The Friedell Committee for Health was formed out of concerns by individuals about the health of Kentucky citizens. It was believed that ideal “health systems” would affect population health in a positive way. It is important to be clear that current thinking is that a “health system” is not just healthcare. It is generally recognized that every aspect of the community (natural environment, built environment, laws, health care, jobs, education, etc.) has an impact on health of the population, thus is part of the “health system”. These are known as the social determinants of health (here is a good link for an overview: http://content.healthaffairs.org/content/21/2/60.full). One major issue is that the impact on health, either in a positive or negative direction, is not being considered in every decision within a community.
HEALTH SYSTEM COMPONENTS
For our purposes, we are going to go with the 1948 World Health Organization (WHO) definition of health. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition was later changed, as in 1986, the WHO said that health is: “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”
Now what are the components of the system that has arisen around health?
There are several aspects to the “system” [NOTE: this list is not exhaustive]:
- social determinants
- affordability and accessibility of health
- cultural issues
- individual behavior
If you are not familiar with the term “social determinants”, this article (http://www.medicalnewstoday.com/articles/150999.php) says this:
The health of individual people and their communities are affected by a wide range of contributory factors. People’s good or bad health is determined by their environment and situations – what is happening and what has happened to them, says WHO. WHO says that the following factors probably have a bigger impact on our health than access and use of health care services:
- Where we live
- The state of our environment
- Our income
- Our education level
- Our relationship with friends and family.
In order for Kentucky to become “Healthier, Wealthier & Wiser” we will have to work on improvement in the five areas that society can affect (all except genetics). These five areas are all interconnected and it is through focus on the interconnection that we will have the greatest success. The Robert Wood Johnson Foundation calls this a Culture of Health (http://www.rwjf.org/en/library/annual-reports/presidents-message-2014.html).
The Friedell Committee has committed to take action to promote health and wellness in Kentucky. Our approach will be to support local organizations that have taken ownership of the health of a community and are seeking to take action. We will be sharing more information on the components of health identified above (where we live; environment, genetics, income, education, relationships). Are there organizations in your community that address these issues? What opportunities are there for you to participate? What role does your local health department play? What role can you or your family play? What specific actions can be taken in your community take make a difference?