Health Analysis? Empowerment is Needed, too.

If you live in Vermont, you may be happy to know that you are healthier than your unhealthier counterparts in Mississippi. I live in New York State; we're right in the middle.

That, according to the United Health Foundation, the non-profit arm of United Healthcare, a health insurance provider, which issued its 2007 report about the health of Americans. This report is "the relative healthiness of our nation, based on a comprehensive set of determining factors including personal behaviors, the quality of medical care, the community environment in which we live, and decisions made by public and elected officials that in aggregate describe the health of our nation."

What did they measure? Determinants include everything from personal behaviors such as smoking and high school graduation, to public policy, to the community environment, to access to healthcare and preventable hospitalizations.

This report is very much about health -- all good. But sometimes we need to understand its distinction from medicine. Health is a goal. Contrast that with medicine, which is a proactive and defensive means to reach that health goal. Patient empowerment is about the medicine side -- providing tools to patients who are trying to regain their health.

I find it interesting that there is no reference to any of the tenets of patient empowerment in this report. They do include high school graduation rates, and state, "Education is vital as consumers must be able to learn about, create and maintain a healthy lifestyle and understand their options for care." Yes -- they even called us "consumers." That's a baby step.

I suggest, however, that real strides for patients and health will be made when organizations like this foundation recognize that areas such as patient literacy, patient safety, healthcare consumerism, and doctor-patient communication are as important as their other preventive determinants.