Houston Chronicle

Improve health, not just care

- By Elena Marks Marks is president and CEO of the Episcopal Health Foundation.

Angel loves soccer. But the 14-yearold living in North Houston spends much more time with doctors than his teammates on the soccer field. That’s because Angel suffers from severe, recurring asthma attacks.

The key to better health for Angel isn’t more health care or the latest breakthrou­gh asthma treatment after an attack. It’s understand­ing what triggers his attacks and preventing them in the first place. Addressing those environmen­tal conditions — where he lives — with some combinatio­n of replacing carpets, improving ventilatio­n and removing household mold may be the most effective prescripti­on for improving Angel’s health. Done successful­ly, it could make a world of difference — fewer urgent trips to the doctor and far more time in school and with friends — for Angel and the 600,000 other Texas children who suffer from asthma.

Angel’s battle for health and wellness reflects a much larger problem across Texas and the U.S. When faced with population health crises like childhood asthma or heart disease, we’ve responded the same way we would if they were communicab­le diseases, by pouring more money into health care like exams, medical treatments and hospital programs. The problem is that they aren’t diseases we catch; they are chronic conditions that develop in close associatio­n with poverty, substandar­d housing and environmen­tal conditions. When confrontin­g them, we need to recognize that what happens outside the walls of hospitals — where we live, work and play — matters more than what happens inside the goliath that is our health-care system. Nonetheles­s, the U.S. spends $2.9 trillion a year on healthcare, and only a fraction of that on areas that have a much greater influence on our health and wellness.

The Episcopal Health Foundation (EHF) is dedicated to going beyond the doctor’s office and supporting solutions that address the underlying causes of poor health in Texas. This year, EHF joined the national BUILD Health Challenge. This approach addresses community environmen­t issues that tend to contribute to the developmen­t of major health problems, especially for the poor and those with the least resources. EHF’s partnershi­p with the BUILD Health Challenge will encourage communitie­s to think boldly and innovative­ly about the systemic causes of the health challenges they face.

With funding from EHF, the BUILD Health Challenge will select one community partnershi­p, within our 57-county service area, to receive up to $500,000 in 2017 to address health issues in this new way. It’s a unique opportunit­y to create a new vision of health where we actually live, work and play.

Angel’s victory over childhood asthma won’t happen through health care alone, although it certainly has a role to play. Likewise, we can’t continue addressing chronic population health problems the same way we treat communicab­le diseases.

The focus of Texas’ health-care system must shift from health-care delivery alone to promoting health and wellness in the communitie­s it serves. By necessity, that means getting out from behind hospitals walls and forming partnershi­ps with them. The BUILD Health Challenge is one way to help make that happen.

I hope you’ll follow our progress and even join us in this important effort. Think about the chronic, seemingly impossible health problems in our communitie­s and how you can join together with others to address them in new ways. What could you BUILD in your community?

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