Mountain Biking, Hot Tubs, and Breast Cancer

Marin consistently ranks as one of the healthiest counties in the United States. In a national study conducted by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, the affluent San Francisco suburb received top marks across a range of factors affecting individual health, including premature death, obesity and smoking, as well as social and economic factors such as high school graduation rates, incidents of violent crime, and prevalence of fast food restaurants.

Yet despite the flourishing individual health of the county, Marin’s rate of breast cancer is approximately 15 percent higher than all other California counties, and much of the country as well. Recent studies have linked the elevated rate of breast cancer to alterations in vitamin D receptors, increased intake of alcohol, and genetic contributions from Ashkenazi Jewish populations, but the studies have been inconclusive landmarks along a frustrating journey towards understanding why this disparity has persisted for more than a decade. Furthermore, with our Co-Founder Matthew Holt moving to Marin in the near future, we have to wonder whether his wife’s medical care will include breast cancer-specific preventative advice, education, or support offered by either community health organizations or health care providers.

The breast cancer data in Marin is difficult to understand, but the situation there is by no means unique. Community level health data consistently reveals health disparities that would not be obvious upon examining a given population at an individual level. For example, African American women experience a lower incidence of breast cancer than Caucasian-American women, but their mortality rates are paradoxically higher. The 5-year US survival rates from 1995-2000 for African American and caucasian breast cancer patients were 75% and 89%, respectively. For all the technological advances we’ve made in the quality and delivery of care, our understanding of why these disparities exist is minimal and our efforts to eliminate these disparities have been superficial in nature — think free blood pressure screenings at small scale community health fairs. We need to do more.

Public health and personal health have traditionally lived in two separate worlds. Especially at the institutional level, there has not been much intersection between the way we manage the health of populations and the health of individuals. However, from our vantage point, we’re beginning to see the disruption of these two worlds by the rise of what we call Health 2.0: a set of adaptable, beautifully designed, web and mobile tools and technologies that use data to drive decisions. It is these tools that have added a third dimension of self-management, communication, and intelligent decision making that is driving the convergence of the hitherto separate personal and public health realms. For example, one recent study from The Ohio State University found that integrating community data into an individual’s EHR maximizes the potential of secondary use of EHR data to study and impact obesity prevention and other significant public health issues. The flow of data goes the other way as well with personal health tracking tools like Propeller Health’s asthma trackers and Kinsa’s smart thermometer health map feeding into a community level understanding of health patterns, air quality, and the general spread of illness.

The Healthy Communities Data Summit represents a physical convergence of these two worlds. Major providers like Kaiser Permanente will present side by side with innovative organizations like Code For America, and government officials from the California Environmental Health Tracking Program and Covered California. This rare combination of thought leaders and change makers in a single room promises to drive meaningful engagement over the hard data and issues that can help us connect the dots between health at an individual level, and the health of a community as a whole. Please come join us as we build the mechanism by which these two worlds are going to connect.

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