Missouri’s health challenges reflect larger systems

Column by Rob Jones, director of Integrated Marketing Communications, University of Missouri Extension; Sarah Davis, maternal health specialist, MU College of Health Sciences; Jollyn Tyryfter, assistant extension professor in nutrition and health education, MU College of Health Sciences; Chiquita Chanay, education director, Community Health Engagement and Outreach, MU Extension; Claire Wolff, education director, Community Development and Regional Economic Development, MU Extension; Michelle McDowell, senior program coordinator, Community Health Engagement and Outreach, MU Extension.

Missouri faces several persistent health challenges. For example, data from the United Health Foundation shows that rates of chronic conditions such as heart disease and lung disease remain higher than national averages. Life expectancy in Missouri lags behind the national average by several years, according to the U.S. Centers for Disease Control and Prevention.

Improving access to health care is an important part of addressing these challenges. Doctors, hospitals and health professionals play a critical role in diagnosing illness, managing chronic disease and helping people live longer, healthier lives.

At the same time, health outcomes often reflect the environments and systems people live in. Communities shape the opportunities people have to stay healthy. When those systems support healthy living, health outcomes improve.

Health is shaped long before the doctor’s office

Public health research shows that medical care accounts for about 20% of overall health outcomes. The remaining 80% is shaped by the conditions people experience in their daily lives.

This means health is largely determined long before someone ever visits a clinic.

Where people live, work and connect with others has a huge influence on health. Access to healthy food, stable housing, safe places for physical activity, reliable transportation and strong social relationships all influence long-term well-being.

These factors are often called the social drivers of health.

They help explain why two people with the same doctor and the same insurance coverage can experience very different health outcomes depending on the environments they live in.

Systems influence health

Because health is shaped by so many factors, improving health means strengthening the systems that influence daily life. Some of those systems are directly connected to health, such as health care access and public health programs. But many others are not always part of traditional health conversations.

Transportation systems influence whether people can reach medical appointments, grocery stores and recreation spaces. Community design influences whether neighborhoods have sidewalks, parks and safe spaces for physical activity. Broadband access can determine whether residents can use telehealth services or access educational resources.

Social connections also play an important role. Communities with strong social networks and civic engagement tend to experience better health outcomes. People who feel connected to neighbors, family and community organizations often experience lower stress and stronger resilience during difficult times.

In many ways, the systems that shape daily life are also the systems that shape health.

Health in all policies

Recognizing these connections has led to an approach often called “health in all policies.”

The idea is simple. Decisions made across many sectors influence health outcomes, even when health is not the primary focus. Policies related to housing, transportation, economic development, education and community planning can all affect whether people have opportunities to live healthy lives.

For example, creating walkable communities can encourage physical activity. Improving food access can support healthier diets. Expanding broadband access can improve access to healthcare and education.

When communities consider health in these decisions, they strengthen the conditions that support long-term well-being.

Strengthening systems across Missouri

University of Missouri Extension works with communities across the state to strengthen these systems. MU Extension faculty partner with local leaders, schools, community organizations and residents to identify barriers that affect health and to develop solutions that reflect local priorities.

Much of this work focuses on policy, systems and environmental approaches that help communities create healthier environments. This might include improving access to healthy foods, supporting opportunities for physical activity or strengthening community partnerships that build social connection.

MU Extension also works directly with residents through research-based programs that promote nutrition, physical activity and healthy aging. These efforts recognize that improving health requires more than treating illness. It requires strengthening the environments and systems that shape daily life.

Building a healthier Missouri

Missouri’s health challenges did not develop overnight, and they will not be solved by health care alone.

Improving health requires both expanding access to health care and strengthening the environments that shape daily life. When communities strengthen those systems, they create environments where healthier choices are easier and more accessible.

And when those systems improve, so will health outcomes across the state.