As business leaders, we often rely on metrics like growth and the unemployment rate to gauge our state’s vitality. However, focusing solely on economic indicators is not enough to answer the question, “How are we doing?” We need to consider other metrics that reflect the health of our communities.
Today, Nevada ranks 46th among the states for healthcare access, quality, outcomes and costs, according to the Commonwealth Fund. United Health Foundation ranks our state 39th, noting challenges such as the state’s high violent crime rate and low high school graduation rate—still among the worst in the country. Poverty is also on the rise, now affecting one in four children in Nevada, according to the foundation.
These facts undercut many of the significant gains our state has made since the worst days of the recession. As a healthcare leader and member of the state’s business community, I find Nevada’s low health rankings deeply disturbing. One reason is that I know healthcare providers are part of the problem. For too long, we have been focused on delivering healthcare rather than promoting health.
In reality, medical care alone contributes little to the overall health of a community (see figure). What matters more are factors referred to as the social determinants of health: poverty, education, housing, transportation and so forth. Economic stability affects many of these drivers. That is why we need support from business leaders across the state to help us tackle some of these main drivers of poor health in our communities.
Perhaps the question we should consider is, “What does it mean to live in a healthy community?” This year, the Institute of Medicine (IOM) released a report of its 15 core measures for health in Vital Signs: Core Metrics for Health and Health Care Progress. The IOM’s core measure set includes metrics we might expect, such as life expectancy, unintended pregnancy and addictive behavior. However, it also includes measures such as care access, community engagement, and personal and population spending burden. These core measures reflect the call to improve care quality, reduce the cost of care and engage individuals and other stakeholders in creating a healthier population.
Fortunately, this new way of looking at health in our communities is gaining traction because of the emergence of new payment models that make healthcare providers more accountable for the outcomes of their care. An emphasis on health, not healthcare, is driving the growing population health management movement, spurred in part by employers tired of seeing insurance premiums rise year after year without measurable improvements in quality.
Of course, no single group can transform our communities alone. Promoting health requires collaborations among business leaders, healthcare organizations, health plans, social service agencies, community groups and government entities. Together, we need to take an honest look at the challenges we face homelessness, addiction, health illiteracy, food insecurity, to name a few—and identify solutions that promote sustainable improvements.
For instance, some communities in Oregon, California, Texas, Florida and other states are testing collaborative approaches through the Blue Zones Project. Some employers in these communities are adopting measures to make their workplaces healthier and help employees feel more connected to each other.
Through 2017, our state will likely add close to 50,000 new jobs per year, according to the Nevada Department of Employment, Training and Rehabilitation (DETR). As the economy grows stronger, it is critical that we take this opportunity to make our state healthier as well. Clearly, Nevada is a great place to work. Now, it is time for us to make our state a great place for everyone to thrive.
Anthony D. Slonim, MD, DrPH is President and CEO of Renown Health.
Pie Graph demonstrating the social determinants that contribute to health status
