The United States spends more money on health care than any nation in the world yet continues to fall behind on important health outcomes. For example, it wasn’t very many years ago that Americans had a life expectancy that was among the longest of any country in the world. Today, the United States ranks 43rd in the world in life expectancy. What’s more alarming is that the longer members of some new immigrant populations reside in this country, the more their health deteriorates. But what seems to be at the root of our nation’s deteriorating health?
Some people would argue that we don’t actually have a “health care” system. Instead, they would say that we have a “sick care” system focused on treating people after they have fallen ill. Furthermore, the Centers for Disease Control estimates that 86% of the nation’s health care dollar is spent managing chronic disease. Sadly, a large portion of chronic disease is preventable.
Recently, however, we have begun to see more attention placed on upstream, preventive actions aimed at maintaining health and wellness. These efforts focus not only on changing individual behavior through education but influencing what are referred to as the “social and environmental determinants” of health. For example, the Robert Wood Johnson Foundation is spearheading an effort to build a “culture of health” in every community across the nation.
The Cooperative Extension System is a part of these efforts to improve health and well-being. In 2014, the ECOP Task Force on Health challenged the Cooperative Extension System to boldly proclaim the contributions it makes toward ensuring lifelong health and well-being for Americans and serve as a champion for mobilizing broader university outreach related to health and wellness.
The report of the Task Force was accepted and endorsed by various boards and committees of the Association of Public and Land Grant Universities. A Healthy Food Systems, Healthy People Steering Committee was created to develop a broad-based initiative to improve human health and reduce chronic disease by capitalizing upon university expertise in agriculture, nutrition, community development, and the human sciences.
If we know that knowledge is not always enough to change behavior, how might Extension work in different ways to build a community culture that makes it easier for residents to implement healthy behaviors?