As published in Toledo Business Journal - September 1, 2017
Randy Oostra
ProMedica
Social determinants impact health and well-being
“Anchor institutions” and collaboration offer new development resources
In an address to the Toledo Rotary Club, insight was provided into ProMedica’s approach to social determinants impacting healthcare in the region, as well as the organization’s plans involving downtown Toledo. ProMedica board of directors co-chairman Steve Staelin introduced Randy Oostra, president and CEO, to the large audience of business and community leaders.
Oostra began his talk by sharing an observation from a presentation given at the University of Toledo, How a Newcomer perceives Toledo: “The ‘Toledo Disease’ is not negativism but rather, low self-esteem … this city does not suffer from a negative attitude as much as from an exceedingly low level of self-confidence.” The ProMedica CEO used this introduction to set the stage for a discussion of key actions being implemented in the community aimed at addressing a number of important healthcare and community issues and at the same time providing positive impact to the issue of self-esteem.
The address to this group of area professionals and leaders also provides insight into the role and significance of private sector leadership and its ability to impact the community.
“There is an attitude in healthcare that social and community health issues are not our problem,” stated Oostra. He then shared information about the quality and extent of medical resources at ProMedica and other area health systems. “The Toledo area has some of the best children’s hospitals in the country, yet still has very high infant mortality rates,” Oostra explained.
Information was provided showing that Ohio ranks 26th in adult obesity and 35th in childhood obesity. 70% of adults in the Toledo area are obese. 19% of Toledoans are tobacco users. And 18% of adults in the Toledo area rate their health as poor.
Oostra then discussed the issue of “well-being” and used a Gallup survey to address this issue. He discussed that essentials of well-being in the Gallup survey include:
- Career well-being which involves the love of what we do every day.
- Social well-being involves the quality of our relationships
- Financial well-being involves security of finances
- Physical well-being concerns the vibrancy of our physical health
- Community involves what we have contributed to our community
Oostra further explained, “Community well-being … can actually be the differentiator between a good life and a great one … Well-being is a positive outcome that is meaningful to people … because it tells us that people perceive that their own lives are going well.”
The ProMedica CEO then turned his attention to the healthcare situation in the US today. He explained that healthcare costs are currently 16.6% of GDP and will be 19.3% in 2023. However, one-third of the population skips care and prescriptions due to the high costs. Healthcare expense is the number one cause of bankruptcy. A higher percentage of the chronically ill do not get the healthcare support they need. Alcohol, opioid, and other drug overdoses are causing over 50,000 deaths annually and rising. And the healthcare debate and legislation in Washington is in turmoil.
Oostra used this background to discuss ProMedica’s “journey” and evolution to how it is now addressing healthcare. He talked about the issues of obesity and hunger, infant mortality, mental health, and other social problems, and the impact these were having on the health of area residents.
In order to support the health and physical well-being of patients, critical social issues had to be addressed. “It was necessary to change from an ‘I’ to a ‘We’ approach and from an illness to a wellness approach,” stated Oostra.
How could the significant resources of ProMedica be employed to address difficult community and social issues? Oostra then discussed the concept of “anchor institutions.” He defined anchor institutions as non-profit institutions that, once established, tend not to move location such as hospitals and universities. He further discussed the need for these organizations to focus on the long-term welfare of the community and to address “tenacious” community challenges. He explained how he sees ProMedica’s role as an anchor institution.
Oostra then addressed the importance of collaboration between government, other public sector organizations, and anchor institutions. He used Harvard’s Michael Porter who said, “ … Shared value is not social responsibility, philanthropy, or even sustainability, but a new way to achieve economic success.” The ProMedica CEO stressed the need to find opportunities for high-impact, “shared-value” partnerships.
Oostra explained that healthcare spending in the US is over $3 trillion annually, but that only 20% of the health and well-being of an individual is related to access to care and the quality of healthcare services. The social determinants of well-being have to be addressed. These include such issues as hunger, obesity, the causes of infant mortality, personal security, financial security, education and job training, and more.
To address healthcare, ProMedica is moving from a focus on “episodic care” to a 24-hour, 7 days a week communications and access to care approach. One area being addressed is the unnecessary and costly use of emergency room visits — averaging $1,000 — which can be replaced by better access to medical care that is more effective and lower cost. Of the 136 million emergency room visits annually, more than 65% are not emergencies.
ProMedica is also addressing needs of area corporations. The organization is operating an employee health clinic and fitness center inside the world headquarters of Owens Corning and is examining options for expansion of its services to other businesses.
“ProMedica continues to field a number of inquiries from other companies interested in an on-site health clinic and fitness center similar to Owens Corning. ProMedica is also introducing a variety of services for businesses, schools, and community organizations that align with our efforts in addressing social determinants while emphasizing overall health and well-being,” stated Tedra White, director of public relations, ProMedica.
Oostra also discussed the background of the organization’s involvement in the issue of hunger. 13% of US households are food insecure. 30.3% of US households have a single mother with children. 31% of seniors cut or skip meals due to lack of resources. ProMedica has put significant efforts into addressing this issue and setting up area programs to reclaim wasted food and assist individuals in need. He also discussed the Ebeid Institute in Toledo’s uptown area and its efforts to provide fresh fruits and vegetables in the inner city, nutrition counseling, parenting classes, financial literacy classes, job training, and more.
“There are several other initiatives in the area including the Healthy Corner Store initiative with the Health Department and Live Well that focuses on increasing availability of healthy food options in corner stores. There is also the Double Up Food Bucks program that enables SNAP recipients to double their produce purchase at our Toledo Farmers Market locations,” ProMedica’s White explained.
Oostra then shared that ProMedica has started screening patients for social determinants of health. These include housing, transportation, food insecurity, utilities, personal safety, behavioral health, financial strain, child care, health literacy, and training and employment. When asked if they are motivated to change their lives, 87% of respondents said that they wanted to make needed changes.
The ProMedica CEO addressed the issue of “placemaking.” “Anyone and everyone who is sincere about creating great places understands how a strong sense of place can influence the physical, social, emotional, and ecological health of individuals and communities everywhere,” stated Oostra. He then discussed a hierarchy of needs involving cities and communities and shared the importance of self-esteem and the sense of place.
In looking at options for ProMedica’s relocation of its headquarters, the need for downtown revitalization and the role that the organization could play was a driving factor in its decision to select the vacant former steam plant on the river. As an anchor institution and in partnership with others, the organization would play a lead role in revitalizing the downtown, including locating its own headquarters in this area.
Oostra discussed a set of action plans that involved the 22nd Century Plan, redevelopment of the riverfront including the new Renaissance Toledo Downtown hotel, Marina District development, Ft. Industry Square revitalization, and much more. He talked about attendance by 7,000-plus at the recent Crystal Bowersox concert in Promenade Park and plans for future events on the Maumee River and in other areas of the downtown. Oostra discussed the new downtown campus for ProMedica and its continued growth. He also addressed the economic impact of the investments being made by his organization and the additional funding coming into the community from other partners and organizations. He provided information about the organization’s efforts involving technology innovation and its incubator operations supporting new entrepreneurs.
Oostra shared information from a U.S. News & World Report, “Toledo, Ohio … proves to be a good place to live for those who want easy access to the outdoors. The metro area’s expansive Metroparks of the Toledo area system, which includes 15 area parks … “
Such positive recognition from national and local media, continued development in downtown and other areas of the city, success with new technology development and job creation, and other economic development successes are important factors in advancing the self-esteem issues facing the area and in building a sense of place that will draw others.
ProMedica’s role as an “anchor institution” and its collaboration in working with others to address critical social determinants will continue to impact healthcare, the community, and the self-esteem of area residents.
