Your health is about more than doctors and pills
Community groups can help prevent health problems before they start
By Monty Laskin
Three friends are walking along a river bank when they hear the distressed calls of children. They run in the direction of the shouting which takes them to the river’s edge. There they see children being swept downstream towards the waterfall.
They jump into the water. One of them shouts, “I’m going to rescue these children or they will fall over the waterfall. The other exclaims, “I will build a raft so that fewer children approach the waterfall in the first place.”
They realize that their third friend is nowhere to be seen. They look upstream and she’s swimming away from them. “Where are you going?” they ask. She replies: “I’m looking for the culprit who’s throwing these children into the river!”
This parable touches on many things. I want it to remind you of the state of Caledon’s healthcare services. The specialists are the rescuers of children at the edge of the waterfall. The primary care physicians are the raft builders; they manage chronic health conditions and make sure you stay afloat when serious health challenges emerge. So who is the third person, the one swimming upstream? This is the person who’s had enough of this routine and opted to pursue some root causes, the social determinants of health. This person knows this is key if we hope to improve people’s health. She’s an “upstreamer,” as coined by Rishi Machandra, a primary care doctor in East L.A. He knows all about social determinants of health, things like housing, nutrition and employment. And he’s convinced that health-care professionals need to pay attention to these things immediately.
Caledon Community Services agrees. That’s why we built the Exchange. Each month, we used to give out pre-boxed hampers of canned food and a gift card for fruits and vegetables. Now we distribute healthy food daily and engage our clients in personalized care plans. These plans deploy many of the community’s resources in pursuit of improved health. In a nutshell, the Exchange is an upstreamer too.
According to Machandra, upstreamers appreciate that health begins where we live, work and play. Upstreamers share something in common: They execute plans that mobilize community resources. They know that the community is critical in supporting a person’s health. And in maintaining it.
Open for not quite a year, the Exchange is becoming popular amongst many in Caledon. The 10 community organizations supporting it want to increase its traffic exponentially so that every day is as busy as it was on a recent Tuesday. The schedule was dizzying (see box).
This is a picture of excellence in community health. It has the upstreamers gaining a foothold on Caledon’s health by touching children, youth, seniors in the places that matter most – where they live, work and play.
The Exchange thinks about community resources differently. And it also asks our local physicians to consider community resources in their stewardship of local healthcare. “Isn’t it the truth that the social and environmental conditions in which a person lives have a far more profound impact on their health than a genetic code?”
Yes, says Dr. Machandra. Further, all the pills and procedures combined that are prescribed by our docs don’t have the impact that our living conditions have on our health.
Imagine this: A cutting-edge tech company has a product that claims to lower your risk of death from heart disease.
If that product is a drug or a device, you might choose to invest.
How about if it was a place like the Exchange? A place that teaches you all about nutritious eating, helps you identify community resources that support a good quality of life and has you coming to yoga class twice weekly. Would you be as likely to invest? Let me make it even easier: Your investment can amount to nothing more than your time. Give us your time and the Exchange will simply overwhelm you with an abundance of resources and activities for your entire family.
We need more upstreamers in Caledon’s health-care services. People and programs that ask what’s happening in your life, whether you eat a nutritious diet every day, if your home is safe, if you have a supportive network of family and friends. Maybe traditional healthcare doesn’t ask about this because they don’t have the resources to respond to it.
Thatâ€™s why the Exchange needs to become part of regular healthcare. Try it, you’ll see it’s perfect for your health.
The Exchange is a newcomer to Caledon’s health scene. It’s welcoming residents of our community to drop in and become an upstreamer in their own healthcare.
The Exchange encourages everyone to take charge in transforming the way they address their health and well-being. The Exchange mobilizes community resources to create solutions.
It pursues a larger collective impact because many Caledon organizations come together to achieve a greater good.
There’s not really a formal training program for upstreamers.
It takes faith from many to get them some traction. Recently the Exchange has been embraced by three progressive funding bodies. The United Way of Peel Region, the Region of Peel and the Central West LHIN have all come aboard and invested in its services.
Their leadership has put wind in the sails of CCS and nine other Caledon organizations. We’re all trying to be upstreamers in Caledon’s health and social services.
These three funding partners have invested their resources in the Exchange. They are supporting our efforts to create a community hub whose impacts are all about improved quality of life through broad community engagement.
We are immensely grateful for their support as it will sustain new approaches to meeting our growing community’s needs.
Dr. Machandra explains that health is a common good, not just a personal responsibility. The 10 Exchange partners agree.
We believe that those who are in good health have ideas about what we can do for those whose living conditions are harsh and consequently, whose health is not good.
If we get more of Caledon involved, we can all play a role in moving healthcare upstream. That benefits an entire community.
We’re rowing upstream in the Exchange and invite you and your families to join us on this journey.
Monty Laskin is Chief Executive Officer of Caledon Community Services. His columns usually appear the last Thursday of each month in the Caledon Enterprise