Berks County Medical Society Medical Record Winter 2020 - 20

M e d i c a l R e c o R d F e at u R e

Assessing the
Community Health Needs
of Berks County

Redefining Factors That Contribute
to Health and Disease
by Michael Baxter, M.D., Former Chair, Dept. of Family and Community Medicine, Reading Hospital

Americans are dying younger.

A recent
JAMA article "Life Expectancy and Mortality Rates in the United
States, 1959-2017" (S. Woolf and H. Schoomaker; JAMA.
2019;322(20);1996-2016) should give every physician pause to
reflect on our traditional understanding of health and disease.
The bio-medical model of the cellular mechanism of disease and
the application of science and technology to advance health care
is clearly not enough. The authors' review of life-expectancy
and mortality data over the past 50 years indicates that "US life
expectancy has not kept pace with that of other wealthy countries
and is now decreasing." In spite of the tremendous advances in
medical knowledge and treatments and the fact that the US spends
more per capita on health care than any other country, US life
expectancy which increased from 69.9 to 78.9 years from 1959 to
2016 has decreased in the most recent period studied, 2014-2017.
During this time midlife mortality (ages 25 to 64) "increased
across all racial groups caused by drug overdoses, alcohol abuse,
suicides and a diverse list of organ system diseases." Our solid
belief that through scientific progress US life expectancy would
continue to increase indefinitely has been severely challenged.
The Berks County region has not been spared these sobering
statistics; therefore, it should come as no surprise that the most
recent "Community Health Needs Assessment (CHNA)" reports
by Penn State Health St. Joseph (PSHSJ) and Reading Hospital/
Tower Health (RH/TH) emphasize Social Determinants of Health
(SDOH) as key factors to be addressed in improving the health
of our community. SDOH are defined by the Office of Disease
Prevention and Health Promotion of the US Department of Health
and Human Services as "conditions in the environment in which
people are born, live, work, play, worship and age that affect a wide
range of health, function and quality of life outcomes and risks."
Such social determinants have been described as having a greater
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influence on the health of an individual than one's contact with
physicians and the health care system (Figure 1), a sobering fact for
those of us who spend countless hours with patients.
Figure 1

It is not surprising then that the latest (2018 for PSHSJ and
2019 for RH/TH) CHNA reports strongly emphasize such social
determinants of health in their efforts to impact the major health
challenges facing our community. Through a comprehensive
review of statistical data as well as information gathered from public
surveys, community forums and focused interviews, both of our
local health systems have developed CHNA reports which include
a wealth of community health data that has led to the creation of


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Berks County Medical Society Medical Record Winter 2020

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Winter 2020

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