Where you live could be a major factor in your health

Where you live could be a major factor in your health

By JoAnne Viviano
The Columbus Dispatch

Education. Race. Wage. ZIP code.

All of these factors, and many more, have an impact on the health of people living in a community.

And local public-health leaders say that tackling the health-care issues of the future will involve addressing disparities among these "social determinants of health."

"Ultimately in public health, our work is very long-term. It also is about creating the conditions in which people can be healthy," said Dr. Teresa Long, Columbus Public Health commissioner. "So I think that work will be front and center 20 years from now — creating the conditions in which people can be healthy and safe."

This could involve anything from encouraging the use of bikes and public transportation to lowering crime and reducing poverty and homelessness.

Tell us what you think Columbus should look like in 20 years

This trend toward addressing "population health" involves looking at the interactions between people and their environments, determining why certain people have better outcomes than others and eliminating the differences, said Andy Wapner, director of the Center for Public Health at Ohio State University's College of Public Health. It acknowledges that these factors, not the health-care system, determine whether a person is healthy.

The public-health arena will be expanded to address neighborhood infrastructure, transportation, education, safety, poverty and other factors.

"Public health is really making a huge effort to say, 'If we want to improve health outcomes, we've got to get to the root cause,'" said Franklin County Health Commissioner Joe Mazzola.

Public-health departments will serve as "chief health strategists" in the community, pulling together organizations, Mazzola said.

That could involve local businesses and food retailers, social-service groups, mental-health providers, schools and more, Wapner said. "Everybody needs to come to the table and has something to bring."

Mazzola said a key is making sure that programming from various sources works together to achieve goals. Groups in Franklin County, he said, already have gained ground by working together, forming coalitions, for example, to fight tobacco use, infant mortality, the opioid epidemic and chronic disease.

Local leaders also had these predictions for the future:
• There will be less cancer, heart disease and infant mortality through the community's continued work to reduce the county's high smoking rate, Long said.
• Public health must continue to address unexpected issues, especially infectious diseases, with community partners, Long said. Mosquito-borne illnesses will increase as the upper Midwest becomes home to more types of the insects. Health care will be challenged by more antibiotic-resistant bacteria.
• New forms of data will be used to understand the community and allow leaders to re-evaluate and re-prioritize in real time, Mazzola said.
• There will be a workforce trained to address social determinants. The College of Public Health at Ohio State currently offers a master's degree with a relatively new specialization in population health management and leadership, Wapner said. And this summer, Columbus Public Health offered a Public Health Camp to introduce young people to the field.

Read about the problem of antibiotic overuse

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