Doctor: Empower people to improve their lives, health will follow
The Daily Reflector
Wednesday, October 4, 2017
Improvement to any community’s standard of health depends on the ability of its people to make meaningful and innovative choices at the grass-roots level, according to the keynote speaker at Tuesday’s Greenville-Pitt County Chamber of Commerce Health Care Summit 2017 at the Hilton Greenville.
The summit, co-presented by Vidant Medical Center and First Citizens Bank, featured Dr. Pritpal S. Tamber, co-founder and CEO of Bridging Health and Community, a Seattle-based nonprofit dedicated to transforming approaches to health care to foster the “agency” of a community — its ability to make purposeful choices.
“There are lots of well thought out programs and approaches to how to get people to adopt (healthy) behaviors,” Tamber said. “It’s not rocket science. Yet, from the 1990s and on, an upward trajectory has been sustained in extreme obesity and its correlation to diabetes. It seems to me that something is broken.”
The physician said that the great challenge faced by communities is to get people to change their lifestyles rather than focus on disease management. About 60 percent of the determinant of life expectancy is based on personal behavior, social practices and the environment, based on research presented in 2002.
“We’ve learned that your genes don’t really tell your body how to behave,” Tamber said. “What actually gets written into your body is their relation to the environment. Your genes alone are not as important.”
Tamber emphasized economic conditions over genetics as a factor in health.
“Economic insecurity is incredibly bad for health,” he said. “Poor housing and education, unsafe areas and poor access to food all are bad for people’s health; probably more important considerations than (diet, exercise, stress management or smoking cessation).”
Tamber said that bridging the health sector and local communities is about facilitating and supporting people’s sense of control.
“We believe that this requires them to have agency — the ability to make purposeful choices,” he said. “While it’s true that some people may make choices to purposefully improve their health, people have a fundamentally different, broader understanding of health than (health care providers) have. It’s also about the context in which they live that we don’t understand.
Tamber offered principles for an approach to health that respond to people’s day-to-day realities and allows a more inclusive and participatory process that fosters community agency to implement and evaluate health solutions.
“We must include those who live in a community, those who work there and those who deliver or support services provided there,” he said.
Vidant Health CEO Dr. Michael Waldrum, who introduced Tamber, said the importance of Tamber’s message was not lost on his organization and this community.
“With 30 percent of our population in poverty and bearing a huge burden of disease, the health care institution needs to be at the table, working with our communities and supporting the improvement of education, commerce and health,” Waldrum said. “The missing link is whether people have a sense of control over their lives, something that requires individuals and communities to have agency.”
Waldrum told Tamber that some of what he presented can make community members, health care providers and community health professionals feel as though their legacy of decades of work to improve regional health has been meaningless or that they “got it wrong.” He asked how Vidant might participate in that work without disenfranchising participants.
“The annoying answer to the question of how to start is to start,” Tamber said. “I agree that it can seem accusatory to say you’re going to start a new way of doing something. It has to be done slowly and carefully, understanding that you’ll get things wrong. But you have to start.”
Vidant Medical Center President Brian Floyd told the audience that part of the Vidant mission is to engage the people of eastern North Carolina in a dialogue on how to improve health together, rather than to simply have people go to receive treatment when they are ill or in poor health.
“The truth be told, most of what we do is rescue people from illness, much of which comes from the social determinants of health, not just patients’ clinical health care,” Floyd said. “We think it’s very important to ... make sure there is a growing body of knowledge and learning so we work, play and behave together in ways that improve our health.”
Contact Michael Abramowitz at email@example.com or 252-329-9507.