If ever there was a wake-up call for those of us who work in public health, it’s this: the current generation of American children—our children—is the first in more than 200 years that may live shorter lives than their parents. All on account of preventable health conditions.
Those conditions—obesity, diabetes, hypertension, asthma—are the chronic, place-based diseases of poverty. Kids who live in unsafe neighborhoods and poor housing, have limited access to quality schools and nutritious food, and whose parents struggle with employment and finances, are many times more likely to develop those diseases, and to have shorter life expectancies, than their cohorts who grow up in more affluent places. In my state, Rhode Island, people without high school diplomas live, on average, seven fewer years than those who have completed high school.
This is unacceptable.
But there’s good news in the works: Because the correlation between zip code and health outcomes is now so well documented, organizations that work to improve community health are beginning to take a comprehensive approach to the chronic diseases of poverty. They’re looking at all the social and environmental determinants of health. And they’re teaming up with other groups and public agencies, and committing resources to things like affordable housing, nutrition, education and financial stability—all of which are inextricably linked to good health and longer life expectancy.
Take the Rhode Island Department of Health. Instead of targeting medical problems once they arise, as health departments have traditionally done, the agency is now partnering with community organizations throughout the state to create “Health Equity Zones.” These zones are geographic areas where place-based strategies are being used to tackle the causes of poor health. Just as important, residents are being empowered and trained to take the lead in changing the health and socioeconomic landscape of their neighborhoods.
Of course, this approach dovetails closely with LISC’s Building Sustainable Communities initiative. And we are partnering with LISC on one of our 11 Health Equity Zones.
As excited as I am by what is happening in our Health Equity Zones, I’m equally excited by how it is happening. Many projects involve municipal leaders, residents, business people, transportation and community planners, law enforcement, and educators and healthcare workers. These collaborators, many of whom have never before worked together, are creating problem-solving blueprints that communities can use in addressing a range of chronic health conditions, and their underlying causes.
Achieving health equity means achieving the best health possible for everyone. And the only way we can do that is by making sure that every community and every city in our state offers its residents the opportunity for a quality education, for healthy, affordable housing, for good jobs, and for safe places to play, work and live. After all, isn’t that what every child, of every generation, deserves?
ABOUT THE AUTHOR
Ana Novais, Executive Director of Rhode Island Department of Health
Ana P. Novais has spent 30 years working in public health, both in the U.S. and abroad. She is executive director of health for the Rhode Island Department of Health. Since March 2006, she has served as the executive director of health for the Division of Community, Family Health and Equity and led the department’s efforts to achieve health equity. She helped develop and implement the Rhode Island Health Equity Framework--a plan of action to achieve health equity at the state and at local level through the state’s Health Equity Zones initiative. Her role was expanded to executive director of health for the full department last year, overseeing strategic priorities.