Something as fundamental as a person’s health and well-being is another effective tool to averting epidemics and pandemics.

No one has immunity to COVID-19, nor is there a vaccine today to give us that immunity. While all adults are at risk for contracting the virus (the risk for children is unclear), its impact will not be equal. Most disturbing is that the virus is saving its worst for the most vulnerable among us: the poor, homeless, elderly, and those with chronic disease(s), many of whom have no insurance or are under-insured. Experts say that people with a healthy immune system should not worry about COVID-19. Our first line of defense against this virus is personal health and good public health practices including: washing our hands; avoiding touching our hands to our face; and coughing into our sleeve or elbow, not our hands or the air. This is all good advice. However, we live in a country where people’s wealth, quality of life, health, and well-being varies greatly. It impacts people’s ability to quickly embrace measures that will ensure all our safety. A few years ago, I attended a meeting in a low-income, inner city hospital to understand the cancer experience of the patients and families. The administrator said that his patients don’t see cancer as the worst thing that could happen to them. Today, in the midst of COVID-19, some people with cancer have told us that the pressing issue on their mind is their current health crisis not the virus. We forget that so many are trying to just hang on for their own survival. So while the debate rages on about healthcare, COVID-19 might just be the very thing that finally forces us to do the right thing.

In 2019, the Annual Review of Public Health looked at whether or not happiness leads to better health. The report identified a link between happiness and a decreased risk of mortality; it is also associated with a reduced risk of specific diseases including stroke, diabetes, high blood pressure and arthritis. In oncology, research suggests that psychosocial interventions can reduce feelings of isolation and increase feelings of hope and activation, which can improve adherence to treatment, outcomes, and quality of life, while lowering costs of care. Happiness matters, and it is influenced not just by what we do as individuals, but what our country decides to do. In an annual global survey called the World Happiness Report, produced by the United Nations Sustainable Development Solutions Network, 156 countries were ranked by how happy their citizens perceive themselves to be. In its 2019 survey, the focus was on happiness and the community. Factors contributing to the top scoring countries were places where people experienced a strong social support system (sense of community), and where governments were perceived as more effective; enforced the rule of law; had better regulation; controlled corruption; and invested in certain ways, such as more on healthcare and less on the military. It also helps to live in a country with more political stability, less violence, and less conflict. The report suggested that overall confidence in government goes hand in hand with a satisfying life. The United States did not make the top 10. In addition, the report highlighted disturbing trends in declining health, mental health, and addiction, supported by the recent declines in life expectancy.

When elected officials say they care about American citizens, check how they prioritize funding. They should be advocating for investing in the things that ensure that everyone can contribute to the country’s success, like people’s health, well-being, and happiness. If we believe that the greatest resource this country has to offer is our people, then we need to invest in them.

In addition to systems level change, work has to happen locally. Community-based non-profits are essential on the front lines, providing culturally relevant services that support people where they work and live. It is important that they remain funded by the public and private sectors. In the case of COVID-19, these organizations see people every day in the community. They can be instrumental in helping people stay aware and use healthy practices; and identifying people at risk or affected before they choose to visit a doctors’ office or emergency room. Should the healthcare system become overburdened, these organizations can be the lifeline to those in the community. When there isn’t an emergency, they can help individuals embrace healthy lifestyles to prevent disease and illness; and deliver supportive services during and after an illness strikes. The healthcare system and insurance cannot address all preventative and supportive care, we need a whole-community approach.

Prepared at 3:00 p.m. on Monday, March 16, 2020.

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