Michael Dowling is president and CEO of Northwell Health. He previously served in New York State government for 12 years, including seven years as State Director of Health, Education, and Human Services and Deputy Secretary to the Governor.

In a recent LEADERS Magazine interview, Dowling explained the importance of arriving at a suitable definition for health and how such a definition can inform the ways health systems affect change.

You have to start with the adequacy of government reimbursement, as mentioned earlier. It is very difficult to get people or organizations to fully commit and sustain the effort when the payment does not cover the cost — when you end up in continuous financial deficit. This must be recognized and addressed.

Despite that, however, we at Northwell are partnering with community and religious leaders and developing joint projects to address many of these issues. It is part of our mission. We are working with high schools, providing mental health and nutrition services, providing educational scholarships and employment opportunities. The overall health of the community is central to what we do.

Innovation, a core cultural value at Northwell, is the creative process of reimagining research, discovery and creating a better future. The Feinstein Institutes for Medical Research is at the epicenter of this effort. Its discoveries have launched a new field of bioelectronic medicine, produced new drugs and medical devices and created new treatments that have improved the lives of millions of patients worldwide. Most recently, we have developed interventions that have allowed a patient who was completely paralyzed to move his arms and have the sense of touch.

Without research and a culture of exploration and discovery, there is little progress.

Education has always been a core component of our mission. We are, at present, one of the largest academic teaching institutions in the country with 2,000 residents and fellows. The creation of the medical and nursing schools was a major enhancement of that focus and they have been extraordinarily impactful and successful. They have enhanced the Northwell brand, helped enormously in top-notch clinical recruitment and accelerated the culture of innovation across the organization. They are also different and unique in how they educate — in the nature of the curriculum. At the Zucker School of Medicine, for example, all students are trained as EMTs in the first nine weeks. They ride the ambulances and participate in seeing and treating patients from the very beginning (under supervision). They are not sitting in a classroom — which is customary. They learn by witnessing and experiencing the circumstances that patients and families live in. This enhances their knowledge and evolves their perspective on the true meaning of health. We broke with tradition and the status quo, and as a result, I believe we are creating better practitioners for the future.

The creation of these schools — in participation with Hofstra University — has been one of our more important initiatives. It’s been a win-win. It’s not static, however. We continue to innovate, evolve and learn. We like to lead, not just follow.

I define health very broadly. Health is much more than the delivery of medical care. People’s health is impacted by lifestyle, behavior and the environment and circumstances that people live in. It’s impacted by business behaviors, government policy, etc. Gun violence is a public health issue, as is poor housing, inferior education, lack of employment opportunities, etc. We are now learning of the negative health consequences of the growing addiction to social media — the growing rates of anxiety, depression and suicide among adolescents. We have an HBO documentary coming out shortly on our efforts to prevent high school and college kids from committing suicide. It’s a new frontier — social media as a contributor to ill health.

If you desire to be a leader in health care, with the goal of improving health, you have a responsibility to be a catalyst in positively affecting as many of these factors as possible. We at Northwell are attempting to do this in gun violence, food insecurity, climate change, educational opportunities for high school students, and access to care in many of our most vulnerable communities.