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