This goal represents our efforts to help patients move from their current Health status to a better one. I like to say that we need to turn the “Health” dial of our patients to the right: toward better Health. We should not stop coaching and mentoring our patients when the disease ends or the pain stops. We need to ensure they have the tools to get back to a healthy lifestyle.When we look around, though, there isn't as much focus on Improving Health by health care providers as one might hope. Often, this is because we don't have enough time in a busy clinic to talk about getting better, beyond what it takes to restore Health.Unfortunately, in many cases, because we are silent when it comes to Improving Health, our patients are left to the often dubious claims of pseudo-medical, health, or exercise companies pushing the latest and greatest extract, diet, or home fitness routine.

Like the other 2 goals, Improving Health doesn't happen in our hospitals and clinics, it happens in the patients' Lifespace. If we are to help inform our patients so that they have the best opportunities for Improving Health, we have to think differently about our roles as health care providers. We have to talk about things that are important to Health and not just focus on the acute reason they are seeking care.

What are those things that are important to Health? It turns out that most of them are behavioral issues. In Army Medicine, we are focusing on 3 in particular: sleep, activity, and nutrition. While each has an environmental component that must be addressed to be successful, the most difficult component is behavioral change.

We have to rethink how we engage with patients, and how we instruct and coach them toward better Health. For the vast majority of these lifestyle-induced conditions, the answer isn't simply more pills and procedures—it's not more metformin for diabetes; not more toe or foot amputations for peripheral vascular disease; and not more imaging, injections, and surgery for chronic low back pain. The answer lies in modifying the thoughts, choices, and behaviors of our patients well in advance of any onset of pathology. An overview of some of the tools we can use to improve Health is included in this month's journal and is titled “Key Enablers to Facilitate Healthy Behavior Change: Workshop Summary.”1

We need to start a conversation about Health. One where maintaining and improving Health receive equal emphasis with Restoring Health. One where every medical intervention addresses the challenges of environment and human behavior—and their effects on Health and healing.This won't be easy; if it were, it would have been done long ago. So let's get on with it—start the conversation about Health.

With kind regards

Sophia

Managing Editor

Journal of Community Medicine & Health Education