December 25, 2007

Health As A Social Activity

In the past month, I have had the privilege of immersing myself in a number of health-based dialogues. As we think about how to get people to engage in healthy behaviors, we must understand the importance of the social networks of which people are a part in driving behavior change.

At Pitney Bowes, we start with the realization that the most important social network is the family unit. If we can reach the individual who makes health-related decisions for the family and persuade that individual to drive healthy behaviors in the family, we have gained a great deal. That’s why we did a home mailing in October to urge our employees and their families to get flu shots.

The workplace peer group is the second most important influence because individuals typically spend more waking hours at work than anywhere else. That’s why we have emphasized creating a culture of health in the workplaces we control.

The next most important social network influence is the social and community peer group. For example, we know that many people, particularly African Americans and evangelical Christians, are heavily influenced by their church leaders. We want them to send strong messages regarding health, and we need to find strategies as a society to take advantage of their power. There are pilot programs, including one in Maryland, that are trying to create health partnerships with faith-based organizations.

The Wellsphere blog cites a New England Journal of Medicine study that reveals that weight loss can spread through social networks of friends and families. The blog is an extension of, an online community launched by Stanford graduates to help people help each other live healthier. I am encouraged by these types of initiatives.

We also know that, for young people, the school is the equivalent of the workplace, in terms of its pervasive influence on their life, and the opportunities to deliver health-related messages. I have specifically believed that schools need to drive home certain messages about nutrition and fitness, and to give students an opportunity to eat healthy food and to exercise during the school day. A recent editorial in the Orlando Sentinel takes a strong position on the need for more encouragement of healthy eating in schools.

I also think that young people are influenced by people closer to their age and life experience. Young fitness trainers at a gym are very influential advisers to teenage boys, and older, successful, popular teenagers, particularly girls, can influence younger ones.

Social networking Web-sites, such as MySpace and Facebook, also play a very prominent role in peer group influence, especially among teenagers. There exists a significant opportunity to reach millions of people with health care information by tapping into these resources.

Finally, there is the group of individuals with similar health-related issues. Some of these groups form naturally within workplaces or communities, especially when someone first learns he or she has a disease or illness and reaches out to others who have a similar condition. Others are forming as a result of web sites, like the Revolution Health web site, which does a superb job creating and nurturing health-related social networks. Blogs are also working to encourage sharing of information about health issues. Some examples include the Parkinson’s Blog Network and the Daily Strength Network, which offers support groups for 500+ health issues.

We have to keep privacy issues in mind, but we need to ask the people who have particular interests relative to health whether they want to have their condition kept private, or whether they want someone to help them find support resources. Giving up a right to privacy is a patient’s decision and the right of privacy is sacred, but privacy advocates sometimes do not understand that some people with a particular disease may want others to know about their condition so that they can get help. Urging individuals with particular medical issues to share their situation with others they trust can be very positive.

As an employer, we believe that respecting the privacy and security of our employees’ health and other sensitive personal information is essential to maintaining the bond of trust we have with them. At the same time, we also know that they are often better off if they confide in trusted peers and get help that we or the others in whom they have previously confided cannot give them.

One of the reassuring aspects of being forthcoming about any medical condition is the inevitable learning that an individual is not alone in having the condition, in the emotions surrounding it, or in the challenges of coping with it. Generally, someone out there has found answers better than those with which the individual starts. Also, support systems are generally invaluable. Alcoholics Anonymous developed this methodology over a long period of time with considerable success, and it has played a significant role in getting those who join its program to understand that they have a chronic disease that needs to be managed actively, and that can be managed more effectively as part of a social network.

The government, large insurance companies, and major medical care providers are also critical players in our health care system, and patient-centered responsibility is also essential, but let’s not forget the power of social networks.