Health Care

Community Health Care Solutions Need to Come from the Ground Up

March 27, 2017  • Ezekiel Emanuel

The political frenzy over health reform in Washington is a distraction. We need to focus on small-scale, local interventions that can drastically improve the health of our communities. While America leads the world in the development of advanced health care technologies and biomedical research, we still lag behind in metrics of community health. Upcoming political and public health leaders will play an increasingly vital role in shaping the habits and lifestyle choices that are needed to improve our nation’s health.

I was excited to join the Aspen Institute in Philadelphia for the Aspen Challenge, a day-long gathering of high school students from schools across Philadelphia, to come up with solutions to challenges faced in both Philadelphia and nationwide. The student teams will compete on March 29 for a chance to present their work at the Aspen Ideas Festival this summer.

It is essential to develop health literacy at a young age, because the habits teenagers cultivate can influence how they live their adult lives. Unfortunately, the picture of teen health in America is bleak. Nationally, only 15 percent of teenagers get enough fruits and vegetables in their diets. In Philadelphia, only 11 percent do. A quarter of teenagers in Philadelphia do not get regular exercise, and the city’s obesity rate is above the national average. America’s immunization rate lags behind the industrialized world. We have to do better.

As a policymaker and physician, I’m interested in low-cost, low-touch ways we can achieve better health for all Americans. In health care, a dollar spent on prevention has tremendous return on investment, and community health interventions and preventative care are some of the strongest tools we have. At the Aspen Challenge, I discussed how the Affordable Care Act improved access to preventative care — including vaccinations, checkups and disease screening — and called for a prevention strategy built on empowering people to manage their own health.

Many of the best public health solutions come from bottom-up thinking, so I challenged the students in the room to beat me at my own game — to come up with strategies to improve the health of individuals of all ages in their own communities. I’m happy to learn that at least two high schools will be taking up the challenge to improve the health of their communities by promoting better nutrition, exercise, and emotional well-being. The pointed questions and palpable interest in the room leave me optimistic for what they will propose.

Dr. Ezekiel Emanuel is chair at the Department of Medical Ethics and Health Policy at the University of Pennsylvania

Civic Action
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