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Pay Attention to the Healthy People

Janice Simmons, for HealthLeaders Media, April 16, 2009

In today's economy, it's becoming apparent that what we consider "health" needs to be redefined, argues Dee Edington, PhD, director of the University of Michigan's Health Management Research Center in Ann Arbor.

In quality terms, the current healthcare model needs to move away from its structure of waiting for defects—and then trying to fix those defects. In other words, the system waits for patients to get sick and then treats them. But this has created a failed healthcare strategy that is posing a major threat to business survival, says Edington, author of a new book, Zero Trends: Health as a Serious Economic Strategy.

"Companies are going out of business because we don't pay attention to healthy people. Our whole country, as we all know, just waits for sickness," he told a Washington audience earlier this month. "Nobody cares about health except for the individuals themselves, and they don't even care because they think, 'It's not going to happen to me.'"

Edington doesn't consider his comments a shot across the bow aimed at healthcare providers. Instead, he sees it as an idea that providers—as employers themselves—can embrace and adopt for their own employee populations. One Michigan healthcare organization, Allegiance Health System, has already taken his suggestions on keeping its employees on the healthier side.

To change the conversation about health in today's environment, Edington proposes five areas of change:

  1. Move from health as the absence of disease to health as vitality and energy. Companies can no longer wait for their employees to become sick. Instead, they need to realize that keeping people healthy adds value on both sides: Costs related to disease are lower while productivity increases.
  2. Move from caring only for the sick to enabling people to stay healthy. A culture needs to be developed that individuals are "winners" when it comes to health. Some corporate and community cultures are starting to change, and governments have put their stamp on change by legislating smoke-free environments or mandating safety belt laws. But more is needed, Edington says. Employers can help by recognizing and rewarding employees for staying healthy. "Set the incentives for healthy choices. Reinforce every touch point, every e-mail. Every time CEOs have a chance to talk, let them talk about the healthy culture," he says.
  3. Move from the cost of healthcare to the total value of health. Governments and organizations generally have focused on how much it costs for someone who is sick. However, the total value of someone's health should be much more than that, he says.
  4. Move from individual participation to population engagement. Health promotion or wellness programs have gone down the wrong path, Edington says. "If you try to change a person or provide something where people can change, then where do they go?" he asks. "You can't put a changed person back into the same environment because what happens? They go right back." Instead, shifts need to be made that keep entire populations in mind. Whether it's a company or a government, strategies aimed at entire populations need to be kept in mind that encourage, for instance, compliance with activities such as exercising or smoking cessation.
  5. Move from behavior change to a culture of health. All too often, a "blame the victim" mentality has emerged for those who drink too much or do not exercise enough or do not eat healthy foods. The solution was to "sentence" them to behavior change programs, which often fell short of their goals, he says. Instead, more encompassing changes need to take place across the culture through vision and commitment that encourage healthier behaviors.


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Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.