County's health officer looks for vital, vigorous partnerships

Stanislaus County faces steep public health challenges in fighting asthma, encouraging healthy eating and tackling heart disease.

Dr. John Walker, the county's public health officer, is eager to try new partnerships that could put a dent in each of those illnesses and help Stanislaus climb off the bottom of the list in statewide wellness rankings.

He spoke with The Bee last week about his approach to building community relationships that stimulate residents to make healthful choices.

Here are excerpts from that conversation. The full audio interview is available with this story at www.modbee.com.

Q: Why does the San Joaquin Valley experience higher incidences of several categories of chronic disease than other parts of the state?

A: It's a reflection of a lot of different variables. I guess you can call it our regional ecology. But it's not just about the individual. It's about what we call the social determinants of health, issues like poverty, educational attainment, employment, air pollution, housing costs -- the broad determinants of health.

Q: What sort of strategies can the county use to improve the situation?

A: I'm excited about that because this is what I call 21st- century public health. I started out 36 years ago in the Centers for Disease Control in Atlanta, and back then, in 1972, we gathered all the statistics from all over the country and they came to us and we analyzed them and we sent out policies. It was sort of top down. We're much more collaborative now. ... So now when we approach the strategies, the social determinants of health, we do it collectively -- not just, "We know the answers and we're going to tell you what to do."

Q: The county has had success in dealing with aspects of infant mortality. What led to those outcomes?

A: Probably our greatest success is with the improvements in black infant health. Back when I started, our county was 55th out of 58 counties. That's pretty awful. Currently, we're ... 43rd, so in a period of seven or eight years, we've had significant improvements.

It was not a purely medical model. We formed a black infant health task force. One of the pastors from west Modesto was our vice chair and we had a pediatrician who was our chair, and we had a lot of community participation.

The community started talking about it. Pastors started talking on the pulpit. ... The community just got energized.

Q: How can the county get people to change the way they live and the choices they make?

A: I would get a Nobel Prize if I could answer that easily, and I'm not going to get a Nobel Prize right now. I will share that we are seeking to emulate one of the most successful models in American history, and that's the initiative to reduce cigarette smoking.

How was it done? It wasn't done just by nagging people. It was done by systemic solutions. It was done by policy changes. It's not OK to smoke in a restaurant. It's not OK to smoke in most businesses. You don't have the machines anymore. It was policy change.

Our initiatives are more now focused on what are the environmental changes we can make. The reality is our county is set up for a car. It doesn't encourage you to walk. That's not good for exercise. Diet -- we have as a county, one of the highest ratios of fast-food restaurants and convenience stores to full-service supermarkets and farmers markets. You'd think here in the vegetable capital of the United States, it wouldn't be so. But it is. We have a lot of urban ills.

Q: Air quality has been an issue with the wildfires around Northern California. How can people protect themselves when the valley air threatens their health?

A: The best thing that your readers and listeners can do is look at your paper every day and right there next to the weather forecast, look on the right side and you will see the air quality index and the projection. That just needs to be an important habit. As far as what people can do to protect themselves short term, be aware of who the highly sensitive groups are. Those are very young children, persons with chronic lung disease, persons with cardiac disease and especially children with asthma.

Bee staff writer Tim Moran can be reached at tmoran@modbee.com or 578-2349.