There is a prevailing belief in this country, founded in its very birth as a nation, that our individual health and well-being are our personal responsibility, a direct result of the sum of our behaviors and actions.
Certainly this is true. However, to a larger or smaller extent for each of us, the opportunities for more healthful behaviors and actions, those more likely to lead to good health and well-being, are frequently unavailable.
As it does every year at this time, the Robert Wood Johnson Foundation released its annual ranking of the health of the nation’s counties. We again rank among the lowest in our state. So what does that say about Fresno County’s opportunities, behaviors, actions?
Dependent upon the differing circumstances into which we are born, we will, each of us, wind up with different ideas regarding what health and well-being means to us, different thoughts on its value and different knowledge as to how we should best achieve it.
These different circumstances include the financial, educational, environmental and social stability of the home and neighborhood in which we grow. These, in turn, determine such things as the:
▪ Opportunities we each have for regular, quality preventive medical and mental health care
▪ Quality of our child care and preschool experience
▪ Stability and quality of our formal education , and whether or not need for special assistance and guidance is discovered and rendered as early as possible
▪ Quality, persistence, and consistency of education in matters of health and well-being throughout our school years
▪ Readiness of access to quality healthful foods and areas for safe, aesthetic physical activity
▪ Safety and wellness of our working environments
▪ Quality of our air and water
▪ Psychological and spiritual support we receive from our neighbors
We know these as “social determinants” of health. I have painted a clear picture of their effect on health and well-being when they are inequitably applied in an article on my To Your Health Fresno County webpage.
For three years as Fresno County Health Officer, I have worked with staff at the Fresno County Department of Public Health to develop a way of visualizing our, and our partners, respective roles in public health, which is our collective health and well-being. This visual symbol encompasses the role of our personal responsibility, along with the equal role society plays in ensuring our individual successes.
This concept we call the Eight Pillars of Public Health. Visualize a healthy, vibrant Fresno County as a massive, but carefully crafted structure. It is easy to see that its construction and on-going existence is strictly dependent upon each of its pillars bearing equally the weight of the structure.
I list these Eight Pillars of Public Health and what is required from each:
▪ Individuals must learn about, and adopt, regular physical activity, healthy eating habits and regular preventive care visits to medical providers and stress-reduction activities. We must avoid tobacco and drugs and use alcohol in moderation.
▪ Families must ensure a safe, loving, and supportive environment that fosters personal growth and individual self-sufficiency.
▪ Employers must adopt and emphasize safety and a culture of wellness in the workplace.
▪ Retailers must assure our community has ready and affordable access to healthful products and services, and limit marketing of unhealthy products and services.
▪ Health care providers must offer their patients every preventive intervention available, and make access to care as convenient as possible.
▪ Educators must assure that each student understands the full meaning and value of health.
▪ Community and spiritual leaders and media partners must empower the community to assess health needs and implement effective actions to address those needs.
▪ Public officials must assure that every decision and policy they make reflects a careful consideration of its public-health impact.
During this, National Public Health Week, there is an opportunity for us all to give serious thought to raising up our poor ranking among California’s counties.
With strong, aligned Pillars of Public Health, we can change this.
Dr. Ken Bird, M.D., M.P.H., is the Fresno County Health Officer, Fresno County Department of Public Health.