Reflection on Where the U.S. is Heading with Prevention: Fostering a Culture of Wellbeing in Our Communities, Corporations, and Care Settings

This presentation will describe nascent efforts to implement a culture of wellbeing in our communities, our corporations, and our care settings. This sea change is fostered by the realization that our current disease care system ignores almost all opportunities for both public health and clinical interventions that can prevent disease and promote better health. The linkage between wellbeing, health, and disease is very clear: The World Health Organization defines health as a complete state of physical, mental, and social wellbeing, and not simply the absence of disease.

The Affordable Care Act (ACA) is helping to foster this transformation to a culture of wellbeing. Under the ACA, more people have health insurance coverage, and their benefits are dramatically different than a generation ago. Today’s benefits cover not only disease care, and also health promotion and care. Thus, everyone covered by the ACA has a mandated disease prevention and health promotion benefit. Under this benefit, some core services are provided without co-pays or deductibles.

Key to implementing the culture of wellbeing are public health, population health, and clinical approaches that together address the social and physical determinants of health, positive health and mental health promotion, and disease prevention.  This presentation will offer a conceptual framework for introducing the culture of wellbeing, as well as operational examples of how it can be implemented in the field.

Current efforts in behavioral health to implement a culture of wellbeing cover a diverse range: peer efforts;  introducing wellness interventions in public sector services;  corporate efforts (such as those by Glaxo Smith Kline and Johnson & Johnson, to transform corporate cultures);  and initiatives to address negative social and physical determinants through public health interventions.

Behavioral health, when aligned with public and population health approaches, has an essential role to play in fostering the widespread adoption of a culture of wellbeing. This work can have very salutary effects for all of us.