By Chris Allen

The following comments were offered to the Southeast Michigan Council of Governments during a public comment period earlier this year.The Southeast Michigan Council of Governments’ “Partnering for Prosperity – Economic Development Strategy for Southeast Michigan” is an impressive document. It certainly addresses most of the indicators of a healthy economy, at least from a traditional perspective: creating an environment conducive to business and residential growth, as well as tourism.

We were struck by how little health plays in this vision. Yes, health care systems are represented as an “amenity” in the region. But are comprehensive academic and research health systems merely amenities of a regional economy? They are part of the infrastructure that sustains an economic culture. It cures disease, repairs injuries, and keeps us going. Arguably, the health systems are as important to the infrastructure as the traditional water and sewer pipes, roads and bridges, and power grids are, as noted in this document.

As essential as high quality medical and surgical capabilities are — and the degree to which they bring return on investment to their communities — the economy of a region relies not on the ability of its health system to cure disease and repair injury, but the ability of a community to create health (rhymes with “wealth”). Health lessens the cost of sophisticated health care services. Health lessens the cost of absenteeism. Health lessens the cost of disability and un-productivity. It has been well-documented that the quality of a work environment is largely influenced by the mental and physical well-being of its workers, as well as its infants and elders.

We noted that “Strengthening Quality of Place” as an important consideration in business and personal location decisions.” Your document references “the quality of K-12 and post-secondary education systems, public infrastructure, and transportation connections…” You note the importance of culture, natural recreational experiences, entertainment. But how does health play a role in the quality of place? Wouldn’t a family want to know the quality of their regional health systems? And wouldn’t a business want to locate in a community that is healthy and prides itself on becoming healthier? They certainly would. After all, a healthy, fit employee thinks more clearly and is more productive. Increasingly, young families are choosing to live in communities that are healthy, and are proud of living healthy lives. And older residents are choosing to remain in their community, also looking to aging well.

All of what you say about place is valuable. But we would like you to consider one aspect of place that goes beyond the role of the health care industry as infrastructure for medical treatment or as an employer. Look upon health as wealth, and look at healthy communities as assets that enhance the definition of a “quality of place.” Consider the economic and social value of a community steeped in a “culture of health,” as opposed to a “culture of sickness and disability.” Would you want to live here?

Consider what is happening in Trenton, Taylor, Dearborn, Wayne, Westland, Inkster, and other communities that are adopting health as an essential value of their communities. People are walking and riding bicycles, they’re promoting more fresh and nutritious food consumption, and they’re learning how to cook a new way. they are improving their parks and digging community gardens. They also learning how to use their primary care medical home in a preventive way, not just when they’re sick or hurt.

Many of the attributes in your strategy fall into what we refer to as “population health,” the structural and environmental improvements that create a healthy place — one which promotes well-being, and thereby productive and a happier population. Housing, education, public safety, clean natural environment, transportation — you touch on all of these, some to a greater extent than others. But you don’t define them int he context of a healthy sense of place.

This is the lens through which we view our communities and region. We know that we need a robust economy to support our quality of life. We also know that we need a health and human infrastructure to create a healthy social fabric. We need more than water and sewer pipes, electrical lines, and roads. We need a public health system that is prepared to prevent disease, protect us in routine occurrences and during emergencies. We certainly agree that we need to invest in “critical infrastructure.” But why isn’t public health part of that infrastructure? Why is it assumed that somehow it will be there when the next epidemic strikes? We agree that “our infrastructure is an asset upon which we can build the economy, much of it is aging and in disrepair.” With all due respect to our public health departments, when was the last time they received significant investment?
We agree that we need to “enhance transportation connections,” with the key word being connections. Just as the “Walking Man” demonstrated how difficult it is for many workers to get to work, it is equally difficult for workers to get to health facilities, quality food retailers, and safe places to exercise. We need a creative transportation infrastructure that not only responds to needs, but anticipates opportunity to serve before there is need.

You note the demand for the top 10, high-wage careers. In this manufacturing, technological culture, this seems to make sense. But what about the health provider shortage? What about the critical need for health professionals at all levels of the industry? What about the crisis in managing the care of our elderly population? These may not be high wage jobs, but they certainly are in demand.

You have done a good job of focusing on many of the challenges and opportunities facing our region, from a strict economic lens. But what’s missing is the essential component of health. As we have noted, if we are able to create a culture of health in Southeast Michigan, we will be more productive and more attractive to businesses and people who are looking for a place to live and raise their families. If we can envision an economically prosperous region that cites health as the essential component of their wealth, imagine how much further we’ll be ahead.
Chris Allen is CEO of Authority Health.