May 8--SACRAMENTO -- Decisions made at home and at City Hall will determine the Central Valley's health care fate more than those made in hospitals or at the doctor's office, a medical visionary said Thursday.
Health care providers, after all, try to fix problems that might never develop if parents teach good nutrition and if government leaders arrange communities to avoid excessive driving, said Dr. Richard Pan of the University of California at Davis Medical Center.
"When you think about it, is it health care reform we want or health reform?" Pan asked several hundred people gathered for the Modesto-based Great Valley Center's annual conference. "In the end, it's not care we want; it's health."
Several indicators bode ill for the valley, Pan and other experts said, including obesity problems costing society $21 billion in 2000. The Great Valley Center's Amy Moffat said one-third of California teens could be obese by 2020, and medical leaders are not meeting goals to improve prenatal care for pregnant women.
Modesto's Melanie Briones, of the Central Valley Health Policy Institute, decried reductions in health services for the poor and mentally ill.
Facing a $34 million budget deficit, Stanislaus County leaders have closed clinics, laid off nurses and substance abuse counselors, and are trying to rescue a physician residency program.
But studies show that poverty leads to poor health much more than poor health results in poverty, Pan said. Others reveal that children are much more resilient if they personally connect with at least one adult, whether a parent or mentor, he noted.
When people visit doctors, "We always ask, 'Why are you here? What's the problem?' and then we try to solve the problem," Pan said. "We need to look at people's assets (and not necessarily) their problems. If we can get health care people to connect with community partners, we'll think of creative ways to improve health."
Health care spending has risen sharply in recent decades and now constitutes 16 percent of the nation's gross domestic product, Pan said. Spending categories with the most dramatic increases are hospitals, physician services and prescription drugs, while public health -- whose mission largely is prevention -- is "buried at the bottom," he said.
Meanwhile, studies show that 40 percent of premature deaths are caused by poor choices. Genetics account for 30 percent, while access to health care plays a role in only 10 percent of cases, Pan said.
He encourages resident doctors in his group, Community and Physicians Together, to get involved with their neighborhood. Some publish newsletters, conduct nature walks or work with children on art murals.
"When doctors give instructions, sometimes they don't make sense," Pan said. "We want to make sure residents know what's going on in the community so they can look at how they can be assets.
"Most of my health care colleagues are not thinking about land use and water redistribution," Pan continued. "The power of getting people connected and working together to redefine social norms leads to the political will to make changes. In a democracy, we decide collectively that we want something to change."
Also Thursday, housing experts said a glut of foreclosed homes now offered at a fraction of their 2007 value is not making much of a dent in California's need for affordable housing.
A study predicts that the state will come up 3.7 million homes short of the need for low-income families by 2020, said Chelsey Norton of the Sacramento planning consultant firm of Mintier Harnish. Meanwhile, demand for large, upper-end suburban homes -- which branded the Northern San Joaquin Valley the epicenter of the bank-owned home crisis -- should be satisfied through 2030, Norton said.
"Enough is enough, and we have enough," she said. "We need to build affordable housing that matches the income of the Central Valley."
Norton recommended that city and county officials provide incentives to builders for such units, as well as community support for nonprofits helping low-income people.
On the Net: www.greatvalley.org.
Bee staff writer Garth Stapley can be reached at gstapley@modbee.com or 578-2390.
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