Moving From Skepticism To Expectation

As part of the celebration of this year’s National Public Health Week, I was invited to participate in a day of events sponsored by the College of Health and Human Services at the University of North Carolina, Charlotte (UNCC). We began the day with Charlotte Talks – a local radio talk show – discussing the role of prevention and access to health care in reducing health disparities. I was joined by Dr. Crystal Piper (UNCC) and Mr. Brad Wilson, CEO of Blue Cross and Blue Shield of North Carolina for the interview with Mike Collins, host of Charlotte Talks. For an hour, we engaged in a rich dialogue and debate about issues ranging from personal responsibility for health, poverty and other determinants of health, to the benefits, challenges, and costs associated with insuring access to health care for all. We were kindred spirits and like minds sharing the microphone –understanding what can be accomplished when public health and medicine join forces to reduce health disparities.  However, the questions and rebuttals from Mr. Collins and his listening audience reminded me again that we must continue to host these conversations in communities, come with examples that people can relate to now, and not shy away from the hard questions that begin with Why? and How?

Some examples of what we heard during the radio talk show include several thought provoking challenges.

“Racial and ethnic health disparities are not new, so why do we think we can change these trends now? How do we personalize the prevention message such that people (of color) see themselves actually doing and benefiting from primary prevention?”

There is a growing awareness that low-income communities and communities of color tend to lack easy access to health-enhancing resources such as healthy foods, high performing schools, employment, and healthy housing, but how do we change this social landscape? These are important ‘close to home’ questions that should guide the planning and content of our outreach and public education efforts.

How do we incentivize prevention within the health care system? Blue Cross and Blue Shield of North Carolina, for example, is working with communities across the state to develop innovative strategies that support clinical and community preventive services –one of four cross-cutting themes of the National Prevention Strategy. Blue Cross and Blue Shield of N.C. is also promoting community gardens and greater use of community health workers in its outreach efforts.

Considerable knowledge and experience have been gained over the past 2 decades demonstrating that health disparities can be eliminated through well designed, adequately implemented, community-focused and community-engaged strategies. The CDC website is one source for national data, and evidence-based programs that can be disseminated and replicated in demographically similar communities. There are others including, but not limited to, HHS, OMH Resource Center, Place Matters, the Diversity Data Project, and the National Diabetes Education Program.

Even as we push out our prevention messages through a variety of channels, and promote the implementation of policy and environmental changes that make the healthy choice the easy choice, there will be those who remain skeptical that people will adopt the healthy lifestyles we espouse. Let’s not be swayed or disheartened by the magnitude of the goal –moving the nation from a focus on sickness and disease to one based on prevention and wellness. We in public health can and will move from skepticism to expectation –the expectation being the attainment of the highest level of health for all.