Community Health Forum: health, education and business interrelate

By Scott Robertson

Leaders from the business and economic development community sat down with leaders from the fields of healthcare and education to see if they could all, “talk the same language Friday in Johnson City. East Tennessee State University hosted a Community Health Forum at the Millennium Center. Randy Wykoff, dean of the College of Public Health, posited the key point for the event.

“If we want to improve health, we have to focus on access to affordable care and encourage good behavioral choices, but we also have to focus on creating jobs through economic development and we have to focus on education,” Wykoff said. “These three things are intertwined. We cannot be successful without them all.”

Wykoff explained that in addition to factors including genetics and behaviors, health is based in part on the conditions in which we live. For instance, Wykoff said, a poor American is three times more likely to die before the age of 65 than a rich American. “What that means to us in public health is, we have to have economic development and create jobs in the region. That’s really important in improving the health of the region.”

Just so, Wykoff added, “A high school dropout will live, on average, five to seven years less than someone who graduates from a four-year institution. If we want to improve health in this region, we have to get more kids through high school and university.

“Ask any employer and he will tell you the number one thing he needs is a healthy, educated, drug-free workforce. Ask any educator and they’ll tell you they need kids that are healthy and they need a robust tax base to support the school system. You ask any healthcare provider, they’ll tell you they need patients with the education to make good choices but they also have the income to invest in their own health.”

In the panel discussion that followed, business leaders pointed out that the affects of health and prosperity on each other go in both directions.

Mark Kinser, executive vice president for General Shale said, “As an employer in 14 states, I can tell you that last year our costs for healthcare for our employees in Colorado were half of Tennessee’s. So economics that you never hear is that all employers, whether retailers, manufacturers or service providers, all have a bucket from which to pay and provide healthcare. And if the healthcare costs are higher, the pay is going to be lower. So healthier communities have a higher wage scale.”

There’s also a hidden economic impact of good or poor health in a region, Kinser said. “Where this affects us is … in where we will decide to build the next brick manufacturing plant because when you do your models it’s all financial. When you look at the financial model, if there is a huge cost for healthcare, then that has a tremendous effect on the decision of where that facility will go.”

In other words, though no press releases come out saying an unhealthy region has just cost itself a couple hundred new jobs, that’s exactly what ends up happening.

“We all understand the health benefits of living safely and living well,” Kinser continued. “But there’s also an economic side, and people should be learning this in college, in high school, and as you move through the workforce. The healthier you live, the greater the economic impact.”

Kinser then added that employees need to have a level of accountability in the process as well. “All of us in this room who are parents spent a lot of time educating our children about car insurance. We teach that it pays to drive safely, to avoid tickets, to take drivers’ ed, to maintain a B average. Those things bring your car insurance down. We talk about those things with our kids. When do we ever talk about the responsibility they have to their family and their employer to be healthy and live a good lifestyle? That needs to become part of the growing up mentality just the same as car insurance.”

Mountain States Health Alliance CEO Alan Levine offered concluding remarks that dovetailed with Wykoff’s theme. “We recognize that first and foremost, we have got to help our employers reduce the cost of healthcare for their employees so they can go out and do the things we want them to do, namely create jobs,” Levine said.

“The more money we in healthcare extract from Eastman here, the less opportunity they have to compete with the rest of the world to grow jobs right here in this region.”

And while healthcare providers must understand that relationship with business, Levine said, they must also be aware of the role of education in healthcare.

“Nothing has a higher correlation with good health than making sure a kid can read at grade level by third grade,” he said. “The discussion about education standards is important. You have to break down the barriers between education and healthcare. The two go hand in hand.

“We’re actually working with the Washington County schools in elementary school and high school to help kids who are six months behind in reading proficiency,” Levine said by way of example. “Why? Because good health ties directly to literacy. We have to eliminate this problem of functional illiteracy. If we want kids to grow up and be healthy, again, it starts with being able to read at grade level by third grade. Before third grade, they learn to read. After that they read to learn. If they’re not at grade level they fall further and further behind. That’s why Mountain States Health Alliance doesn’t draw a line between education and healthcare. The two are very closely aligned and we are deeply committed to invest in both.”

The probems of healthcare in America and in the region will not be fixed quickly or easily, even with business, education and healthcare on the same page, though. Said Kinser, “When (potential) employees come to us with questions during an interview, they never ask what we can offer in terms of how to live a better lifestyle. It’s ‘What’s your deductible? What’s your copay?’ The day this room comes together is the day when employees want to know about a company’s wellness program. This is a culture change. Most people will tell you to change the culture of an organization or business takes five to ten years. This is societal.”

Wykoff agreed, adding, “We spend 50 percent more per person on healthcare than any other country in the world. Our healthcare infrastructure is the envy of the world. Yet in 2014, the U.S. ranks 33rd in the world for life expectancy. Worse, if you look at early death rates across all 50 states, you will find Tennessee at 43rd. So we live in the state that ranks 43rd in the nation that ranks 33rd in the world.”

Concluded Levine, “There are a lot of people working really hard, but the data speaks for itself. The pathology here – the rate of addiction, the rate of diabetes, the rate of chronic heart failure and heart disease, obesity – we have a ways to go. It starts with acknowledging you have a problem. The good news is we’re talking about it and we’re doing things about it.”