By Chris Pernell, MD
“Be an advocate for the people and causes important to you, using the most powerful tool only you have—your personal stories.” John Capecci and Timothy Cage
This past February, I visited Capitol Hill to add my voice to the growing chorus of community partners—including the YMCA and various physician groups—calling on elected officials to support the Medicare Diabetes Prevention Act. For this Advocacy Day, the American College of Preventive Medicine (ACPM) organized preventive medicine physicians and residents to meet with their congressional representatives and senators to discuss prevention-related topics, as part of its annual meeting. Although I have participated in previous ACPM-led advocacy efforts, this occasion was truly special to me, since we are piloting the Diabetes Prevention Program (DPP) at one of our partner hospitals. Started in October 2015, the 1199SEIU Caring for Our Healers DPP program at Mount Sinai Beth Israel has launched four cohort classes to date.
On Capitol Hill, I spoke about more than alarming statistics and the population-wide implications of Congress allocating funds to cover DPP classes for seniors. I also carried personal stories of lifestyle change to explain why prevention matters. In face-to-face meetings with congressional aides, we personalized the power of prevention and the imperative for Congress to act. In particular, I spoke about healthcare workers and the impact the DPP has had on their health and wellbeing, using frontline workers as an example. Their ability to empower not only themselves but also their families and communities with the information they learn about diabetes prevention was a powerful way to highlight how the DPP changes lives and outcomes. Further, our example showed how organizations can practice institutional accountability, making provisions for the wellbeing of its workers. Our stories were not the only stories that mattered, but I do believe hearing about the experiences of healthcare workers helped crystallize for legislators what was at stake and gave them a deeper understanding of the issues involved in this work.
After our visit, the U.S. Department of Health and Human Services announced the landmark decision that Medicare will cover lifestyle change programs using trained coaches to guide participants in healthier eating and greater physical activity to help prevent type 2 diabetes. This decision will likely influence more insurers to cover the DPP, which will hopefully lower the incidence of type 2 diabetes. When I heard the news, I reflected upon that rainy February morning on the Hill—and more importantly, on the lives of the participants in our DPP classes, and the mandate to improve their quality of life.
A consistent theme across the ACPM annual meeting was the power of prevention. In addition to the advocacy day, the conference focused on clinical preventive and lifestyle medicine, global health, population health and public policy, and quality improvement, among other topics. Another conference highlight was a symposium titled Building Community Health & Wellbeing through Business, Culture and Policy, which challenged attendees—including those from the business sector, community-based organizations and public health agencies—to expand our way of thinking about health. Specifically, we were challenged to:
- think about our organizations as an amplifier of wellness;
- see health as a fundamental component of organizational identity;
- bring wellness to where people live; and
- empower local neighborhoods to imagine and devise what it means to be well.
The day featured insights from the former executive director of the First Lady’s Let’s Move Initiative, Robin Schepper, who spoke about how to leverage partnerships and coalitions to build capacity and deliver uncommon success. A representative of the Boys and Girls Clubs of America talked about using resiliency training, dental health and STEM education to affect the social determinants of health and drive wellbeing outcomes. In addition, we learned about the Way to Wellville, a five-year challenge to dramatically improve population health outcomes in five US communities.
The ACPM conference, especially the advocacy day and symposium, emphasized an important fact we know from our practice: Health happens outside of the four walls of medicine. Health happens in our congressional representatives’ offices, on our community streets, in our homes, and at the hands of our frontline workers, providers and business partners. Good health takes a village!