Joyce Dombrouski

Joyce Dombrouski

Creating a healthy community is good for everyone. Healthier people live longer with less disease. Caring for healthier people costs less and saves money for communities and individuals.

The Centers for Disease Control and Prevention focuses on three areas for building healthy communities: increasing physical activity, decreasing unhealthy eating, and reducing tobacco use and exposure to secondhand smoke. These areas make sense because of the numerous health problems and increased costs associated with obesity and smoking.

For instance, medical costs for someone who is obese are on average, $1,400 more per year than someone who is not obese, and the medical cost of obesity is about $150 billion per year (Weight of the Nation, 2012). According to the American Cancer Society (2014), smoking and exposure to secondhand smoke account for about $300 billion annually in costs to the economy. With costs like these, it makes sense that together we try to decrease health risks associated with these and other behaviors.

Across the nation, communities are trying to get healthier. Coalitions of state and local governments, businesses and health care organizations are working together. In fact, hospitals and health care systems are often considered an “anchor” institution in this effort. Creating health is typically part of their mission, as they help individuals to heal through disease or accident. It is also in their best interest as they provide leadership in the communities they serve. And, based on cost examples like those above, creating healthier communities is a fiscally wise approach.

What are hospitals across the nation doing to contribute to healthier communities? Some are working with other leaders to address homelessness and affordable housing. Others are working toward capacity building – strengthening a community’s abilities and goals while understanding the obstacles that inhibit change in order to create results – to help local residents be more knowledgeable about health issues and to advocate effectively for better health conditions.

Another important element is local hiring to help support the economic vitality of a community. Some invest in their communities by supporting low-cost loans or shared loan expenses. Hospitals often work with multiple institutions and organizations to provide a web of services that can work together efficiently. Hospitals are also taking more of an interest in helping to build healthy communities by decreasing pollution (including pollution created by hospitals) and supporting healthy nutritious food programs. For more information, visit

State and local governments are working to improve public health by creating healthy communities. Maine has taken a lead in this effort through a coalition of agencies, nonprofit organizations, health care institutions and individuals. They are making progress on goals that include increasing childhood immunizations, while decreasing tobacco use, addiction, obesity, heart disease, cancer and preventable hospital admissions.

Cities also lead the way. Minneapolis has been ranked as one of the healthiest cities for many years. It works across sectors to increase activity and healthy eating, and to decrease tobacco use. Missoula also has several important initiatives underway to improve health. The Let’s Move Missoula! program encourages fifth-graders across the city to stay physically active. Missoula in Motion encourages people of all ages to commute to school and work using physically active means. The Our Missoula planning project underway envisions our future, including how we can create better health. The Missoula City-County Health Department helps ensure clean air and water, and that services are available to the underserved. Numerous nonprofit groups work on improving health in Missoula from providing nutritious foods to mental health services.

Though creating a healthy community is an ambitious effort, many individuals and groups are working together to do so. Until recently, hospitals have been the place where people go when they are ill. Today, however, hospitals are called to help people be well, which represents a change in focus.

For all of us who value health, this is an exciting time to be in health care, where with terrific teamwork we can measurably improve the health of our communities and people.

Joyce Dombrouski is a registered nurse and chief acute services officer at Providence St. Patrick Hospital.

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