Moving Upstream: Health starts outside of the doctor’s office

By Edlín Maldonado-Fuller, collaborative grants specialist

The United States leads the world in medical research and medical care. This would make you believe we are the healthiest people on Earth. Surprisingly, however, the U.S. isn’t even in the top 25 countries on some of the most important health indicators, like how long we live. We’re behind Bosnia and Jordan! We have the most expensive health care system in the world, yet rate 33rd in quality of care (read more). The majority of our health care costs go to direct care to manage the “downstream” consequences. Not much is invested in the “upstream” factors like housing, education and employment. Yet, years of research tell us good health depends on many things beyond health care.

Our ZIP code is a strong predictor of how long we live and of our quality of life. Health care (clinical care) is not the only aspect that determines our health and is not the sole answer to better health. Nonmedical factors play a substantially larger role (read more). Even if every individual in Methodist Healthcare Ministries’ 74-county service area in South Texas could afford to see a doctor when they were sick, it would not necessarily result in healthier communities. If we look closer, we learn that various factors within our communities truly influence both our health and our ability to make healthier choices.

Health starts outside of the doctor’s office – in our homes, workplaces, schools and places of worship. We need to enable people to choose the best path to health and ensure that everyone has the tools and resources to make healthy decisions. As a health care system, I believe we should seek upstream solutions to drive vast improvements in health. We should consider promoting health as a community, and unite health and other sectors and disciplines. We need to focus on the nonmedical determinants of health present in our communities, such as social, environmental and behavioral factors.

As an organization, we acknowledge achieving healthy communities takes different, localized approaches. The needs and resources of urban areas vary from rural areas. And not all rural areas face the same challenges. How we work together with communities is changing and is moving toward intentional partnerships to address the Social Determinants of Health (read more). Thankfully, various interventions exist to help our health care system address the nonmedical factors, both within the system and externally.

Still, how do we best address the other factors beyond clinical care that greatly impact our health? Methodist Healthcare Ministries is hard at work meeting with partners across the Rio Grande Valley and greater Coastal Bend regions to understand the needs and resources of communities. We ask questions and listen attentively to identify opportunities for collaboration, alignment, and new ways to leverage resources. Guided by our community partners, we seek to build cross-sector partnerships and promote health. We are also committed to identifying different ways to collect and use determinants of health data to inform and create transformational change.

God intertwines our talents with the needs of others to allow us the privilege of touching, serving, and inspiring others as they journey to become healthier communities. Imagine what could happen if we focused our efforts on preventive measures and upstream factors to keep people healthy!

Edlín Maldonado-Fuller is the Collaborative Grants Specialist for Methodist Healthcare Ministries. She provides technical assistance to community partners in Methodist Healthcare Ministries' service regions, ranging from grant-writing, vetting grant opportunities, supporting collaborative funding initiatives and sharing information about development resources.