Addressing Community Well-Being: Adventist Health's Transformational Strategy

Ben Leedle, president of Adventist Health's Well-Being Division, shares how the health system strives to improve health and well-being in the community.

Clinical care only makes up 20% of a person's health while the other 80% is attributable to “health behaviors, the physical environment, and socioeconomic conditions," Benjamin Isgur, leader of PwC's Health Research Institute, told HealthLeaders last year.

What happens when a health system makes steps to improve health for "the other 80%?"

In April 2020, Adventist Health acquired Blue Zones®, an organization dedicated to improving the health and well-being of communities across the globe and transforming the health system's approach to caring for the overall health and well-being of the communities it serves.

In October, the West Coast-based health system announced the launch of the organization's new Well-Being Division as a "breakthrough move to promote community well-being." Blue Zones® CEO Ben Leedle was appointed division president.

Blue Zones® was founded in 2008 by Dan Buettner, who partnered with a “multidisciplinary team of scientists, sponsored by National Geographic and the National Institutes of Health” to research "blue zones" or "longevity hotspots" across the globe and identify the lifestyle habits these different zones all had in common, Leedle said in an interview with HealthLeaders.

Leedle added that following Buettner's studies and publication of a National Geographic cover story, he and Buettner met in 2009. A year later, they created the Blue Zone Project, to "set out to try to Blue Zone America” and help create a healthier country.

According to Leedle, the goal was to "help people live that longer, better life, and reverse engineer those principles that [Buettner] discovered into American communities."

Leedle spoke with HealthLeaders about his role as Well-Being Division president and the strategies he looks forward to implementing in addressing the health and well-being of communities across Adventist Health's reach.

Ben Leedle, Blue Zones® CEO, Adventist Health Well-Being Division president (photo courtesy of Adventist Health)

This text has been edited for clarity and brevity.

HL: Why is it important for health systems to focus on community well-being?

Leedle: If you look at the classic world of medicine and the delivery of care, which is so critical as a resource to people in a community, health systems have not aimed or been fully accountable to addressing what I think of as the "real beast," which is our environment.

We are where we live and spend our time; there's a real connection. If health systems are held accountable for highest quality of care, they must pay attention to where their patient population is coming from. It affects the outcomes.

HL: What was the strategy behind Adventist Health acquiring Blue Zones® and creating the Well-Being Division?

Leedle: If you had asked me 15 years ago if this type of work would be nested inside of a healthcare provider organization, I might have been skeptical about it. But Adventist Health is unique on a couple levels.

Its heritage and its affiliation with the Seventh-day Adventist Church takes this idea of well-being all the way back to its roots of establishing sanitariums in the 1840s. Out of those sanitariums became hospitals, and hospitals became providers. The leadership at Adventist Health [created] its mission: 'Our job is living God's love by inspiring health, wholeness, and hope.'

We have an obligation to do that outside the services that make up our core care company. We need to begin to create capabilities that help address the needs of all people in the communities in which we serve. Adventist Health identified that they needed a new source to be able to do that work and Blue Zones® was a perfect fit.

As a non-profit, there's a requirement in the Affordable Care Act for [Adventist Health] to put part of its economic stream into these communities. We want to do it in a way that stays accountable to the core healthcare that we're delivering.

We're at the beginning of building out what's called the Well-Being Division. It's an early effort, but it's exciting because in addition to Blue Zones®, we will add other assets and capabilities that allow us to help on three levels of well-being:

1. [Helping] consumers engage and drive more well-being in their life. That can be self-directed with all the resources support they need in these communities.
2. Helping organizations, which is about place-based change. If you think about the influences on our health and well-being, the two big levers are who we spend our time with and where we spend our time. A good portion of this is intended to be working with those places to create change.
3. [Helping Communities.] We know that there's a big influence in terms of where you shop for food, where you eat, where you might practice faith, and where you might recreate and spend your time outside your home.
    

The Well-Being Division has the calling to see a time when everyone, everywhere, has access to higher well-being and well-being support. Our value is to try better performance for individuals, organizations, communities, and add more good years into the equation for all three of those.

HL: How has the pandemic affected the creation of the Well-Being Division?

Leedle: The methods by which we typically would engage organizations and communities [are] grassroots; a lot of convening in groups bigger than 10. We must credibly leverage our experts, which historically was done by people descending upon a community and spending time with local expertise and building plans. Their assessment processes required hands and eyes on the community.

This is such a fundamental analog-type model, and what we discovered by necessity is that innovation gets diffused quite rapidly when it's a requirement. [Also,] we re-engineered all our workflows to be done virtually. I don't think that we ever can 100% replace the idea that this type of work has its physical presence, but it's clear that we've been able to enable and advance this work during this time.

We found key decisions are happening locally around this pandemic [through] mayors, town councils, county councils, local business leaders, and healthcare organizations. What we're finding is an influx of demand for our help, because people look at the Blue Zone model and they see that this is a pathway for them.

We've come up with four parts as to why we're seeing increased demand on this idea:

1. All those leaders need [to respond] and the response needs to be fulsome and long-term.
2. Every one of these communities is aching for economic recovery, to return to the vitality that they might have previously enjoyed.
3. This pandemic has shown us that the poor health collectively of our nation has been an amplifier of the virus. COVID-19 lives well in America because it has attacked the more vulnerable.
4. [We need to return] to a new degree of readiness; to not be caught off guard like we've been. Response, recovery, resiliency, and readiness are part of the Blue Zone Project. At a time where many might have projected that our pipeline for development would be shrinking, it's growing.
    

HL: How will you lead the Well-Being Division to fulfill Adventist Health's focus on community health and well-being?

Leedle: I'm in my fourth decade of trying to create solutions that help create healthier people, who perform better and cost less.

My first decade was spent being part of the delivery of diabetes care as a certified diabetes educator. The second decade was spent trying to translate what we know in diabetes care to create new models for broader impact. That work later would be referred to as disease management. The third decade was spent looking at how to model population health and to deliver on this idea of well-being.

In this fourth decade there is an opportunity to take all those learnings, [and] design and create the next generation of expression of this work for population health.

The way we create value from the work that we do with this division will be an accountable care model. It's wonderful because the opportunity we have will be to use the footprint of Adventist Health, with communities up and down the West Coast and even a location out in Hawaii, [and] be the frontline implementers of these new capabilities.

I'm not aware of this type of incubator at this size and the dimension of Adventist Health's footprint. [The hope is to] then rapidly share in a way that the rest of the world can learn what we're learning, invite them into that equation, and export capabilities out to them.

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