Be The Change You Want to See

Something wonderful happened in Madisonville a few months ago.  After 16 years, the Salvation Army re-opened their homeless shelter in their McCoy Avenue building.

In the previous articles I’ve written about community health, I’ve stressed that one of the reasons why we can, if we so choose, change the future of our region and everyone who lives in it, is that we have a lot of resources already in place. A homeless shelter for men and women was one crucial piece that was missing, but to keep this asset open will require the ongoing support of the community. Our journey to a new culture of health requires that we, as a community, commit to it.  We can’t just say it’s a good thing.  We can’t just agree we want it.  If we are going to make it happen, we have to do things, and we will have to keep doing them.  Everyone has to contribute in whatever ways that they can.  Maybe you can afford to help support our community organizations with money.  Maybe you can contribute your time.  Just find a way to help someone, somewhere, and keep doing it.  That is the way meaningful change happens.

As I’ve mentioned, about 80% of the factors that determine individual and community health don’t have anything to do with health care as most of us think about it.  It has to do with how and where people live.  It has to do with education, job skills, nutrition, and access to transportation. It has a lot to do with personal safety and security.  It also is about choices—bad choices, good choices and, quite often, lack of choices.  When people are in situations where they have no options, or where all the options are bad, the world can be a very harsh place.

Again, I stress that this is not the opinion of some bleeding-heart liberal.  I’ve been a moderate conservative all my life.  I do feel for those in need, on a human level, as almost all of us do.  However, I also realize that we can never build the community we want, we can never become the economically vibrant place that has a bright future that our kids will want to be part of, if we continue to let so many of our people get left behind because of poor health.  Every single person who lives here, from the youngest to the oldest, represents human potential and if we continue to leave that potential untapped, it just means that we, as a community, are weaker and less productive than we could be.  I should care about everyone else, just because it’s the right thing to do, Golden Rule and all that.  But even if that isn’t a good enough reason, I should care about everyone else because it’s in my own best interests to care for them.  If THEY do better, then the COMMUNITY does better.  If the COMMUNITY does better, I will be better off.

The math is very simple, and we can use the homeless shelter as an example.  Let’s say it costs $5,000 a month to operate the shelter.  For the sake of the math, let’s say they average 10 people a night, 30 nights a month.  That is 300 people-nights.  That means each people-night costs about $17.  For that, people not only have a warm and safe place to sleep, they also receive nutritious meals, the opportunity to wash their clothes, a hot shower, proper sanitation and, not inconsequentially, the support of other people.  That last bit is way more important than you might think.  It’s a big part of the overall equation of individual and community health. When people know other people care about them, they are much more likely to extend a hand than a fist.  Let’s say that the availability of the homeless shelter prevents one homeless person from contracting an infection, and they don’t end up in the Emergency Department.  That one hospital visit would almost certainly have cost more than the entire month of costs for the homeless shelter.  The hospital would have had to write off the cost of the indigent care, and that lost revenue means that the hospital has fewer resources to provide services to the community.  Let’s say the shelter keeps someone out of jail.  More costs for police, courts, and the jail are saved.  Then there’s the big payoff.  If just one person coming through the shelter gets the help they need to turn their life around, gets some job training, gets a job and joins the ranks of productive workers, not only are we saving the money that would have been spent to deal with the consequences of his homelessness, he actually becomes a net contributor to the community and the tax base.  I’d say that is the very definition of a win-win.  I’ll support the shelter and any other initiative that leads to that kind of community (and human) benefit, all day long.  And you should, too, whether you do it for humanitarian reasons or economic ones, or both.  It’s just the right thing, and the smart thing to do.  Like I said, it’s a win-win.

I can’t make the changes we need to transform our community happen.  Baptist Health can’t make it happen.  The Salvation Army can’t make it happen.  Habitat for Humanity can’t.  Breaking Bread can’t.  Pennyrile Allied Community Services can’t.  The school district can’t.  The state Department of Health and Family Services can’t.  None of us can do it alone, but we can do it together.

I was fortunate enough to be invited to a meeting of county leaders not too long ago, and I’m convinced that everyone in that room, elected and otherwise, has a sincere desire to help make their communities and the region better.  There are a lot of issues they need to deal with, just to keep things working, but I think they are people of vision who want what we all want.  Let them know that improved community health matters to you, and then make a move of your own.  Whatever your circumstances or abilities, there is something you can do.  Start by taking a small step to improve your own health.  Eat one really healthy meal a week.  Get a little exercise.  Then pass it forward.  Read to a kid.  Look in on your elderly neighbor.  Volunteer.  Clean up that empty lot.  It’s not like anyone needs to look hard for something they can do to make a difference.  Just do it.  And then keep doing it.  Make the change you want to see happen.