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There is a large gap between the health enjoyed by Americans and what it could be if our medical skills and knowledge were used effectively. Faith groups constitute an underutilized resource for closing that gap. They also are in a position to further the dialogue on the unstated issue in health care reform--the need for health reform.

Health care is only one of many activities required to improve health. While much of the discussion has centered on access, quality, and cost, the truly important point is outcome--the elimination of unnecessary suffering, premature death, and impaired life quality.

While health care delivery increases in complexity and cost, there is ample evidence that the most potent way to improve health would be to involve individuals in reducing their disease risks by simple and inexpensive methods. An article in the Nov. 10, 1993, issue of The Journal of the American Medical Association demonstrates that half of the deaths in the United States could be delayed by straightforward preventive actions. We are accustomed to thinking that we die from heart disease, strokes, cancer, and in automobile accidents. But if we focus on the lifestyle choices that contribute to the killers, we find that the three leading causes of death in this country each year are tobacco (more than 400,000 deaths), diet (about 300,000 deaths), and alcohol con-sumption (about 100,000 deaths). More than 2,000 funerals are held each day because of these three risk factors.

In addition, social factors of all kinds--illiteracy, poverty, homelessness, unemployment, hopelessness--interact with these lifestyle choices to make the risks even higher. We don't totally understand how these social factors fit into the puzzle, but we do know they must be addressed as health problems if we are to make progress. However, the health care industry is not organized to deal with these social ills, nor do we suggest it could be modified easily for such activities.

Instead we need to use every resource and every approach that can be found to collaborate with health care service providers. The 145 million members of faith groups, for example, have the interest, the mission, and the vast human resources to make a difference. The needs of this country for smoke-ender programs, substance abuse programs, nutritional information, exercise programs, AA groups, safe sex education, and other programs far exceed the reach of our health system.

Synagogues, churches, and temples are organized to involve their own constituents and to reach the com-munity. Many have buildings used only a few hours a week, and they have the commitment to teach people how best to live. Around the country there are examples of congregations involved in this kind of health reform, enriching the lives of their members and their communities.

Many cities have organized interfaith coalitions to increase the effectiveness for community action. In Atlanta, Baltimore, Dallas, Los Angeles, St. Louis, and many other cities, there are coordinated efforts between congre-gations and public health programs run by the government. The challenge is to involve all groups and to make this a comfortable way of improving the health of individuals and their communities.

The country is moving inexorably toward health care reform. The attention is on systems and structures, yet the most powerful force for improving health could be the effective involvement of every individual in their own health care. If we are to achieve our national potential for the highest quality of life, the health care industry must stay focused on reform and draw on the resources and talents outside the industry to focus on health. U.S. faith groups have an opportunity to create inspired ways to give each individual the power to improve his or her own health. That would be a worthwhile gift, indeed.