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Posts tagged ‘Children’

Nov 5

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My Life: Breast Cancer and Children

The very important and ubiquitous pink ribbon (with a touch of blue for my fellow male breast cancer survivors/thrivors) triumphs in October, however, it hushes and casts an elegant but huge shadow on the equally important fact that October is, also, Children’s Health Month.

Both of the above logos touch my world very personally.

In June 1999, I heard the words, “Michael, you have invasive ductal carcinoma. Breast cancer. You need a modified radical mastectomy.” What!?  Yes, breast cancer; thirteen years of wonder, amazement, empathy, reflection, and gratitude for each sunrise. Men have breasts…we can/do get breast cancer. Who knew? I didn’t, but I do now. I am also a father, grandfather, and the lead in a major initiative to improve the health and wellness of children. Little babies right through to 19 year-old young men and women. I’m talking about your children, my children, our children. Some of who will, undoubtedly, have breast cancer when they grow up.

The wearing of the logo on the right was not my choosing. I am the reluctant and accidental beneficiary of this strangely wrapped gift. I didn’t ask for it; at least, I don’t think so. It’s so confusing.  As for the second logo, the health of our children, I humbly and with respect, asked for it and wear it proudly.

In the past, I have written extensively on the topic of breast cancer, so this posting is focused on kids.

A funny thing happened on my way to retirement…

In November 2010, after a very fulfilling and successful — defined as happy, meaningful, and satisfying — 30+year career in the field of health promotion and disease prevention, I retired. Well, okay, I didn’t “retire,” but I pulled myself out of the day-to-day world of what some would call, “work.” I took the following year to write, climb over a mountain pass in the Peruvian Andes, trek to Machu Pichu, walk down the isle with my daughter, celebrate the birth of our first grand child, and give talks to the wellness and cancer communities. Nice, very nice, indeed. And, then, Peter called.

Peter Roberts is a friend and colleague that I have known for a number of years. He is a veteran of the health insurance industry, a “C-Suite” hospital administrator, and a long-time proponent of community health promotion and disease prevention.  In January 2012, he accepted the position as Executive Vice President, Population Health & Network Development, for Children’s Medical Center of Dallas, one of the top ten leading pediatric centers in the country. On Day One, Peter rolled up his sleeves and — under the direction of CEO Chris Durovich — set out to expand Childrens’ mission beyond outstanding treatment to include the whole child, the total health and wellness of the children of North Texas.

Peter asked if I would help.

Cue: Ringing of my phone, pinging of my e-mail, stirring of my conscience, shaking of my bones, lifting of my spirit, and yanking on my heartstrings. Would I consider providing some guidance and support to this initiative? Well, yes, yes, of course. Working with children, promoting health, preventing disease, impacting the social determinants of health, helping to form community action groups? Well, yes, yes, of course!

I was asked to be — and I humbly accepted — the role of Interim Executive Director, The Health & Wellness Alliance for Children, sponsored by Children’s Medical Center of Dallas. I now live in Dallas three days each week and will do so until we hire a permanent director. My responsibility is to help rally the North Texas community stewards around a transformational initiative to improve the health of all kids living in this area of the country. Mind you, I’m not talking about another politically correct “tweak,” I’m talking about disruptive innovation, ruffling feathers, sacrificing sacred cows; I’m talking stand-on-your-head change. And, this time, going about it by looking through the lens of the community we serve; the kids and their families. I’m talking about their views, their voice, their passion, their lives, and their future … and, by the way, all of that impacts the future of all of us.

It’s no secret that despite excellent medical facilities and isolated pockets of exemplary social accomplishment, the health of our kids isn’t good; it’s bad, and it’s getting worse. In Dallas County, almost 30% live in poverty…enough children to more than fill Cowboy Stadium TWICE! And, here’s a shocking fact: In this day and age, you could completely fill the stadium with the number of kids in this community who go to bed each night malnourished and hungry. More than a quarter of a million of these kids are on Medicaid, and 18% have no health insurance at all. Also, of growing concern and economic burden is the fact that, in the absence of having a primary care physician, unnecessary emergency room visits are on the rise; Children’s Medical Center of Dallas alone, had over 135,000 ED visits last year; many of those, unnecessary. Your community isn’t much different; just look around.

It’s about the kids; yours, mine, ours…

There is a frequently repeated sentiment whispered with a slow headshake, lips pursed, eyes focused downward, and shoulders somewhat slumped in resignation.

“There, but for the Grace of God, go I.”

Yes, that’s the phrase. We’ve all said it—or, thought it—sometimes making a mental note to do something about it. But, for most of us, we simply count our blessings and go on about the business of the day.

“I’m really busy right now. Besides, I’m sure someone is doing something about it. And, maybe it’s not as bad as I think it is.”

Feeling a little more righteous for at least taking notice, we move on about our business echoing the mantra that begins…and ends with:

“Someday.”

First of all, the at-risk children of our community haven’t fallen from God’s Grace; they have fallen between society’s cracks. They are victims of a failed system. Remove the notion that these children are without grace and the phrase becomes “There…I go.” That means you, me, all of us; our entire community. Communities collapse the moment we sever the connective tissue — humanity — that joins us as a collective unit. Second, the conditions are as bad as we think they are, even worse. And, third, the “Village of Someday“ is very crowded. It is lined with streets, boulevards and avenues with names like,  “Not Now” “Maybe Soon” and “Next Year.”

Another often quoted sentiment …

“If not now, when? If not us, who?”

– John F. Kennedy


Follow this blog as I update our progress in North Texas. And, please let me know what’s happening in your community. What steps are being taken to improve the health and wellness of the children; all of the children, yours, mine, ours?

Jul 23

We Need to Talk About Our Children…

In the United States of America:

  • ~ 25% of kids ages 0–18 are underinsured[1]
  • ~ 35% of kids ages 2–17 are not receiving needed mental health treatment[2]
  • ~ 40% of kids ages 0-18 do not have a medical home[3]
  • ~ 30% of kids ages 10-17 are overweight or obese[4]
  • ~ 55% of kids in high school do not meet minimum physical activity levels[5]
  • ~ 22% of kids under 18 (or 16 million) live at or below the poverty line[6]
  • ~ 25% of kids under 18 (or 17 million) go to bed hungry every night[7]
  • ~ 10% of kids under 18 (or 7 million) have asthma[8]
  • ~ 26% of kids under 18 (or 19 million) are raised in single-family homes[9]

  

 “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.”

– The Once-ler from The Lorax by Dr. Suess

There is an often repeated sentiment whispered with a slow headshake, lips taut, eyes focused downward and shoulders slightly slumped in resignation, “There, but for the Grace of God, go I.”

Yes, that’s the phrase. We’ve all said it—or, thought it—sometimes making a mental note to do something about it. But, for most of us, we simply count our blessings and move on about the business of the day. “I’m really busy right now. Besides, I’m sure someone is doing something about it. And, maybe it’s not as bad as I think it is.” Feeling a little more righteous for at least taking notice, we move on about our business echoing the mantra that begins and ends with, “Someday.”

First of all, the at-risk children of our community haven’t fallen from God’s Grace; they have fallen between society’s cracks. They are victims of a failed system. Remove the notion that these children are without Grace and the phrase becomes, “There…I go.” That means you, me, all of us; our entire community. Communities collapse the moment we sever the connective tissue—humanity—that joins us as a collective unit. Second, the conditions are as bad as we think they are, even worse. And, third, the village of “Someday“ is extremely crowded. It is lined with streets, boulevards and avenues with names like, “Not Now,” “Maybe Soon” and “Next Year.”

Another often quoted query …

“If not now, when? If not us, who?”

– John F. Kennedy

Current State

Overall, throughout our country, despite extensive and excellent cutting edge medical facilities, the current state of our children’s health and wellness is not acceptable. This is not meant to be just a moral judgment; it is a fact.

To be clear, this is not a call for—nor a time for—blame, condemnation or pillory. This is a request for collective action leading to collective positive impact. We are all equally culpable for the eyes-half-shut-indifference that has led to this crisis. Certainly there are pockets of compassion, dedication and accomplishment, but, for the most part, these efforts are isolated, fragmented and, in many cases, redundant. In any case, they are simply not enough. The challenge is too broad, the cost of continued failure too devastating.

So, what’s the good news? Oh, there’s plenty of good news. Informed, aroused, harnessed, coordinated and given a call to action, there isn’t anything this country can’t accomplish. We have talent, passion, energy and — with collective focus — we can save our kids and put them on a path to optimal health and wellness.

“It’s not about what it is, it’s about what it can become.”

– The Once-ler from The Lorax by Dr. Suess

A Moral Imperative…An Economic Urgency

Every child is entitled to an equal opportunity for life-long optimal health and wellbeing.

The Economic ROI:

  • A Reduction in Unnecessary and Expensive Hospital Services
  • Improved Student Graduation Rates
  • Reduced Need for Special Student Services
  • Fewer Incarcerations
  • A Rise in Business Development Opportunities
  • Fewer Unwanted Pregnancies
  • A Reduction in Premature Births (“Million Dollar Babies”)
  • Improved Employment Outlook
  • Reduced Chronic Disease and Associated Costs

A Call to Action

Despite the best efforts of the healthcare system, we are losing the battle to attain and sustain adequate levels of health for all of our children.

The core mission of every healthcare provider has always been to improve the health of the patient. Unfortunately, medical care provides only one point of contact with children and their families and, unfortunately, the context tends to create a relationship of dependency.

To advance quality of life, prevent avoidable illness and compress morbidity, community leadership must embrace and advance a health model that goes beyond reactive care. In addition to treatment, providers need to focus on effectively engaging children and their families in self-management and lifestyle behaviors that enhance health. In addition to medical treatment, a comprehensive, preconception-to-adult model must include attention to the social determinants of population health, primary prevention, and wellness. The goal is to keep all children healthy, purposeful and out of the hospital and emergency rooms.

A “Whole-Child” model requires that today’s healthcare providers identify and mobilize community-based coalitions with a focus on advancing new and bold initiatives to transform (not tweak) how we protect and serve the health and wellness needs of our kids. This transformation from a reactive, paternalistic model to a proactive model driven by shared responsibility (and accountability) requires a different skill set than the direct provision of acute medical care.

The challenge is immense but, collectively, we are more than up to the task. We can, and we will, save and facilitate the wellbeing of our children.

“I know, up on top you are seeing great sights, but down here at the bottom we, too, should have rights.”

– Yertle the Turtle and Gertrude Mc Fuzz by Dr. Suess

[1] Commonwealth Fund, 2012

[2] ibid

[3] ibid

[4] ibid

[5] ibid

[6] US Bureau of the Census, 2010

[7] USA Today Kindness Blog

[8] Centers for Disease Control and Prevention, FastStats, Asthma

[9] The Oregonian, April, 2011