Business, government can map out path to healthier communities

Posted: September 24, 2012

By Michael A. Nutter

and Deirdre Connelly

Though we may look at Philadelphia from different perspectives - a lifelong resident and a relative newcomer - both of us have a passion for the city we call home. And we are troubled by the overall health of Philadelphians.

How can it be that the City of Brotherly Love, with its history of medical innovation and impressive collection of world-class medical institutions, including the nation's oldest hospital, has one of the highest death rates in the nation, and the worst health outcomes of any county in the commonwealth?

Health officials, civic and business leaders, and policy makers grapple daily with this contradiction. But, for Philadelphia and other American communities striving to improve the health of their citizens, success has been elusive.

To accelerate a conversation about the problems and solutions, GlaxoSmithKline is joining with the Atlantic magazine to convene "A Conversation on Community Health" on Monday, the first in a series of events in U.S. cities this fall that will bring together the region's top minds to examine the barriers and the opportunities to achieve improved health outcomes.

Philadelphia faces significant challenges to the health of its residents: More than a quarter of Philadelphians are living in poverty. Two-thirds of the adults and 40 percent of children are overweight or obese, and 25 percent of adults smoke. Not surprisingly, the number of residents with chronic health conditions, such as cancer, heart disease, and diabetes, increased over the past decade and remains significantly higher than the national average.

With the support of federal funding, Philadelphia has made a substantial commitment to improving citizens' health and physical fitness through Get Healthy Philly, a public-health initiative focused on healthy eating, active living, and tobacco control. Thanks to this and other efforts, there has been measurable progress in creating environments that make it easier for Philadelphians to engage in healthy behaviors in their neighborhoods, schools, and workplaces. New data show that we are reducing the city's obesity rate.

However, we still have a significant need to provide quality care to those with chronic illness. Many people lack health insurance, access health care sporadically or ineffectively, or do not fill prescriptions for necessary medications. According to a recent report from the Robert Wood Johnson Foundation and Trust for America's Health, if we continue on this trajectory, health care costs in the state are on track to increase more than 9 percent.

The United States spends more per capita on health care than any other nation. Still, there are large disparities in health outcomes in relation to race, community, and socioeconomics. Paradoxically, some of the highest life expectancies in the country are found in non-wealthy, rural parts of Minnesota, Wisconsin, and Iowa. And Los Angeles County has among the highest life expectancies in the country, despite a poverty rate above the national average.

Why are these communities healthier than Philadelphia, with its apparent health-care advantages?

Now is a good time to explore this question and challenge conventional thinking about the range of issues that affect the health of a community. We have an opportunity not only to expand access to health care, but to expand innovative approaches, uncover new ideas, and rethink incentives for improving the health of the community as whole. We can rebalance our efforts between health-care spending and public-health investments. We can make our health-care dollars more efficient and our public-health interventions more universal and frequent. We can move our dollars from treatment to prevention of illness.

Certainly, there are many examples of innovative local organizations that are making a difference in the Philadelphia region, demonstrating that better results can be achieved through community-based approaches and creative collaborations and partnerships.

We are fortunate in Philadelphia to be home to some of the world's leading hospitals and health-care providers, a great Department of Public Health, academic programs across many health fields, and a vibrant life-sciences industry. Unfortunately, we face serious public health challenges that could cripple our future. It's time to begin a national conversation. With business and government working together, we can find innovative solutions to our must troubling public health-care problems.

Michael A. Nutter is mayor of Philadelphia. Deirdre Connelly is president of North America pharmaceuticals at GlaxoSmithKline.

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