Oregon | 50 states of population health

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JIM GUYN, MD. Senior Vice President of Population Health, St. Charles Health System (Bend, Ore.)

On the top challenge

"Only 11 percent of health is based on medical care, [so] we really have to address the social determinants of health. We as a medical system are responsible for 80 percent of the cost, but we impact again 11 percent. That isn't a very good equation. We have to figure out how to be less expensive, but the way to do that isn't by telling the newest technology that's really expensive that we don't want you. It's really trying to cut down the number of people who end up with the need for acute medical care, particularly hospitalizations. We really need better ways of addressing social determinants of health."

On the hospital's response  

"One of the things we're looking at is trying to create America's healthiest community together. And that expression — together — is intentional. We know we are not experts in housing or food shortage issues, among a whole host of other social determinants. But we know we have a role, so we are working with the Central Oregon Health Council that does get involved in those things. And we have a seat at the table, and we're actively involved in our community in trying to change some of the issues that so adversely affect everybody's health.

I'm a family practice physician by training. It's difficult when you know you have somebody who needs some sort of medication, and you prescribe that medication but they don't fill it because they don't have any food, and they need to spend their money on food and not the medication. That's really a bad equation. We have that all the time here in America with the way we've structured our health system. So we really need to figure out better ways to help people with some of their basic necessities — education, housing, food, those kinds of things — so we can cut down the number of people who really need acute medical care."

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