October, 2012

Promoting health and wellness on our campus and in the community

As an academic health center, we have a proud mission that extends beyond treating the sick - promoting health and wellness has long been a vital part of what we do for our patients, our employees and students, and the community as a whole. Increasingly our nation's health care system is changing in ways that reinforce the importance of wellness, prevention and effective disease management. More than ever before, hospitals and clinicians are being rewarded for keeping people healthy and out of the hospital, rather than the more traditional model of being paid for taking care of people once they're sick. With preventable illness and often manageable chronic diseases taking a significant toll in terms of mortality, quality of life, productivity, and health care resources, it's essential for academic health centers to lead the effort to find effective strategies to promote good health through prevention, wellness programs, and tools to help patients and the public take charge of their health.

The Centers for Disease Control and Prevention (CDC) has defined obesity as an epidemic. It accounts for more than 10% of U.S. medical costs, or about $150 billion a year. Currently 1 in 3 adults and nearly 1 in 6 children are obese, so finding effective ways to help patients reach and maintain a healthy weight is one of the most important ways an academic health center can improve health and well-being among the populations it serves. We know that cultural changes such as the increased presence of higher calorie foods and larger portion sizes have contributed to the obesity epidemic in the past few decades. At the same time, Penn State Hershey researchers are finding that other societal changes, like the advent of social media, may be useful in fighting it.

A recent study conducted by Jennifer L. Kraschnewski, M.D., M.P.H., assistant professor of medicine and public health sciences, Christopher Sciamanna, M.D., M.P.H., professor of medicine and public health sciences, and chief of the Division of General Internal Medicine, and colleagues in Hershey and at University Park, demonstrated the effectiveness of a web-based weight loss program that features successful strategies of others who have lost weight. The researchers designed a website called Achieve Together using data gathered from a previous study that identified key behaviors associated with successfully maintaining a weight loss of 30 pounds or more. The website matched users to role models closest to them in age, gender, and target weight, and allowed them to view their role models' strategies for weight loss, which they could then use to develop their own weight-loss plan. Over the course of twelve weeks, study participants who used the web-based program lost an average of 4.5 pounds more than members of a control group of people trying to lose weight on their own. As the researchers suggest, since web-based programs like this one entail minimal costs, they could prove to be a cost-effective way to promote and support weight loss.

As anyone who has struggled to change their health habits knows, it is easier to develop healthy habits early in life than to make significant behavior changes later on. That's why many of Penn State Hershey's efforts to promote wellness and healthy lifestyles focus on children's health. Even in children, chronic disease and health risk factors such as obesity are becoming more common, leading to tragic predictions that today's children may be the first generation of Americans with a lower life expectancy than their parents. Over the past three decades, the percentage of children who are overweight has more than doubled. In addition to causing physical health problems such as Type 2 diabetes - once rare in children - overweight and obesity can take a toll on children's social and emotional health.

Helping kids to embrace healthy lifestyles at a young age prepares them to continue making good health decisions and to enjoy healthier lives as adults. The Center for Nutrition and Activity Promotion (CNAP), through its nrgBalance program, reaches children and schools across Pennsylvania with programs that encourage balancing healthy eating with physical activity. CNAP provides school leaders with the resources and technical assistance they need to make schools a healthier environment for kids, including programs to promote walking and pedestrian safety, outdoor recreation, and healthy meals and snacks. Special events like "Go for the Greens" and "Apple Crunch" make trying healthy fruits and vegetables fun for kids. Though the nrgBalance program is primarily school-based, it recognizes the vital role that families play in the health of children, providing many online resources for parents so that the entire family can embrace the goals of eating healthy and becoming physically active. Since it was first launched in the 2003-04 school year, the nrgBalance campaign has reached nearly 2.7 million children in Pennsylvania.

Just as schools are often the best place to reach children, the workplace may be the best place to reach adults. Since Penn State Hershey is one of the region's largest employers as well as a leading provider of health care, we are well-positioned to set an example for other regional employers when it comes to workplace wellness and health promotion. In recent years we have stepped up our efforts in this area, introducing new programs and benefits for our employees, including smoking cessation programs, weight management programs, and reimbursement for fitness classes, just to name a few. More and more companies are investing in employee wellness, recognizing that healthier employees not only lead to lower overall health care costs - they also are happier and more productive.

Our efforts to promote health and wellness extend beyond our current patients and employees. To be effective and to reach as many people as possible, community-based prevention and health promotion efforts require creativity. The Pennsylvania Farm Show proved to be the perfect venue for Penn State Hershey nurses to raise awareness about high blood pressure, a common condition that often goes undiagnosed until it leads to other health problems such as heart attack, stroke, or kidney failure. At the 2012 Farm Show, over 1000 people had their blood pressures checked by Penn State Hershey nurses who volunteered to conduct outreach, and many others received other health information.

Penn State Hershey Dermatology's sun safety and skin cancer prevention efforts also epitomize creative approaches to promoting awareness and healthy behavior. While Penn State Hershey researchers are making promising advances in developing more effective ways to combat melanoma, the deadliest form of skin cancer, prevention is the best option of all. With that in mind, Penn State Hershey Dermatology has partnered with the Hershey Gardens at the Hotel Hershey to promote sun safety and skin cancer prevention. Visitors to the Gardens are able to use special shade umbrellas - specifically designed to shade out harmful UV rays that can cause skin damage and skin cancer - provided by Penn State Hershey Dermatology. Promoting and protecting the health of the community isn't just about encouraging people to take care of their own health; it can also include empowering and educating people to help others stay healthy. One excellent example of this can be found in the Penn State Hershey Heart and Vascular Institute's community CPR training event held at the Giant Center in February 2012. At the event, which was held in partnership with Hershey Entertainment & Resorts and with support from other Hershey entities, 300 community members received training in hands-free CPR, a potentially life-saving skill. The Heart and Vascular Institute also offers CPR classes on a regular basis for the public as well as for health professionals, along with many other classes aimed at helping people live heart-healthy lives.

The Farmers Market in Hershey, now in its third year, is yet another avenue for reaching the broader community with health education and health screenings. Like most farm markets, the Farmers Market in Hershey is an excellent source for local farm products, including a vast array of fresh, healthy fruits and vegetables. But more than that, each week the market features information and activities aimed at helping people lead health lives, including healthy cooking demonstrations, "Know Your Numbers" health screenings, and health and safety information from Penn State Hershey programs and community health partners. Danny George, Ph.D., assistant professor of humanities, has published research showing the beneficial health impact of health center-based farm markets. Across the nation, more and more academic health centers and community hospitals are embracing farm markets as an opportunity to promote healthy foods, support local agriculture, and provide health information and education to community members.

No matter how healthy the choices we make, illness and injury still sometimes occur. Nonetheless, from a public health and population health perspective, changing health behaviors can have a dramatic impact in reducing the incidence of preventable disease and disability. By keeping people healthier overall, we are able to reduce the toll of preventable illnesses and premature death - a toll that is measured in years of life lost, quality of life diminished, lost productivity, and escalating health care costs. Promoting wellness and preventing disease are not always easy - and unhealthy habits can be very difficult to break - but through our efforts we are finding ways to reach people in ways that can improve health. Prevention truly is the key to a healthier tomorrow.


Harold L. Paz, M.D.
Chief Executive Officer, Penn State Hershey Medical Center
Senior Vice President for Health Affairs, Penn State
Dean, Penn State College of Medicine