LCHM Winter18 - 13

L C M E D S O C .O R G

The first important concept is the Social
Determinants of Health. Over the past twenty
years a large body of evidence has accumulated
that reveals a powerful role for social factors -
apart from medical care - in shaping health
across a wide range of health indicators, settings,
and populations.  In fact, it is now generally
accepted that medical care only impacts about
20% of measures of morbidity and mortality in
our country. Other social determinants, such
as education, income level, housing stability,
employment, neighborhood environments
and individual behaviors are stronger predictors
of how long we will live, and how healthy or
unhealthy our lives will be. Countries that
spend more on social programs rather than
medical care have better health outcomes than
the US.  Spending more on medical care does
not necessarily produce better health outcomes
- building and promoting social capital may be
a more effective approach.

close social ties and a strong sense of purpose
can and does contribute to our health as surely
as access to top-notch medical care. 

Six years ago, my oldest son had a massive
stroke that, but for exceptional medical intervention in the most timely manner, would
have taken his life.  While I have reason to be
grateful to a number of highly trained doctors
for intervening expertly to help him, there is one
that stands out to me above all others - the ER
doctor who first called to give me the terrible
news.  This doctor called me not once but three
times during my 90-minute scramble to get
to the hospital where my 19-year-old son lay
semi-paralyzed and unable to speak - to keep
me updated, reassure me, and just be "present"
with me through my anguish. As soon as I
arrived, he hastened to my side to explain what
was happening. As paramedics loaded my son
onto the Medivac helicopter, he personally went
and got me a cup of coffee to take on my hourIn the book Blue Zones, Dan Buettner has long drive to the hospital my son was being
identified communities around the world where transferred to for his life-saving procedure. As
people live the longest and healthiest lives.  After I prepared to leave, this physician reassured
immersing himself in these communities he me that the surgeon waiting to operate on my
found the main reasons why residents thrive son was the best in the nation, and asked me
to be the result of healthy diets comprised to keep him informed about the outcome - he
mainly of plants, physically active lifestyles, didn't just provide quality medical care to my
social cohesion, the importance of family, son, he connected with us, fretted with us, and
and having a well-defined sense of purpose.  made us all feel like he was personally invested
Closer to home, in the local town of Roseto, in our family.  Yes, he delivered exceptional care
researchers identified a similar concept in the to my son - but what really touched me, what
1960s - Rosetans had much lower rates of heart has stayed with me to this day, was the way he
disease than residents in other local towns such showed how much he cared.
as Nazareth, Bangor, and Stroudsburg. After
looking at many possible explanations, they
This type of meaningful personal connection
concluded that it was the close social ties of this has often been lost - not just in our medical care
community that protected them from the heart system, but in our daily lives as well. Our fastdisease ravaging our country. At first it may seem paced lives, filled with all kinds of time-saving
far-fetched that social interaction can prevent technologies, have rendered us disconnected
heart attacks and other chronic diseases, but more than ever from the very social energy all of
there have been many studies since the "Roseto us need to feel fulfilled and achieve healthier lives. 
effect" was identified that corroborate this As such, behavioral health problems, violence,
finding. More recently the Adverse Childhood and chronic health conditions are becoming
Experiences study has shown that children worse as all of us look to cope with growing
exposed to abuse, violence, neglect and other isolation.  Technologically advanced medicine
psychological traumas early in life live shorter can't come close to solving socially complex
lives and suffer more frequently from a long problems, and in some cases may inadvertently
list of chronic and mental health conditions. contribute to making things worse.
Our social environments are strong predictors
of both our physical and mental health. We
And this brings me to the second concept
are most definitely social beings, and having I see as so important to creating healthier

communities - collective impact. With medical
care only contributing a small degree toward our
overall health, the answer to a healthier America
can not and will not be the medical care system
by itself.  To make our communities healthier
will require collective impact efforts. No one
sector can solve the complex social issues which
have caused us to rank so low compared to
other countries on measures of health.  Instead,
health care systems must partner with other
health, social, political, academic and public
safety institutions to understand the root causes
of poor health status and collaborate to create
meaningful systems change that will create
the conditions in which people can be healthy. 
So the answer to healthy communities rests
just as strongly with the education system, the
justice system, social agencies, the business sector,
housing policies, transportation agencies, etc.,
as with our medical care system. True impact
comes not from silo-ed work done in each
of these disciplines, but rather in bringing all
these systems together to work collectively. As
the Chairman of the St. Luke's Department of
Community Health and Preventive Medicine, I
have had the privilege to work with other local
agencies to take a broader look at the concept
of health and develop initiatives that can truly
advance the health of our communities. I
have seen over and over the power of a simple
human connection to build trust that makes
a difference in vulnerable lives.
Over the past twenty years I have observed
collective impact strategies gain traction in
very exciting ways here in the Lehigh Valley.
St. Luke's University Health Network, initially
through the Bethlehem Partnership for a Healthy
Community, and more recently through the
Affordable Care Act's Community Health
Needs Assessment process, has partnered with
hundreds of other organizations in our local area
to improve the quality of life for community
members. No one organization can do this
work alone. Complex social and health issues
require systems change thinking by many diverse
organizations. The United Way of the Greater
Lehigh Valley has been a strong and vocal leader
in the collective impact arena, and has made
Continued on page 14
WINTER 2018 | Lehigh County Health & Medicine 13
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Table of Contents for the Digital Edition of LCHM Winter18
