As those here have abundant cause to know, I do have opinions to share. So I was delighted when LinkedIn invited me to join its inaugural group of 150 “Influencers,” and blog directly to their network of 175 million or so. When I saw the company I was in – Barack Obama, Richard Branson, Arianna Huffington – I was pretty sure they had made a mistake, but I wasn’t about to tell them! I would ask that you not tell them, either.
LinkedIn asked us all recently to share our ‘big idea’ for the upcoming year and beyond. 50 members of the group responded. My big idea was about the next big thing in health promotion, which, at present, is an all too often a missing link. More specifically, my big idea was: family.
Preventive Health Care Starts in the Home
The basic functional unit of our society is not the lone individual. We are social creatures, to our pith and marrow. The basic functional unit of our society is family. Family comes in many forms, of course, but any variation on the theme will do. However we define family, we know our own, and that’s what matters.
There was a time, in fact, when the irreducible unit of human culture was larger than the family. It was the clan or tribe or village. Family used to be what is now called the “extended” family, and traversed several generations.
But the “nuclear” family does persevere, and is the smallest unit of social cohesion at which culture is achievable. And it is culture that will determine the road we take to the future of our health. It is culture that will make all the difference.
Yet family has been routinely neglected in efforts to confront the salient human health threats of our time. This might be shocking, but it may be symptomatic of a larger trend in health care: oversight, born of expertise. So much attention is paid to the parts that we fail to see the proverbial elephant in the room.
Adults address the challenge of weight loss and control by going on diets that leave spouses and children behind. Employers implement wellness programming to lower disease-care costs but don’t extend the programming to the children of employees as a matter of routine. Schools strive to implement health promotion programming for kids despite want of resources, and when they do manage it, they often leave out parents.
So, my opinion is that the next big thing in health promotion will be a rediscovery, and reaffirmation, of the family. Because children and parents shape one another’s culture; because adults and kids will become healthier together, or probably not at all; because in unity, there is strength.
Before continuing as I intended to, I am obligated to note that news of the appalling calamity in Newtown, Connecticut, a town I have visited often and know well, broke while I was working on this column. As a parent, I confess I am selfishly trying not to imagine the agony of those most intimately affected. My thoughts and deepest sympathies nonetheless bind me to them, and that pain.
I can’t begin to know what malignant dysfunction led a son to kill his own mother and the innocents that followed. The family at the center of this story was clearly torn apart, with appalling collateral damage. Perhaps prioritizing the solidarity of families might spare some of us, some day, a repetition of such tragedy.
The reaffirmation of family must involve more than philosophy, of course. It should engender novel public health interventions. Businesses, for instance, long accustomed to adopting stretches of interstate highways, could start adopting schools, andsponsoring complementary wellness programming for the children of their employees. Health promotion programming delivered in schools could be designed to reach parents as well as children. Weight management programs for adults could be family-friendly by design.
Children could be engaged in the processes of health promotion, rather than having its products simply imposed on them. The right medium could be selected to reach every age group so that we are all part of the common solution, and none of us is left as a part of the problem, alone and adrift.
John Donne told us centuries ago that “no man is an island.” The future of health promotion will owe much to looking back at the words of Donne, and then moving forward.
David L. Katz, MD, MPH, FACPM, FACP is the founding director of Yale University’s Prevention Research Center. He is a board certified specialist in both Internal Medicine and Preventive Medicine/Public Health. He is the director and founder of the Integrative Medicine Center at Griffin Hospital in Derby, CT. For more information visit http://www.davidkatzmd.com
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