For much of our country’s history, medical services have been offered in the home and local community. Most people could not afford to travel for treatment. Instead, medicine came to where they lived and worked. Doctors made house calls. Families could get ailments diagnosed at their local pharmacy or apothecary. The treatments might have been primitive, but they were very convenient.
Later on, healthcare evolved into a centralized model. This model expected people to go to a specific location, usually a hospital, for everything from broken bones to pregnancy counseling. Healthcare stepped away from the community. The burden fell on patients to bring themselves to medical services.
Now the pendulum is swinging again. The modern medical system is embracing a hybrid model of distributed care. Here, hospitals and emergency rooms still have their place. However, many health services are now offered in the community through neighborhood urgent care centers, mobile services such as dialysis vans and outreach programs popping up where people gather. The rise also of in-home care and monitoring and the growth of telemedicine, advance this trend.
This change in how medical services are delivered is driven by many economic and technological factors, all of which were accelerated by the Covid-19 pandemic. However, underlying all of this is a simpler truth: health doesn’t happen in the hospital. It is built one brick at a time during everyday life and in the community. Thus, the centralized model of healthcare is yielding to the distributed model.
Modern Health Takes a Holistic Approach
How does the community influence health? With the obesity epidemic for example, the National Institutes of Health has done a lot of research into why people struggle to maintain a healthy weight. Some common reasons include not learning healthy eating habits from their family or school.
Obesity can flow from living in a food desert where grocery stores are far away but fast food restaurants are everywhere, and where no safe outdoor exercise spaces or affordable fitness centers exist. And with no affordable community programs for depression or addiction, people may self-medicate with food.
The busy nature of modern life plays a role also, as working people struggle to care for elderly parents and young children, while also holding down a job, leaving no time for home-cooked meals and exercise. Some people simply can’t arrange complicated public transportation schedules to get hormonal issues treated at a distant hospital.
All of these factors have one common root: their community isn’t supporting wellness of mind and body. The yearly ‘healthy eating’ lecture from their doctor cannot overcome 365 days of obstacles to a balanced lifestyle. It will take a grassroots, community-focused approach to improve patient health.
Health Services are Embedded in the Community
Getting health services in a centralized setting is quite a burden for people with tight budgets and those who live in rural areas. They need to find childcare, take the morning off from work, navigate public transport schedules, and sit in a waiting room hoping they’ll be seen on time. If they need a follow-up visit, all of these steps have to be repeated.
Moving some services into the community gives people more options. Doctors can make virtual home visits by video call. Patients can drop into an urgent care clinic with extended hours. Mobile dialysis units literally drive life-saving technology into the areas where they’re most needed and least accessible. And the immunization tents popping up at parks, shopping centers and county fairs bring preventative care to the public instead of putting the burden on people to come in for care.
In the long run, community outreach programs don’t just improve health. They empower patients. Medical technology is rapidly evolving, and many people don’t know the true scope of their options. They may learn about affordable, in-community treatments through word of mouth. With this knowledge, they can make the best choices for themselves and their families.
Technology Connects Us
In recent decades, advances in technology have made the distributed model possible. They have also expanded the boundaries of what counts as your local community. Fast, affordable internet even in rural places means that a doctor’s visit is just a video call away. People with busy or unpredictable schedules can still squeeze in half an hour to get an expert opinion in their own homes.
Meanwhile, life alert systems and other health monitoring devices have taken the burden off of caregivers and given many patients the option of staying at home. This allows retirees and seniors more easily to plan for aging in place. Their vitals can be monitored remotely and their patient chart updated in real time. If someone worries about an error message popping up on the device, the nurse is just a text away. Patients are still connected to their healthcare team even though they aren’t within the same building, city or county.
Medical software loosely grouped under Artificial Intelligence (AI) is another tech advancement with tremendous potential to improve health in the community. Some software programs work as sophisticated screener apps. Health workers out in the field can quickly screen people for common conditions such as hearing loss. Patients concerned about their symptoms can interact with these programs and forward the results to their therapists. AI works to erase some walls between people and medical practitioners, widening the net of physical and mental healthcare.
Bringing Healthcare to the People
Health organizations across the country are committed to giving high quality, patient-centered care. Ironically, that means care that doesn’t only focus on the patient. The home environment and community are vital for preventing and treating illness. In the big picture, healthy people and healthy communities are one and the same.