What does a fire hydrant have to do with population health? More than you'd think.

As a high school student in Indianapolis, John Lyons, Ph.D., took a summer job painting fire hydrants for the water company. "I got paid only $1 per hydrant, but I figured out a way to be fast and efficient, so I could paint about 20 in an hour," he said. His plan worked: Lyons racked up about $13,000 in four years. 

That eye towards building innovative systems that are efficient and productive propelled John Lyons on a career path that could ultimately improve population health in Kentucky and beyond.

The health challenges faced by Kentuckians are daunting. Each year, thousands of preventable deaths occur from diseases such as stroke, heart and pulmonary diseases, substance abuse, diabetes, and cancer. In the Appalachian region – where the population, in general, is chronically underemployed, less educated, and has limited access to resources like affordable transportation or healthy foods – the situation is even more dire: the largest decreases in life expectancy in the U.S. are currently in eight eastern Kentucky counties.

Yet in the challenges faced by Kentucky, Lyons sees opportunity. As the director of the Center for Innovation in Population Health (IPH), established last fall at the University of Kentucky, he's leading a large-scale initiative to integrate the public and private sectors – researchers, health care organizations, government agencies, and communities – in a comprehensive program that will reduce health disparities for all Kentuckians. If this initiative succeeds in altering the landscape of health in Kentucky, it will produce models that can be implemented across the nation.

“Kentucky provides a unique environment for this initiative, with some of the nation’s poorest health outcomes, many of them rooted in challenging social, economic, and environmental conditions. While eastern Kentucky is the epicenter of the ‘deaths of despair’, solutions to the excess mortality risk in Appalachia have been elusive,” said Donna K. Arnett, dean of the College of Public Health. "John and his team bring a wealth of experience to the challenge. We're very lucky to have him."

Lyons and his team came to Lexington in September 2019 from the University of Chicago. Based in the College of Public Health, the IPH will bring together experts from multiple sectors with the goal of improving population health, well-being, and equity.  

To achieve this ambitious goal, Lyons says, "we'll have to think differently."  

Lyons, who also is professor in the Department of Health Management and Policy, is embracing that need for innovation by involving every single college at UK in the project. He offers the theater department as an example: they are exploring the use of drama as a therapeutic approach to wellness.

To achieve what Lyons calls "a culture of health,” the IPH will emphasize four strategic goals: making health a shared value, fostering cross-sector collaboration to improve well-being, creating healthier and more equitable communities and strengthening integration of health services and systems.

"How do you create healthy people? Help them develop meaning in their lives," Lyons said. His goal for the center is to identify and implement what he calls "pathways to meaning." 

"If we can strengthen relationships in the cultures of family, work and outside work, i.e. being involved in something larger than yourself, we enhance health in its broadest definition."

According to Lyons, one of the most intriguing questions and a key to improving those pathways lies in a shift from a model of compliance management – punishing people when they don't follow the rules – to a model of aspirational management, where people are rewarded for embracing a shared desire to be helpful.  

"We spend a lot of time and resources trying to determine why people commit crimes," he said. "The more telling question, I believe, is why people DON'T commit crimes. Useful answers most likely lie there." 

To complete its work, the IPH will embrace a concept developed by Lyons called communimetrics – a communication theory of measurement in human services settings. 

"Numbers alone can't capture the full picture," Lyons said. "Every situation has multiple stories from multiple points of view. How do you synthesize all of those stories into a cohesive and actionable narrative?  We have assessment tools that help quantify what is essentially a qualitative process."

With some of the nation's poorest health outcomes, Lyons said Kentucky is one of the best places for his team to be.  

"But we also want to be here," he emphasized.  "UK has a uniquely collaborative environment among its colleges, which is an essential propellant of innovation."