Patient Engagement

Can the community help stop the spread of disease?

Dr. Mark Hyman, director of the Center for Functional Medicine at the Cleveland Clinic, offered some powerful evidence that points to “yes.”

community support concept

If the traditional Western medical establishment can’t stop the spread of disease, can the community? Dr. Mark Hyman, director of the Center for Functional Medicine at the Cleveland Clinic, offered some powerful evidence that points to “yes.”

More than one-third of U.S. adults are obese, and statistics about diabetes and pre-diabetes are staggering. Diabetes and other lifestyle diseases are “social diseases that need a social cure,” Hyman told attendees at the Cleveland Clinic Patient Experience Summit on Monday.

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And contrary to common belief, Hyman said noncommunicable diseases like diabetes are contagious. He pointed to statistics showing that while having family members who are overweight increases risk of being overweight, having friends who are overweight increases the risk much more significantly.

Because lifestyles that contribute to sickness and disease spread in communities, Hyman asserted that creating sustainable biological and behavior change in those same communities can lead to the cure.

“Illness starts with ‘I’ and wellness starts with ‘we,’ Hyman said. And social networks — online or off — have shown the power to cure.

When Hyman went to Haiti after the January 2010 earthquake and saw firsthand the results of illness and disease, he realized community was the vital delivery system of health. “The cure wasn’t surgery or medications; it was people walking 10 miles to make sure [other] people knew how to take their medicine,” he said.

Since basing its healthcare organization on an integration of wellness practices including medical, behavioral, dental and the traditional practice of “talking circles” — that is, community members meeting together with a goal of improving their health — the Southcentral Foundation, a Native Alaskan community in the Ahklun Mountains, has seen a 75 percent reduction in hospitalizations.

Hyman said such formalized community-based health programs are successful because they deal with the “upstream causes” of disease rather than waiting for the disease to show up “downstream.”

When Rick Warren, pastor and founder of Saddleback Church in Lake Forest, California, realized he and many of his 25,000-member congregation were seriously overweight, he repented at the pulpit and asked whether church members would be willing to join him in a quest for better health, Hyman noted.

More than 5,000 people signed up that day. Then Warren called on some big guns in the medical world — Hyman, a self-described “Jewish doctor from New York,” Dr. Mehmet Oz and Dr. Daniel Amen — to create a biblically based plan for his congregation. “The Daniel Plan: 40 Days to a Healthier Life” (2013) was the resulting program and best-selling book.

But more than the book’s reception, or the collaboration between a church leader and physicians of different faiths, it was the process that was extraordinary, Hyman said. The process was all about community.

Instead of pancake breakfasts and ice cream socials, church members “started grocery shopping and cooking together. They started exercise together,” Hyman said. They told each other things such as, “Don’t eat the food man made, like Twinkies and pop. Eat the food that God made, like avocados.”

On average, participating members saw a 7.6 percent loss in body fat, according to Hyman. They also documented reductions in symptoms of rheumatoid arthritis, chronic pain, headaches, high blood pressure and low testosterone.

While “The Daniel Plan” launched programs in churches around the country, Hyman said he believes it can work just as well in a secular setting. And he believes the program’s powerful results were based on working together toward healthy lifestyles as much as they came from following dietary guidelines.

“This wasn’t a weight-loss program. This was a program based on functional medicine,” Hyman said. “We weren’t treating these people. We were just providing them with the basics of self care.”

A question from the audience addressed the unavoidable business fact: medical billings and reimbursements are based on patients coming to doctors’ offices.

Hyman agreed that it is a roadblock to expanding community models of care.

“We don’t have evidence-based medicine. We have reimbursement-based medicine,” he said. “And this will change as we move to a value-based care.”

In the meantime, perhaps we’ll get by with a little help from our friends.

Photo: Bigstock Photo