Engagement in Health

I mentioned in my post on Monday that I was in Memphis, TN, last week visiting and learning from the terrific folks at the Congregational Health Network (CHN). This dedicated team is attempting to re-create the healthcare system in that town of 1.2 million, and address some of the most distressing health disparities in the nation. What is most fascinating to me, is the engagement of faith communities in the process to aid the engagement of their congregations in health and healthy behaviors. This is echoed by a recent address given by Dr. Jessie Gruman of the Center for Advancing Health. (see: http://e-patients.net/archives/2011/06/jessie-gruman-at-icsi.html) This sould be required reading for all providers of healthcare services as it crystallizes the issues that we all face.

As a pharmacist, I've spent much of the last 25 years attempting to figure out the best ways to "ensure" compliance and persistence with medications. Still today, however, about 50% of the prescriptions written in America go unfilled. Those that are filled, especially for chronic conditions (e.g., high blood pressure, diabetes) are taken more or less appropriately by the population. Medications can be life prolonging and in some cases life saving - but only if they are ingested (they are 100% ineffective if they remain in the bottle)!

I've come to see persistence and compliance as an engagement issue thanks to Dr. Gruman's work - and my own spiritual journey. The white papaer on patient engagement that is available on the CFAH website is terrific. Engagement for me comes down to a belief model, which puts it squarely in the spiritual arena. If I don't believe that I'm 25 pounds overweight (which I am), and I don't believe that if I continue the same trajectory that I will soon develop all the associated problems of overweight (which I will) - then I will not do anything about it. Just this week, however, I have awoke from my "slumber of denial" and begun to walk every morning. My ability to engage in my own health-promoting behavior is directly tied to my ability to name my demons (my love for food and eating when I'm stressed) and exorcise them. I can not be successful alone, however - I need support and affirmation.

Now, the spiritual language may be anathema for some, but it has helped me to adopt a more positive life narrative. Belief that I've been placed on earth for some reason, that there is something larger than myself that I'm connected to, and the witness of countless people in my life who need me to be healthy, are all working together to support me as I move forward. Engagement of faith communities in a revised and revitalized health care system is for me foundational to address the deep seated societal issues that we have created. The CHN is doing some wonderful work on these matters, and is beginning to be recognized for it. Developing support systems for folks who are coming out of our hospitals sicker and more debilitated is key to having a system that is more efficient and effective. Fully engaged people are the key to a healthier world. Faith communities can and should engage in the provision of this integrated model of healthy living. It only makes sense - what we've been doing is not working.

Gandhi told us all that in order to change the world, we have to become the change we want to see. This is engagement, this is belief, this is necessary, this is do-able.

Peace,
Dan