and planners, need to really, really know an area they want to make a difference in. more on what that entails below.
And it is important to note that health care is being delivered, in such a way, by many people here, and in our wider community, by people who do not have medical careers; it is very true that a lot of the health problems in our area are also caused by the spread of misinformation on health matters. The key is to unlock the strengths of community connections and trust, and build on them with a little training, and using right information to spread in the community (where word of mouth, and personal relationships are the currency). All of which is testament to why the community health workers, health coaches, lay advocates, whatever you want to call those who will be partners in health with those most in need and without anyone serving that function from their family or their community connections already, why they must be people who live in the area where those seeking care come from.
It is also why, if I had been asked yesterday what I thought would make the most difference in health care from the medical school, I would answer with the simple but radical response: tell your graduates to move and live in areas of high poverty, add to the diversity of those neighborhoods, learn from them, make a difference in that 51 percent category even if you make your living still in that 10 percent category; you can do it and you can make it happen; we are proof of it. Also, give your employees in health care institutions bonuses, merit pay, for choosing to live in the areas where the patients with the least resources live, and where they can be a part of that informal, community grassroots health delivery. If health care, especially, is more of a calling, a vocation, and not just a profession, and certainly not just a job, then be open to the nature of a call. Talk about “disruptive innovation” and helping to shift the focus and locus of health care…or we can continue to tinker and plan and rearrange the chairs on the Titanic.
This is also why there is a connection between the health of the community and the health of the neighborhood schools, why we need to be ble to graduate students from McLain high school now who can and will go on to become nurses and doctors and other health professionals, the same as happened when my wife was a McLain graduate. To grow health in the 74126, make our schools in the area healthier and give them the resources and the curriculum offerings to produce graduates who will not be scared to remain or return to the area to live and work and be a part of that important community informal day to day life.