In 1988, I moved to Burlington. It was my home for over 30 years. I raised a family there and I was an active participant with many charities and organizations, including the Carpenter Hospice, Canadian Cancer Society, and Joseph Brant Memorial Hospital Foundation. I played a lot of baseball and hockey, and I was a pretty active curler. It is also where I lived when I was diagnosed with rheumatoid arthritis (RA). In 2008, my life changed and I became a chronic disease patient, with all indications that I would be a chronic disease patient for the rest of my life. Well, I’m still a chronic disease patient, but I’m not the same patient I was in 2008. I’ve learned a lot over the years and I’m still learning.
Chronic disease is the most significant cause of death worldwide (63%) and premature death under age 60 (13% in high-income countries, 29% in low-income countries; Elmslie, 2016). More than half of the Canadian adult public report having one or more forms of chronic illness (Montague et al., 2019). It creates a burden on the healthcare system, and it often creates a burden on family members and caregivers. I think we can change that, and I hope you do too.
The current healthcare system (often referred to as conventional medicine) has done a very good job dealing with acute conditions and the prevention of many types of disease through vaccination and other preventive measures. However, when dealing with chronic disease and mental illness, the results are not as good. Many variants of medicine (including conventional, integrative, functional, lifestyle, preventive, and others) are trying to lessen the incidence of chronic disease (prevention of new cases, more cases of recovery) and to help people improve both the quantity and quality of life. While the intentions of these “styles” of medicine are mostly good, the terms can be confusing and they can also be polarizing. For the most part, it is accepted that in order to decrease chronic disease and mental illness incidence and their associated burdens (some would suggest these are at epidemic levels), there needs to be a much more focused effort regarding health management, disease prevention, and recovery. This includes both the healthcare system and public health.
It will take a significant effort to improve health outcomes and I have long believed that a community approach could have a significant impact. Around 2014, I approached then-mayor Rick Goldring about setting the goal of Burlington becoming “Canada’s Healthiest City.” A bold goal. An audacious goal. Was it a realistic goal? Personally, I think it was. The city of Guelph was in the midst of the Community Wellbeing Initiative under then-mayor Karen Farbridge. Rick and I spoke with Mayor Farbridge. We convened a group of community leaders in Burlington. We weren’t sure where we were going, but we took the first few steps.
Creating change in a community is hard. It was hard in 2014 and it is still hard today. We kicked off the process but we stalled. A hundred-year flood happened. An election happened. And my personal goal of being a participant in making Burlington Canada’s healthiest city stalled with it. But my dream has not. I still believe in the power of community to “create healthy communities” and I have a lot better idea of how to make it happen.
There are precedents of highly successful community-based approaches and community mobilization as highlighted in this TED Talk from 2013, “How an Obese City Lost a Million Pounds.” In the early 1980s, Oklahoma City was suffering from an economic downturn, and young people were leaving the city. In 2007, Oklahoma City made Men’s Fitness magazine’s list of the “FATTEST Cities in America.” It was not a walkable city, and it had been designed more for cars than for people. On New Year’s Eve 2007, Mayor Mick Cornett announced that the city was going on a diet and was going to lose a million pounds. He appeared on The Ellen DeGeneres Show, and the Oklahoma City website reported 150,000 visits that day. Conversations started happening in homes, churches, schools, and businesses.
The city then embarked on creating more health-related infrastructure — a large park, senior health and wellness centres, investments in their river (Olympic-calibre canoe, kayak, and rowing facilities), inner-city programs, and hundreds of miles of new sidewalks and bicycle trails. Essentially, the city was redesigned around people, not cars. By January 2012, five years later, the city had lost 1 million pounds and was #22 on the list of “FITTEST Cities in America” in the same Men’s Fitness magazine. Highly educated 20-somethings started moving back to the city.
More recently, “Blue Zones” are increasing in number through civic engagement and community-based approaches to health innovation. Blue Zones are regions of the world where people experience a high quality of well-being and live longer than average, including having a high proportion of centenarians. Dan Buettner, who coined the term, identified five areas that he considers “Blue Zones”: Okinawa (Japan); Sardinia (Italy); Nicoya (Costa Rica); Icaria (Greece); and among the Seventh-day Adventists in Loma Linda, California. Key themes of Blue Zones are: an ability to move naturally; supports for stress release; refraining from overeating; eating more of a plant-based diet; spending time over food and drink in social settings; finding a sense of belonging; and developing healthy personal connections with friends and family. Cities with Blue Zone designations have become more common (currently listed at 56) in the United States. One project In Canada began in Airdrie, Alberta, but has been cancelled due to COVID-19.
Creating a healthy community is NOT about having all the answers today, it is about gathering for a common goal. The magic happens when the community comes together. Can it be done? In a word, YES! More on that in the second part of this series, where I will talk about how social media can be used as a tool to reach the goal of becoming a healthy community.
Sources
Elmslie, K. 2016. Against The Growing Burden of Disease. Public Health Agency of Canada. Url: https://cagh-acsm.org/sites/default/files/resources/2016/10/elmslie.pdf (accessed Dec. 8, 2021).
Montague, T., Nemis-White, J., Aylen, J., Torr, E., Martin, L., MacPherson, N., and Gogovor, A. 2019. Chronic Diseases in Canada: Contemporary Burden and Management. Url: https://www.mcgill.ca/hcic-sssc/files/hcic-sssc/hcic_chronic_disease_in_canada_burden_and_management_2019.pdf (accessed Dec. 8, 2021).
Blue Zones Project. Url: https://info.bluezonesproject.com/home (accessed Dec. 8, 2021).
A past Burlington resident of over 30 years, Ken Jaques is an empowered patient, contributing to improving health outcomes and healthcare systems. Diagnosed with rheumatoid arthritis in 2008, Ken believes that patients and practitioners can collectively achieve these outcomes.
