Minnesota Department of Health Commissioner Dr. Ed Ehlinger, dressed in nickers and a bow tie, quietly made his way through the Mayo Clinic Health System in St. James last Thursday before heading to Memorial Park for some one-on-one time with the community.
He offered the opportunity for members of the community and government to pitch horseshoes with him while they pitched him ideas on how to improve overall health in rural Minnesota.
Dr. Ehlinger believes the best way to improve community health – working toward a day when everyone in the community is healthy – is by local, state and federal governments working together to improve community-level programing.
"I'm out here as commissioner, saying what do we need to do to strengthen our relationship," said Dr. Ehlinger. "I'm not going to be successful unless you're being successful – we're in this together."
Dr. Ehlinger said that although Minnesota has been the healthiest state in the nation for some time, that ranking is slipping during the last five or six years. This is due to population diversity, a lack of funding for education, public health cuts and a lack of local community involvement.
He said there is a fundamental problem with healthcare today. When people think of health they think of doctors , clinics and hospitals – who play a big roll in getting people healthy – however, doctors, clinics and hospitals only account for 10 percent of our overall health. Even with that being true, doctors, clinics and hospitals receive 95 percent of all healthcare dollars (about $8,000 per person). The activities that really impact overall health are environment (5 percent), social circumstances (15 percent), genetics (30 percent) and behavior (40 percent).
"Behavior is influenced not so much by the individual choice, but the communities in which they live," said Dr. Ehlinger.
Residents who live in a community that makes eating healthy a priority are going to eat better. If the community offers transportation, education or low income housing, it will be able to invest less in healthcare – because an educated and residentially stable community is a healthy community.
The State Health Improvement Plan (SHIP) will focus on three major factors. One will be maintaining the health protection activities that have made Minnesota one of the healthiest states in the nation.
"If you look back over the past 100 years, we've gained 30 years to the average life," said Dr. Ehlinger. "In the last 50 years, those haven't gone away – we need to maintain those things that got us to where we are."
There is also a lot to be done on the health improvement front. As a nation, we have gone from having acute diseases being the number one leading cause of death in patients, to chronic diseases being the leading cause of death. Dr. Ehlinger said there is an 'immunization' for chronic illness which is taking simple steps to live a healthy lifestyle. It's as easy as riding a bike to work, walking to the grocery store or not eating unhealthy foods at work. Making healthy decisions is simpler in a community that make health a priority and healthy lifestyles easily supported in the context of a community.
Page 2 of 2 - Dr. Ehlinger said the final step to a more healthy community is creating public health assessments and sharing them at the local, state and federal level to archive what the community wants and needs in order to maintain a healthy lifestyle.
"We need to look at our healthcare system, because that is where 95 percent of our healthcare dollars go," said Dr. Ehlinger. "Most of those dollars go into the treatment side, not the prevention side – most of that goes into specialty care, not primary care."
In fact, only $250 of the $8,000 invested in each person medically in this county annually goes into primary care, yet according to Dr. Ehlinger, primary care access can improve and reduce healthcare costs by one third.
The State Innovation Model (SIM) is a step taken by the state to oversee the total cost of health, not just the cost of care. SIMs focuses on preventative care and developing a community leadership team that can work with public health, education, communication and transportation.
These are the major factors in reducing healthcare costs.
He ended his speech saying the healthcare is a balancing act, and that's why he likes playing horseshoes before he gives his pitch to the community. Healthcare is like horseshoes, in that you can pitch too far to the left or too far to the right; you can't pitch too long or too short, or you don't get anywhere. In order to get a ringer, you need to maintain balance and throw the shoe right down the middle. In healthcare one side is treatment, the other is balance; one side is public health policies the other is private health policies. Getting all of these initiatives to work together will help maintain community health.