Athena Godet-Calogeras–The Olean Times Herald
Health is like a jigsaw puzzle. The picture is complete when all the pieces fit perfectly. To continue with the analogy, you are healthy when all the pieces, or determinants of health, are in place.
What are they? For many of us, biology comes to mind first, and, certainly, our genes can predispose us to certain diseases or help us resist them. We can’t change the genetic configuration we’ve inherited, but the good news is that it accounts for just 20-30 percent of our health (and longevity). Most of the rest we can do something about.
Most obvious is our behavior. We decide on what and how much we eat, whether or not to smoke, take drugs, drink an abundance of alcoholic beverages and move our bodies or settle for being couch potatoes. Also, just like we drive our vehicle to a favorite mechanic for regular servicing and tuneups, we can schedule appointments with our doctor for checkups. Those behaviors, which very much influence health, are totally under our control.
Perhaps I shouldn’t have used the word “totally” when it pertains to scheduling appointments with physicians or other health professionals. For, unfortunately, we live in a medically underserved county. That is, Cattaraugus County lacks a sufficient number of physicians, primarily in primary care and mental health, as well as dentists, to care for all of us. In addition, the poorer among us rely on Medicaid, and many medical professionals do not accept that as payment.
Thus, the availability of health services, another factor that determines health, is not under individual control.
With the above consideration, we’ve moved into an area where “it takes a village” to promote health. The environment, both social and natural, is a huge determinant of health. Take an obvious social factor: jobs. If you need a job and can’t find one or are in a low-paying job and can’t find one or are in a low paying job and can’t make ends meet; if your workplace closes shop and moves elsewhere dumping you back into the unemployed, or if you simply must remain at a job you hate because you need the money for you and the family, you experience stress–and most probably the physical and psychological maladies that accompany it, including the potential loss of your health insurance.
Then there’s the natural environment. We live in the beauty of the Enchanted Mountains. But we also live in an area high in radon, a naturally occurring radioactive gas found in soil and rock that seeps into our homes where its concentration can contribute to lung cancer. Radon is the second leading cause of lung cancer after smoking. (In our county, lung cancer is the leading form of cancer.)
Before my husband and I moved into our Allegany home, we had it tested for radon and, learning that the level was high, had it mitigated, sharing the cost with the home’s seller. While anyone can obtain a test kit from the county for minimal cost, fixing the problem is expensive. At present, there is no county, state or federal financial incentive or assistance.
That brings us to a final determinant –or puzzle piece–of health: legislative policies.
To be healthy, we need our “village,” our government, to legislate for our good, for the common good. We need incentives to bring qualified and compassionate medical professionals into our county, increases in the state budget to help us pay to fix radon problems, priorities that recognize and respond to employment needs in rural communities and elected legislators at all levels committed to our good, our health.
Each of us can fit our “behavior” piece of the puzzle of health in place, but let’s work collectively for the total jigsaw of health for each of us–and for all of us.
(Athena Godet-Calogeras is chairwoman of the Health Care Access Coalition and a volunteer with the Cattaraugus County Health Department.)