West Virginia’s future with a culture of health - Beckley, Bluefield & Lewisburg News, Weather, Sports

West Virginia’s future with a culture of health

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Brooks McCabe Brooks McCabe
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Brooks McCabe is managing member and broker of West Virginia Commercial LLC. He has been involved in commercial and investment real estate for more than 30 years, and he also is general partner of McCabe Land Co. LP. He has served in the West Virginia Senate since 1998, and is a special project consultant to The State Journal.

West Virginia’s future is directly tied to economic development — job creation, education/workforce training and public health.

Much time and effort is spent on the first two requirements, but much less time is spent on the third. West Virginia’s health statistics are abysmal. Everyone knows the state has a problem with obesity, heart disease, diabetes and a host of other health related indices. We in West Virginia do not have a positive “culture of health.” We seem to accept our fate and chalk it up to demographics or poverty induced by few good jobs and low levels of educational attainment. Not enough time is actually spent on looking at public health as a way to drive our future prosperity. Public health historically has been West Virginia’s Achilles Heel.

Dr. George Benjamin, executive director of the American Public Health Association, defines a “culture of health” as “living as long as you can, as well as you can and having a short, but glorious ending. — It also means having a system in place that ensures we can achieve it.”

Health is much more than health care. In West Virginia health care is an insurance- (Medicare & Medicaid) driven system. The United States has a very good sick care system, but a very poor health care system. West Virginia is no exception and our situation is accentuated by a poor culture of health as well as a poorly funded and loosely organized system of public health. The West Virginia University School of Public Health, the W.Va. Bureau for Public Health and several of our county health departments are trying to change the way we, as a state, look at public health.

The Health in All Policies (HiAP) concept is a direct path to improving our culture of health. The Texas Health Institute has pioneered in this concept and it is being embraced and adapted to West Virginia by the WVU School of Public Health. The strategy is to link health to other policies and determinates that directly affect public health. These social determinates include, among others, individual lifestyles, the built environment, social institutions, governmental policies and both individual genetic and biological factors. One could look at this list and conclude everything affects public health, and if so, how in the world can we effectively manage such a massive task?

In a simplistic way, it all goes back to changing our culture of health and making everyone more health conscious. This requires a change in perspective of the general public and our social agencies along with business and industry. We all have a vested interest in changing our culture of health.

To some degree this sounds like “mom and apple pie.” In reality, the details can be more problematic. We need to change our lifestyles and our business practices. Public health affects us all and change is difficult. It is more than focusing just on the individual and family along with employment and educational opportunities. It is about clean air and clean water. It is about creating sustainable built environments and the economies they support.

Health Impact Assessments (HIA) are beginning to be performed on certain projects with federal funding or as the result of a disaster. Usually they are only required when something has gone wrong or there is a perceived significant problem on the horizon. Historically they have been required as a reaction to some negative impact. If business and industry want to be truly proactive, some form of voluntary health impact analysis should be built into their planning due diligence. Sometimes it seems better not to ask a question about uncomfortable potential health impacts because of possible cost considerations. If the culture of health is to be truly embraced by business and industry, these questions should be asked about externalities that can impact the health of our communities. Addressing these issues early on is far less expensive than dealing with the cost of mitigation or remediation at later date. Up-front health impact analyses need to become part and parcel of our business mentality. This, of course, is easier said than done.

Paul Nyden’s recent article in The Charleston Gazette, “W.Va.’s No. 1 in U.S. aid” has caused quite a stir. Many of the underlying causal effects of this uncomfortable situation relate to our culture of poor health. The statistics do not shine a good light on West Virginia. With 26 percent of our annual personal income originating from government programs verses the 17 percent national average, we have a problem. Medicare, Medicaid and Supplemental Nutrition Assistance Program (formerly the Food Stamp program) provide much of the disposable income. These programs are heavily regulated, which means the federal government is omnipresent in our poorer communities.

In reality, these communities have a much higher level of transfer payments due to the concentration of the poor and less healthy West Virginians. Several counties have 50 percent of the disposable income originating from transfer payments. Some of our neighborhoods have such a high level of negative social determinants that success is just not possible unless we embrace a “health in all policies” approach to community and economic development.

We must find ways to escape this cycle of poverty and poor health. Heretofore, we have been tackling negative outcomes, such as treating the sick or focusing on crime, and not tackling root causes. But a positive culture of health addresses the problems at the source. We must find opportunities to advance our understanding of how public health, our families and our communities can all work together with the support of the public sector along with business and industry. We must change the way we live and work and to do so in a manner that viable healthy communities become the norm.

West Virginia has great possibilities going forward. To meet its full potential, we must find ways to stop the hemorrhaging of dollars directed to chronic illnesses and unhealthy lifestyles. These dollars in health care, social programs and criminal justice programs are consuming the state’s budget. Clean air and clean water, coupled with the creation of an environmentally friendly energy economy, will lead West Virginia to new levels of prosperity. If we are going to be able to live as long as we can, as well as we can, and be lucky enough to have a short, but glorious ending, we need the systems, policies and lifestyles that allow it to happen. Much of that falls on the shoulders of public health and the development of a positive culture of health. It is hard to do, but certainly worth the effort. From a purely “dollars-and-cents” perspective, it may be the most cost effective thing we can do. In many ways, our health is our future.