1 of 28

GETTING HEALTHY TOGETHER: �THRIVING IN COMMUNITIES

AMY B. LOCKE, MD, FAAFP

PROFESSOR AND CHIEF WELLNESS OFFICER

UNIVERSITY OF UTAH HEALTH

2 of 28

What does it mean �to be well?

3 of 28

THE CONTINUUM OF HEALTH

Poor health

Optimal health

4 of 28

WHO WELLNESS DEFINITION

Wellness is the optimal state of health of individuals and groups. There are two focal concerns: the realization of the fullest potential of an individual physically, psychologically, socially, spiritually and economically, and the fulfillment of one’s role expectations in the family, community, place of worship, workplace and other settings.

World Health Organization, accessed October 30, 2006

5 of 28

University of Wisconsin

6 of 28

PREVENTION IS THE FOUNDATION

High risk/cost

intervention

Early, lower risk treatments

Stress management

Health behaviors/environment

7 of 28

PERSONAL WELL-BEING: FOUNDATIONS OF HEALTH

  • Nutrition
  • Physical activity
  • Sleep
  • Connection
    • Self (self awareness)
    • Community
    • Meaning and purpose

Resting State

Stressor

Manage stress

8 of 28

Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health

Economic Stability

Social and Community

Neighborhood Built Environment

Access Quality Healthcare

Access Quality Education

9 of 28

Building the Foundations of Health

©UNIVERSITY OF UTAH HEALTH

10 of 28

A healthy diet, regular exercise and not smoking can eliminate 80% of heart disease and 70% of some cancers.

Willett; Eat, Drink and Be Healthy; 2005

11 of 28

Date of download: 3/28/2017

© The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Leading risk factors for disease-related death and disability-adjusted life years in the United States, 2010. �

12 of 28

NUTRITION: WHAT IS A GOOD DIET?

13 of 28

MEDITERRANEAN STYLE DIET

  • Emphasis on fruits and vegetables
  • Plant proteins and fish over other animal proteins
  • Whole grains (coarsely ground)
    • Low glycemic index
  • Healthy fats
    • High omega-3 and monounsaturated fats
    • Low omega-6 and saturated fats

1. de Lorgeril et al. Circulation 1999 2. Esposito et al JAMA 2004 3. Esposito et al. Endocrine 2016

©UNIVERSITY OF UTAH HEALTH

14 of 28

15 of 28

Barriers and Opportunities for Healthy Eating

Afshin et al. 2014

Global

Governmental

Agriculture, industry, market

Community Environment

Sociocultural

Individual

16 of 28

PHYSICAL ACTIVITY

17 of 28

DIABETES PREVENTION PROGRAM

  • Walking superior to metformin; NNT 6.9

Guidelines evidence

Knowler et al. NEJM 2002

©UNIVERSITY OF UTAH HEALTH

18 of 28

SLEEP

19 of 28

SLEEP

  • Cognitive Behavioral Techniques1,2
    • Education (sleep hygiene)
    • Address anticipatory anxiety and coping skills
    • Relaxation
    • As effective as meds but last longer

1. Smith et al Am J Psych 2002 2. Morin et al JAMA 1999

©UNIVERSITY OF UTAH HEALTH

20 of 28

CONNECTION

21 of 28

MINDFULNESS

Bringing

non-judgmental awareness to the present moment

22 of 28

Connection

Thriving

“I define connection as the energy that exists between people when they feel seen, heard, and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.”

- Brené Brown

23 of 28

What is one strategy you have used to help you eat healthier, be more active or get more sleep? 

©UNIVERSITY OF UTAH HEALTH, 2017

24 of 28

STRESS

Photo by Aarón Blanco Tejedor on Unsplash downloaded 9/17/2020

25 of 28

FOUR CAUSES OF STRESS INJURIES

Life threat

Loss

Inner conflict

Wear and tear

A traumatic injury

Due to the experience of or exposure to intense injury, horrific or gruesome experiences, or death

A grief injury

Due to the loss of people, things or parts of oneself

A moral injury

Due to behaviors or the witnessing of behaviors that violate moral values

A fatigue injury

Due to the accumulation of stress from all sources over time without sufficient rest and recovery

Shanafelt et al. Caring for the health care workforce during a crisis: Creating a resilient organization. AMA STEPS Forward. 2020. https://www.ama-assn.org/system/files/2020-05/caring-for-health-care-workers-covid-19.pdf

26 of 28

STRESS RESPONSE CYCLE

Resting State

Stressor

Manage stress

©UNIVERSITY OF UTAH HEALTH

27 of 28

COMPLETE THE STRESS RESPONSE CYCLE

  1. Physical Activity

  • Breathing

  • Positive Social Interaction

  • Laughter

  • Affection

  • Cry

  • Creative Expression

Burnout: The Secret to Unlocking the Stress Cycle by Emily Nagoski Ph.D. and Amelia Nagoski, D.M.A

28 of 28

Discussion

©UNIVERSITY OF UTAH HEALTH