What’s Next for Health in Missouri?


While politics might still remain in the forefront of our minds, it’s essential that our focus turns forward to the crucial task at hand – improving the health and well-being of communities and people most in need in our region. We have much to do. Unfortunately, Missouri is well below average among states on most health measures. And health in the United States overall lags behind almost all other developed countries. Given that we spend nearly twice as much on health care as comparable nations, these statistics are even starker. And while we’ve seen some improvements in our health and health care efforts as a country, there’s still a ways to go regarding access and outcomes. I think that we’d all agree as Americans that we can do better.

Seeing an opportunity to further the national interest and inform a new administration, the prestigious National Academy of Medicine (NAM) undertook an initiative, Vital Directions for Health and Health Care, to offer pathways for improvement. Leading experts in 19 working groups produced papers in three broad areas: better health and well-being, high-value health care, and strong science and technology. Many of the ideas presented apply to Missouri, but I’d like to focus on two of the papers because both had an author from Saint Louis, and both highlight health topics with work ongoing in our state.

Ross Brownson, professor at the Brown School of Social Work at Washington University, co-authored the article, “Chronic Disease Prevention: Tobacco Avoidance, Physical Activity, and Nutrition for a Healthy Start.” It highlights the fact that chronic disease is responsible for the vast majority of morbidity, mortality, and costs of U.S. health care, yet many chronic diseases can be prevented. Unfortunately, preventive care has not been prioritized by our health care system. Reducing tobacco use, increasing physical activity, and improving access to nutritious food for children are all cost-effective approaches. The Foundation recognized the importance of reducing tobacco use through our nine-year Tobacco Prevention and Cessation Initiative, which led to an estimated lifetime medical care savings of $108 million and nearly 40 new smoke-free policies. Our ongoing childhood obesity initiative, Healthy Schools Healthy Communities, works with nearly 30,000 students in 33 school districts across the state to increase physical activity and improve nutrition at school, home, and in the community. These are just two examples of how we are promoting healthy habits and new ways of thinking about preventive care.

Steve Lipstein, president and CEO at BJC HealthCare, co-authored the article, “Workforce for 21st Century Health and Health Care.” This timely piece poses the idea that, with large changes already taking place in the health care sector, now is an opportunity for us to fundamentally alter the occupational structure of its delivery. The article explains that our current system is not organized to simultaneously promote population health, treat major episodes of illness and injury, effectively address chronic diseases, and care for patients at the end of life. We require a system with people in new roles working together in teams that are designed to meet patient needs. Appropriate technology – especially telehealth – needs to be integrated into our systems of care. Here in Missouri, telemedicine has promising applications, especially in rural areas, which you can learn more about from our Policy team. We at MFH are continuously working with a variety of community partners to experiment and research new strategies to offer care that is efficient, cost effective, and leads to better outcomes.

NAM’s Vital Directions initiative is a treasure trove of ideas for improvements in health and health care. Though it was prepared to be used at the national level, the content is just as relevant and insightful for our state in particular. Perhaps, by carefully selecting ideas that are the best fit for Missouri, we can move up the ranks of states in achieving positive health outcomes for our residents.