Promoting Health Your Secret SuperPower

[Music]

how many of us believe we could take

better care of ourselves

i think probably most of us i know i

could exercise better eat a bit

healthier and especially sleep more

so why is taking better care of

ourselves so challenging

what if we had the ability to help each

other be healthier

these are really important questions

because collectively

we are getting sicker and sicker our

unhealthy habits are exploding into

epidemics of obesity

diabetes heart disease depression and

arthritis

that’s where i come in that last one

arthritis

as an orthopedic surgeon people come to

see me because they have knee pain from

arthritis

and pain is so not good pain makes us

suffer and it keeps us from doing things

that bring us joy

a lot of my patients are women because

women

suffer more from knee arthritis than men

do and some have disease that’s so

severe that surgery makes sense

but for many their knee pain would

improve with weight loss

and increasing their level of physical

activity and we

talk about them doing those things but

you know what often happens

they come back to see me and their knee

pain is worse

and although i know how difficult

healthy change can be

there are days when i find myself

feeling like

i am failing my patients i mean

what kind of doctor am i when i can’t

help my patients

improve

the reality is is that our health care

system the system that i’m a part of

typically fails to support patients on a

journey towards wellness

last year 1.1 million knee replacement

surgeries were performed in this country

i performed some of them that’s a lot of

knee replacement surgery and in 2040

that number is projected to be a

staggering 3.4

million i mean honestly i can’t even

fathom it

we are certainly not supporting patients

on a journey towards less arthritis

and i could share other frightening

numbers related to obesity

diabetes heart disease and other

conditions

so i decided to study this problem and i

asked myself what is it that makes us

healthy

i was surprised at what i learned you

might be too

it turns out only 11 percent of our

health and well-being is actually

related to medical care the kind of work

that i do

now that’s not very much but it is a

critical component if you need it like

if you’re having chest pain or you broke

a bone

environmental and social factors

contribute seven and 24 percent to our

health and well-being

if you live in an area where the air is

bad chances are more likely you’ll

suffer from asthma

if you live in a food desert a

neighborhood where there’s no grocery

store

it’s harder to eat healthy we are

starting to recognize more and more how

these

social determinants of health are

impacted

by systemic discrimination and

structural racism

important topics that i don’t have time

to discuss today but are worthy of their

own ted talk

genetics contributes 22 percent to our

health and well-being

that makes sense family history matters

it makes us more or less susceptible to

certain diseases

but the largest contributor to our

health and well-being

is our individual behavior at 36 percent

and i thought to myself now that’s

something each of us can influence

and influence now

so i turned to an organization committed

to health equity

and i asked is there something we can do

to support

individuals in making healthy behavior

change

we brainstormed on possible solutions

quite honestly

we didn’t know what would work or

exactly what to do but what we did know

is that the current system is failing to

improve health in so many of our

communities

we started by asking ourselves what do

we think

the key to health is we realized

it’s movement you see when you develop

joint pain which is so common we

decrease

our mobility because the joint hurts so

we don’t want to use it so that lowers

our level of physical activity promoting

weight gain and obesity which then puts

more pressure on the joint

causing more pain more functional

limitations more obesity

ultimately resulting in severe arthritis

but that’s not the only thing that

happens because

with the development of obesity and lack

of physical activity comes the

development of heart disease

diabetes and depression in other words a

person who has

serious medical illnesses

we see that the key to breaking this

vicious cycle

is movement movement helps keep our

joint healthy

it helps us control our weight and our

blood pressure and our blood sugar

and movement is so powerful in helping

our mental and spiritual health

movement is truly powerful

we also know that women are more likely

to suffer from knee arthritis than men

and women are also more likely to get

trapped in this vicious cycle

so we asked ourselves is there something

we can do

to support obese women with knee pain

adopt healthier behaviors

the answer is yes

we created an 18-week community-based

program for these women

we wondered if they would feel more

comfortable grouped together with other

women of similar backgrounds

so we kept that in mind when we created

the groups

each week 40 or so women would come

together

for three hours the first hour would be

educational in nature

with a topic like nutrition or diabetes

or arthritis

and the second hour would be movement

like line dancing or yoga

and the third hour would be in smaller

groups for motivational interviewing

to really help these women understand

what are their personal barriers to

adopting healthy behavior change

i’m excited to share that our program

works surprisingly well

but maybe not for the reasons you think

it wasn’t because our health information

was better these women could have gotten

the same information from their own

health care providers or even the

internet

it wasn’t because we provided access to

medical care

because we didn’t we did not increase

funding for local social programs or

solve

food security or safety issues in their

neighborhood

all those efforts are still needed it

was because

our program created the opportunity for

these

women to make the emotional connections

with other women

that would support them on a journey

towards better health

instead of treating these women as

individuals we treated them as a

community

we gave them the tools and created the

community

so they could support one another in our

five

programs to date over 200 women

with an average body weight of over 190

pounds

have made remarkable improvements in

their health

in just 18 weeks they’ve lost

3 percent of their body weight decreased

their knee pain by 35 percent

and increased their walking speed by an

amazing

18 percent reflecting greater movement

and less pain and perhaps what i think

is

most impactful their feelings of

hopelessness yes hopelessness

decreased by nearly 40 percent

all without drugs injections or medical

intervention

wow so i want to share with you

our three biggest takeaways from our

program

some were unexpected

first when we asked the women what did

you like best about the program

we expected we’d hear while my knee

hurts less or i’m feeling more hopeful

instead the women talked about and we

did hear those things but what the women

talked about

so much more was the relationships they

formed with each other

we repeatedly heard we lift each other

up

these women are now my sisters we even

heard

this program saved my life

the biggest need in our world to improve

health

isn’t more medical education or access

to care although those things matter the

biggest need

is emotional connection

illness can be transformed to wellness

when we move from i to we

emotional connection to others gives

people the support they need

to make healthy behavior change

our second takeaway these women became

health promoters they didn’t just cook

better meals for themselves

they also did so for their children and

their partners

and their children will grow up

healthier because

one woman was in a community of other

women and they supported each other on a

journey towards better health

if you can improve the health of women

in your community

you can improve the health of your

community for

generations to come our third takeaway

healthy habits are best adapted within

culture though the principles were the

same

we believe success of our program was

promoted by grouping

the women together by background this

allowed nutritional classes to focus on

foods they were familiar with music in

the movement classes

to be culturally aligned and perhaps

a greater sense of psychological safety

in the motivational interviewing

sessions

because these women saw other women who

looked like them

this program has been one of the most

rewarding activities of my professional

career

it changed me this journey has taught me

something about our responsibility and

privilege

as individuals to shape the health of

those

around us

i now think of health care differently

i see an opportunity for us to move

forward and improve

health in our communities in ways i

didn’t see before

please understand i am not saying that

we can ignore the systemic

discrimination or structural racism

that creates health disparities of

course these need addressed

but what i am saying is that we need to

leave sick care

in the doctor’s office where it belongs

and move

wellness promotion into the community

where it can work and it works in the

community because of the relationships

form between people it is just as

simple and as beautiful as that

communities come in many shapes and

sizes and we’re all members of various

communities although we may not always

appreciate that

communities can be a church a

neighborhood or just a group of people

somehow connected to each other

communities

allow the influence of our culture and

genders

powerful forces as we saw in supporting

behavior change in our program

my goal is for organizations listening

whether you’re related to government

business churches neighborhoods

is to see the people they serve not just

as individuals

but as communities of people who can

lift each other

up and combat the emotional isolation

so common to those with chronic

illnesses

this will improve health and for you

individuals listening

here’s the one big thing i’d like to

leave you with

the single most powerful force to shape

the health of our nation

isn’t doctors like me or education

it’s you while my credentials make me a

health care provider

the real power to shape the health of

those around us lies with you

as a health promoter

small things can make a difference and

add up as a health promoter you could

get everyone out for a stroll after

dinner do

face time with your best friend while

you’re taking a walk you could bring a

healthy dish to the potluck

or simply include more fruits and

vegetables in your family meals

what if you asked people at work to take

a 10 minute walk with you over lunchtime

movement is powerful

i invite each of us to embrace our power

as health promoters

in our own ways in our own communities

and for our own

culture and values we can make a

difference today

and when we embrace our power as health

promoters we will

elevate humanity with more emotionally

and socially connected people

who will be happier and healthier

thank you