A country is only strong, productive and competitive if its citizens are healthy. Moreover, health care is assuming a larger and larger share of government budgets. One of the major ways to reduce health care costs and improve the health of citizens is for communities to do more to focus on prevention and wellness and building healthy communities. Here are some thoughts on possible strategies that might be adopted.
Measuring Where We Are. We need to gather, analyze and track the current state of community health so we know where we are, determine where we realistically can go, monitor progress and make the adjustments required to achieve continuous improvement.
Comprehensive Health Care/Insurance System. A great deal of needless pain and suffering could be prevented if health care systems placed greater emphasis on prevention and wellness. This includes the very important area of nutrition and dental health with evidence suggesting a strong correlation between the health of your mouth and overall health. Another much neglected area is mental health. The World Health Organization, for example, estimates that 1 out of 5 people suffer from clinical depression.
Democratic Participation and Expertise. Put the ‘community’ and ‘public’ in health by setting up structures to tap into the democratic wisdom of the crowd. In this way organic solutions may more likely be accepted and meet the needs of the largest number of people. This is often better than top-down approaches. This is not to say expertise is to be ignored. That is needed too, but in concert with public consultation.
Education. People need more education about health. This includes all levels of home and formal schooling. However, it also includes medical education, which, in many countries focuses unduly on crisis care and gives far too little attention to nutrition, prevention and community health.
Transparency. We need transparency about how much is spent, where the money goes and for whom. This will promote efficiency, discourage and expose corruption and give people confidence that the significant public funds are well spent.
More Physical Education. Part of the problem is that we do not exercise enough. We need more physical education in schools, in the workplace and general community. Physical education classes in school need to involve more ‘physical’ activity. Outside of school times, we need to promote activities that encourage people of all ages to engage in individual or team activities involving physical activity.
Road Infrastructure. We need to make it easier for and encourage people to walk or ride a bike rather than drive. Enhanced public transport will also reduce the number of cars and make more room for bike and foot paths and space for parks and physical activity.
More Exercise Areas. We need more exercise areas built into public spaces as well as in the workplace. Chin-up bars, step-up benches and other devices are inexpensive. In some countries, such as the US, fear of litigation has unfortunately turned our playgrounds into boring places that are unattractive to children.
Making the Most of Space, Schools, Parking Lots and Other Public Areas. Communities need to make greater use of schools, sporting ground facilities, parking lots and other public areas so that they are available after normal hours for physical activities by the whole community.
Role of Town Planning. Communities should zone for mixed-Use Development. This means that employment, public institutions, residential, and other property uses should be in close proximity to one another. Abandoned and run-down buildings are not only an eye-sore—they also are devoid of safety, become havens for illegal activities and promote idleness as opposed to physical activities. Mixed-use neighborhoods promote a sense of community, make jobs available close to home and promote a culture of community growth and pride. Another aspect of town planning is to promote advertisements and availability of healthy food offerings, for example from vending machines. Finally, town planning should include ample walking/bike paths and promote greater use of public transportation.
Advertising. Following the lead from bans on advertising for cigarettes, laws should also restrict advertising for unhealthy foods and proactively promote the advertising of healthy foods.
Economic System of Food Production. We need to look at our food economic system and simplify and diversify it. For example incentives should be offered to food retailers to offer healthier choices. We also need to make it easier to purchase directly from farms and reduce the chemical use and huge distances between food production and supply.
Breastfeeding. We know that breastfeeding has lifelong benefits for children. We should make it easier for women to breastfeed in public, in the workplace and everywhere.
Illegal and Legal Drugs. Responsible drug use is vital to health. Combatting illegal drugs and enforcing laws against smoking and other illicit drugs should also be part of community health improvement. We should also take the ‘politics’ out of drugs. For example, the harm from legal drugs such as alcohol should be re-examined. If alcohol were to be invented today, it seems clear that it would be treated far less liberally than it is today when it has become socially acceptable.
The Role of Law. Looking more generally, the role of law also plays a key role in promoting community health. This includes more transparent and accurate food standards, the development and enforcement of laws related to pollution, limits on advertising; providing sufficient checks and balances in relation to development of new drugs, etc.
The Role of Technology. Technology is part of the problem and solution to community health. We should all be concerned about the negative health impacts from children and adults spending so much of their lives in front of screens. Many child care centers, for example, are adopting policies that limit screen time for children. On the other hand, technology such as those related to e-health and wearable computing are providing great opportunities to monitor our health and focus more than ever before on wellness and overall community health.
“For he who has health has hope; and he who has hope, has everything.”– Owen Arthur