At an exercise class conducted by Team Up 4 Health, residents of Bell County, Ky., rally each other to get fit. (Photo courtesy of Team Up 4 Health)
A community health model that was developed in Palestine, Jordan, and Kenya has made its way to rural Kentucky, where neighbors are helping each other lose weight, exercise more often, and make better food choices. Early success of a program called Team Up 4 Health suggests that the strategy of “contagious health” has the potential to spread wellness to diverse communities around the globe.
Team Up 4 Health partners include Humana, a health care and insurance company founded in Kentucky more than half a century ago, and a pioneering nonprofit called Microclinic International (MCI), based in San Francisco.
Daniel Zoughbie founded MCI in 2005 after testing his contagious health hypothesis in the West Bank, where his grandmother died from complications of diabetes. “It’s common sense that individuals influence each other’s behavior,” says Zoughbie, a public health expert. “We know that kids convince each other to smoke. We know that gang violence and other antisocial behavior spreads infectiously throughout society. The big idea here was, why can’t our real-life social network interactions be harnessed to induce positive behavior change?”
To encourage healthier habits, MCI recruits community participants to form small groups called microclinics—typically, two to five friends, coworkers, or family members who have chronic health issues. They take part in health education classes aimed at controlling conditions such as diabetes, obesity, and heart disease. Group members then support each other as they make lifestyle changes linked to healthier outcomes and lower health care costs.
Leveraging face-to-face social networks “may sound like Stone Age technology,” admits Zoughbie, “but we apply the highest scientific standards to make sure that what we’re doing is effective.” Recognizing the potential impact of this low-cost health model, the Mulago Foundation has selected Microclinic International for its Scalable Solutions Portfolio.
Humana recruited MCI to bring its approach to Bell County, Kentucky, for the first implementation of microclinics in North America. “We know that prevention works, but trends are going in the wrong direction,” says Alan Player of Humana, who serves as program manager for Team Up 4 Health. Kentucky, for example, has one of the highest obesity rates in the country. “We have to make it easier for people to recognize and ultimately adopt healthier habits,” Player says.
Willene Black, a lifelong resident of Bell County, has made walking a regular habit since going through the 10-month program with her brother. She says she has learned to read food labels carefully, eat more fruits and vegetables and less fried food, and avoid high-calorie treats when she’s out with her 11-year-old granddaughter. “She’s the light of my life, and now she’s gone from drinking pop all the time to drinking milk or water. She has her friends eating better, too,” Black says.
Leigh Ann Baker heads Team Up 4 Health for the Bell County Health Department. “We knew we had a need here,” she says. “We also know that people are community-oriented and that they would be supportive of each other.”
Weekly health education classes focus on “small things,” Baker says. Participants sample unfamiliar foods like avocados and hummus, set goals for regular exercise, and go with health educators on grocery shopping excursions and walking picnics.
After the first year of the program, 97 percent of Team Up 4 Health participants improved in at least one health indicator, such as losing weight or lowering their blood sugar levels. Follow-up surveys show that benefits have continued after the formal intervention ends.
An unexpected outcome of the initiative has been what Leila Makarechi, COO of MCI, describes as “structural changes in the environment.” A new, five-acre community garden and two outdoor fitness parks, for example, offer visible evidence that good habits are taking hold in Bell County. Some local restaurants have even modified their menus to offer healthier choices.
Read more stories by Suzie Boss.