The established idea of health care starts at the doctor's office and stops at the hospital.

But to effectively combat the rising tide of health care costs, communities have to reach people long before they walk through their health provider's doors. That's the message an envoy from Buchanan County returned with after spending the better part of a week in England earlier this month.

The United Kingdom's National Health Service (NHS) sent eight senior managers to Buchanan County in April to tour Heartland Health and study how Buchanan County has addressed wellness issues. The NHS then paid for seven people from Heartland and the community to visit the U.K. at the beginning of November.

Presiding County Commissioner R.T. Turner returned from that trip with two messages: Educational outreach on a youth level is key, and communities need to stop waiting for federal and state programs and take it upon themselves to solve the impending crisis.

Mr. Turner points out that by the age of 16, most people have a set belief system. The commissioner acknowledged it's important to provide incentives to get adults to the doctor for regular checkups and to extend services to seniors. But he said he believes the crux of the problem lies with children developing poor lifestyle habits and never deviating from them.

The child obesity rate in Britain actually has started falling recently, while it continues to rise in the United States. Some of the things the NHS has done is form strategic partnerships in its various communities with schools, hospitals, universities and sports teams. One example: Mr. Turner toured a health care facility housed in a pro soccer stadium during the November trip.

The goal is to eliminate the negative association with going to the hospital. Mr. Turner also visited a university complex containing more than two dozen soccer fields on which the school's teams practiced, as did the local pro team. But the facility is open to the public as well. Small projects like this use the appeal of sports and pro athletes' celebrity to ingrain good habits in impressionable youth.

In St. Joseph, Mr. Turner said he'd like to partner with Missouri Western, Northwest Missouri and even the Kansas City Chiefs when their training camp comes here next year in a similar capacity. He also said he believes the community needs to form a coordinated effort to open up its public facilities to the youth. It's tough to put down the controller and pick up a ball when all of the gyms and fields are locked up.

"You have to get the locks off, but you have to develop a program where it will be utilized," Mr. Turner said.

Another interesting idea Britain has tried is soliciting sponsorships for its failing schools. In one case, Mr. Turner saw a school in which a local hospital and university jointly invested. The hospital added classes about healthy living, while the university intervened with college prep for students who were 17 and 18.

In another instance, the British government took an area infamous for its drug dealing and planted a community garden. The garden provided fresh fruit and vegetables and even chickens for local residents who previously didn't have ready access to healthy foods. Part of the program also included education on how to prepare those types of foods.

And that's what Mr. Turner believes the United States needs to turn around this problem as well - not a sweeping national program, but small bursts of ingenuity on a local scale. The message of the conference was not that socialized medicine is the answer or the enemy.

"They realize their system isn't perfect, and they are trying to make some changes," Mr. Turner said. "That's where we're at with our health care system. Everybody realizes that something has to be fixed. For the uninsured, we are already paying for it in some way or another."

Locally, Mr. Turner touted the emPower Plant and Success by 6 programs as part of the community's response. The emPower Plant involves junior high students in problem-solving activities in the community, while Success by 6 provides children's educational materials for young parents who can't afford them.

"If this community would've waited for some national policy, it never would've happened," said Mr. Turner, who noted there is a direct correlation between one's education level and health. "Communities need to take ownership and work within the rules and funding they have.

"Local governments, businesses, health care, schools, universities, they all have to be a part of this and support whatever initiatives come out of these groups."

Mr. Turner plans to sit down with all the vested parties in the community to start forming the necessary collaborations to initiate additional programs.

"You don't just want to put them on a back shelf and say, 'Yeah, this was a good idea. Someday we'll get around to it'," he said. "We really need to start thinking about these things."

R.J. Cooper can be reached

at rjcooper@npgco.com.