Reflection by Edgar Cahn
Health is more than medical care. According to experts, what we buy from the medical care system determines only about 10-12% of how good our actual health is. One expert, David Nash, MD, MBA, dean of the Jefferson College of Population Health, says: “The most important five-digit number I need to predict your health status and wellbeing is your ZIP code, bar none. It’s not your cholesterol level or your blood pressure number or your age. The No. 1 health predictor is your ZIP code.”
Social isolation is more dangerous to health than heavy smoking. Neuroscientists have identified regions of the brain that respond to loneliness resulting in cognitive decline, frequency of illness and reduced longevity. As a nation, we spend more on professional, licensed medical care than any other nation. Yet, in a study of eleven nations (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, United Kingdom, United States), we rank last in actual health outcomes. We also rank last in access and in equity. So there is more to health than doctor visits and prescriptions.
Health care plans could – and should – provide and promote activities that promote health. The Archdiocese of New York seeks to create what they call a Continuing Care Community that includes a TimeBank that works with neighborhood organizations and participates in member-led group activities. They list as key services escort to the doctor, assistance with food shopping, prescription pick-ups, tutoring, English lessons, minor home repairs, post hospital stay support, assistance for caregivers. Participants reported improvement in physical health, mental health and enhanced ability to remain in their community as they age. Most exchanges bridged different generations, income levels, and ethnic backgrounds.
For me, one of the most intriguing stories came from a health center in Great Britain where doctors actually specified participation in the local Timebank in the regimen they prescribed for hypertension, depression, and other conditions. Now that’s what I call being a doctor.