Innovation. It’s at the heart of TED talks, the annual confab of creatives, thought leaders and entrepreneurs that focuses on technology, entertainment and design. And so it was at last week’s gathering in Washington, D.C., of TEDMED, the health and medicine offspring of TED.
APHA members had a front row seat, thanks to APHA’s collaboration with TEDMED and global simulcast of the program. In case you missed it, here are four public health innovations from the 2013 talks.
1. Make a lose-lose a win-win.
When Men’s Fitness magazine ranked his city among America’s fattest in 2007, Oklahoma City Mayor Mick Cornett took it personally. Having battled obesity himself, the mayor put his city on a diet. He urged residents to collectively lose 1 million pounds and created www.thiscityisgoingonadiet.com, a website to inspire his community, provide healthy resources and track weight lost.
More exercise and healthier eating habits would help, but he learned there was more to the story. With wide streets, ample parking, few sidewalks and spread out neighborhoods, Cornett came to realize that they had designed a perfectly good city, “if you are a car.”
Cornett led the charge to pass an innovative $800 million investment in parks, urban transit, wellness centers and infrastructure, including over 400 miles of new sidewalks and 100 miles of jogging and biking trails, that has begun to dramatically reshape the city and enhance the quality of life of its residents.
The results? More than 40,000 people accepted his challenge and lost over a million pounds. And in 2012, Men’s Fitness magazine recognized Oklahoma City as one of America’s fittest cities.
2. Question the dominant paradigm.
When asked about the importance of her work with Latino Health Access, a center for health promotion and disease prevention in Santa Ana, Calif., executive director America Bracho tells a story. She recounts how a woman struggling with obesity-related health conditions sought health care.
“Her doctor insisted she stop eating tortillas, but didn’t know that’s all she had to eat,” said Bracho, a physician trained in public health. “And told her to walk every afternoon, but didn’t know [the dangers of] her neighborhood.”
Doctors “tell us what to do.” This dominant paradigm, she points out, misses much of the story.
Rather, Latino Health Access works to empower the community and uses participatory approaches to community health education. Her agency trains community health workers — or promotoras — to teach neighbors and friends how to be healthy. She said they don’t need medical degrees, just the desire to be agents of change working from the ground up.
“I invite us to embrace the alternative story,” she said, referring to one of hope and inclusion. “This is the only story that can transform health care in this nation.”
3. Make being healthy fun.
“We gotta bring joy back to being healthy,” posited U.S. Surgeon General Regina Benjamin.
Lamenting the prevalence of obesity and chronic disease in this country, Benjamin suggested looking for new approaches to engage people in healthy behaviors.
“We need to stop telling people what they can’t do and start telling people what they can do,” said Benjamin.
“We’re kicking off a walking campaign,” she announced, referring to her recently launched initiative Every Body Walk! The Campaign to Get America Walking. The nationwide effort is working to spread the message that walking 30 minutes a day, five days a week can improve overall health and prevent disease. Walking is a very accessible activity, and in addition to the physical and mental health benefits, it can foster social engagement.
“We can have fun enjoying being healthy,” she said.
4. Look at old models in new ways.
After spending a decade fighting infectious disease in Africa, public health physician Gary Slutkin returned home to Chicago only to learn of another epidemic plaguing his hometown: children shooting other children.
Soon after, he began to ask questions about the gun violence and exploring the data.
“Mapping [the violence] reminded me of what we saw mapping cholera” thousands of miles away, he observed. In his eyes, homicide cases, in many ways, paralleled cases of tuberculosis.
His team discovered that “the greatest predictor of a case of violence is a preceding case of violence.” And in its spread, violence was behaving like a contagious virus or disease, similar to the transmission of influenza.
He began to deploy strategies he practiced in Africa: (1) interrupt the transmission; (2) prevent its future spread; and (3) shift the norms.
“Then you have group immunity,” he said, recounting his experience controlling AIDS in Uganda.
So just as he hired health workers in Somalia to prevent the spread of disease, his group in Chicago — Cure Violence — now hires violence interrupters to intervene in the community and outreach workers to address behavior change.
The interventions led to a 67 percent drop in shootings in his first neighborhood in Chicago, and a 45 percent decline in his second neighborhood. Similar successful results have been shown “time and time again.”
It’s been so successful that they made an award winning-movie about it: “The Interrupters.”
“If we view violence through an infectious disease model, we get more effective interventions,” he said.