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Health is Not Simply the Delivery System … It’s Bigger


Posted on 01.05.09

As the nation rallies around a new administration, I am excited about the potential of having a fresh perspective on health. Health is not just about the health care delivery system.  The health care system is a participant within the larger arena of our communities.

Though family physicians know the importance of disease prevention and coordination of care, acknowledging a broader definition of health is useful.   With a public health perspective, we can advocate for healthier communities every day, encouraging health promotion and disease prevention within the socio-economic, political, and environmental context that surrounds our patients' lives.  We must advocate for reducing social inequalities, bridging the economic and racial divides.  Let's acknowledge the health of our economy, education system and environment.  There sectors are inextricably linked.  What I know for sure is that we will need to expand our definition of the health of our nation.

I've been speaking to mentors, peers, friends, and colleagues about my leadership project, thinking largely about health. All the residents are required to conduct a leadership project over the three years of residency.  Some have started an integrative medicine clinic, a weekly yoga class, a safety net for new diabetics, teen health education, etc. I am not sure how to label my leadership project since my interests are so broad, but I do know what I want it to feel like. I want to belong to a like-minded group of people that inspires cutting-edge innovation and encourages interdisciplinary approaches to wellness that include business, education, faith communities, environmental, social and governmental collaboration.  I want to see the village come together to help the villagers within.  If we are spread too thin, how will be form the social bonds that connect us back to well-being?

The picture attached shows dogs and their owners at a watering hole as a snapshot example of health. There is joy and socialization with a strong sense of belonging and community.  People are out being physically active, making friends and feeling safe and good about their morning.  This is just one example of community health.  How can each person feel a strong empowered sense of healthy community and belonging?

I am hungry to find out what communities are already doing in cities such as Sonoma and San Francisco as well as courageous cities, counties and states all across the country - and countries around the world. The Commonwealth Fund, World Health Organization, Robert Wood Johnson Foundation, and Kaiser Family Foundation are all doing great work on reporting on the health of our communities.  In California, the Center for Civic Partnerships http://www.civicpartnerships.org/ helps networks cities in California towards health.  They feature publications about city projects, free toolkits, and other valuable resources.

Our families are doing what they can, given the barriers of time, energy, and cost restraints.  Nonetheless, Americans know how to persevere. There are common-day leaders in every family making small, yet big, decisions every moment.  Perhaps someone today will recognize them for that.

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