When it comes to the “determinants of health” genetics play three times the role of health care. Although this may seem the least controllable factor, we have seen an increase in the number of health insurance providers that pay a percentage for certain genetic tests which can help doctors better determine your risk factor for a certain disease. Most recently, you may have seen publicity for “BRCA” genetic testing to help determine if you have a higher risk of developing breast cancer. Screenings for certain conditions may also be covered earlier based on “family history.” So, although we can’t control where we came from, we are seeing—through regulations and policy changes—the large role genetics play in our wellbeing is being recognized.
A lot of attention is also focused on people's behaviors—which, as you might guess, is a majority factor in our individual health. There are often strong and sometimes negative messages attacking people’s decisions to smoke, drink, eat poorly and live inactive lifestyles. Every day we see marketing and propaganda offering education about how to live a healthier life, but such a change is not always a simple, surface fix. A person’s behavior is often influenced by circumstances and events, friends and family, education, job opportunities, income, housing and environment. These factors are known as “social determinants of health” and recently there has been a lot of focus on this factor of health and how it greatly influences behavior—the largest determinant of health.
For example, marketing outdoor exercise to an overweight, single mother of three who lives near a busy highway with no sidewalks is probably not an effective message for the target or her environment. Perhaps, obesity can be addressed better by changing systems than offering broad suggestions. Fostering an environment that supports physical activity and connectivity within communities makes exercise more convenient. Thus, it is more likely for people to choose healthier lifestyles. If that same mother of three was in safe walking distance to a park, playground or walking trail she may be more likely partake in physical activity. Creating family-based based recreational opportunities and improving access to healthy foods in low-income communities are just a few ways some communities have changed behaviors by changing environments.
St. James Parish Hospital is and always will be committed to offering the healthcare piece of the pie with the highest quality and most convenience, but we do recognize the large role other determinants of health have on our community. We are also committed to leading change and supporting initiatives outside of healthcare that make our community a healthier place to live.