We’ve all experienced the crushing agony of a heartbreak, or the deep foundational stress of worrying about how you’ll pay all your bills, or the isolating and bleak reality of a mum or dad or loved one whose health is failing in a way you can’t figure out how to stop – or fix. Life is hard. Now – how hard is all relative … but for most of us, our days are consumed on some level with a pretty significant level of worry. Did you overextend when you bought that house? Is so-and-so gunning for your job? Is it wrong that you secretly and deeply resent your partner because you’re sick of them “never doing anything”?
And how about the real worries – will you have food, electricity, heat, clothing, safety…the worries that consume more people than any of us would care to imagine (The Shriver Report has 1 out of 3 women living ‘on the brink’ – in other words, right smack dab in this reality). For fun – let’s try an exercise marriage counselors use for marriages that are in trouble…they have each of you sit down and write on a piece of paper what matters to you, and what you think matters to your partner. Then they compare the two. And what do you think stands out in stark testament to the current state of the relationship? Pretty much zero overlap. You don’t understand what matters to me, and I don’t understand what matters to you.
Let’s extend that analogy to the healthcare space…picture a typical day for many of us in the health communication space, for example. How are we spending our days? Dreaming up new and more imaginative ways to lecture about the importance of getting a colon cancer screening, or eating well, or taking your blood pressure medication, or getting in for your annual Medicare wellness visit, or or or…
And a question for those of us working on this stuff. If you turned all that passion and intensity you bring with you to work, and to the task of telling others how to live in a way that complies with HEDIS this or STAR that or [insert any other traditional health quality metric here]…if you turned that lens on yourself – how are you doing? Do you eat the way you should? How’s your weight? Do you sleep the recommended 7 to 8 hours of sleep a night? How are you on your preventive screenings – are you up to date? Did you exercise at all in the last week?
I’d bet the answer to all those questions is “no”. And I’d even go so far as to bet on some level, you (like me) are toiling away in your own private little hell. Most of us are pretty fundamentally lonely. Lost in a world of rapidly increasing communication mechanisms that with all their connecting are still, somehow, leaving us feeling incredibly alone. Alone in a world where it looks like everybody else is doing just fine (‘Check out how happy I am in this Facebook photo!!’) – and we’re the only ones kind of failing at everything.
Let’s compare those two lists – what matters to me as a human, and what matters to the healthcare system. What matters to me is my financial stress, my caregiver stress, my relationship stress, my job stress….and what matters to the healthcare system is checking the boxes on ‘quality’ metrics designed solely around a traditional definition of health.
My dad always told me if you want to start a business, pick a tidal wave that’s happening with or without you…because you’re going to make mistakes and when you do, that tidal wave will pick you up and carry you along with it. The extent to which our lives define our health is a tidal wave – and we can both acknowledge that, and start building products and tools and solutions and movements that meet each of us in the messy reality of our lives, or we can get washed out by that very same enormous and fast moving force.
The literature is clear – when life goes wrong, health goes wrong. Case in point – it’s now estimated that workplace stress alone is causing additional expenditures of between $125 to $190 billion a year – representing 5 to 8 percent of national spending on health care…and even more importantly – 120,000 deaths a year.
There are growing examples of individuals and organizations that get this stuff – and that are fielding solutions to help. Companies like Health Leads (meeting us on the lowest rung of Maslow’s Hierarchy and getting us access to heat, water, safety…), and Iora Health (meeting us squarely where we are and getting us support for our caregiver stress, our divorce, our substance issue…). I recently got to be part of the latest Robert Wood Johnson Foundation’s Pioneering Ideas Podcast (link below) and in the process learned how broadly this idea is spreading…Dr. Paul Tang of linkAges from Palo Alto Medical Foundation(a project RWJF supports) talks about stress, and its effects – especially on seniors – and what we can do about it. Harvard economist/MacArthur Genius Grant winner Sendhil Mullainathan shares ideas for transforming health and healthcare in a world where ‘attentional real estate’ – given the messy realities of life – is scarce. We double dog dare you to listen here:
As an industry with a mantra to heal, this is ground zero. We need to expand our definition of health to include life – and take this on not just as our obligation, but as our opportunity to address the fundamental drivers of health. And let’s not stop there. Let’s practice radical empathy with each other, and with ourselves. Let’s do it in the privacy of our homes, and let’s bring that raw authenticity with us to our work. Whatever you do to start acknowledging that health is life – start it now… maybe just by closing your eyes and inhaling a big fat breath of fresh air while reminding yourself, ‘I am not alone in this crazy world, because we all feel alone and on some level we are all crazy – but only in the very best of well-intentioned ways.’
Alexandra Drane is the Founder and Chairman of the Board of Eliza Corporation and Queen of the UnMentionables (a series she started at Health 2.0 in October 2010)