Place Matters: How Neighborhoods Affect Our Health
By Ned Calonge, MD, MPH, The Colorado Trust
Health depends on more than health care; it’s affected by where we live, the education we receive, the work we do, the wages we earn and by our opportunities to make decisions that affect our own and our family’s health. Last week, in the second presentation of our Health Equity Learning Series, our speaker noted that health is tied directly to the heart of where we live—our neighborhoods.
Brian Smedley, PhD, Vice President and Director of the Health Policy Institute of the Joint Center for Political and Economic Studies, discussed the center’s “Place Matters” project. The project is helping people in 24 communities around the country identify and address social, environmental and economic conditions that affect their health. They are finding, he said, that “once you know one community…, you know one community.”
This is not to say that what is learned in one area is not applicable to others. Certainly what is learned in one place can be applied to others, but there can be dramatic variation in the conditions in which people live, learn, work and play, not just from town to town but from neighborhood to neighborhood. “Place Matters” found some startling differences in life expectancies among neighboring communities. For example, in New Mexico’s Bernalillo County, which includes Albuquerque, life expectancies vary by up to 22 years depending on one’s ZIP Code or Census tract, and more often people of color experience the shorter lives. As Dr. Smedley pointed out, minorities are more likely than whites to live in poorer areas with problems such as polluted air and water, lack of transportation, and little access to health care or safe places for children to play—all factors that affect one’s health.
In Colorado, we know that blacks and Latinos experience significantly higher rates of infant mortality and deaths from diseases such as heart disease, cancer and diabetes than do whites, and research finds that most of these disparities are not explainable by biologic differences.
While Colorado communities are not participating in the “Place Matters” project, there are lessons and strategies from this neighborhood-based work that can help us to better understand how healthy our individual communities are and to guide efforts to gain health equity for our residents.
We have seen this approach demonstrated in Colorado before, where communities themselves drive the change. From projects like The Colorado Trust’s Healthy Communities effort a decade ago, statewide health reform initiatives, newly launched hot-spotting projects and local alliances working to improve health in their communities, we have learned that making collaboration work across different sectors requires that the community itself guide and set the agenda for change and that all sectors see a benefit for themselves.
Another powerful step is for communities to engage elected officials in community health issues. Contacting one’s public representatives can provide a neighborhood with the information and strength needed to improve its situation, and help make the voices of many heard loud and clear.
Making true change in a neighborhood requires a long-term policy agenda with multiple strategies, and a sustained investment in communities that takes into consideration the intertwined factors that affect our health, such as housing, transportation, labor and education.
If you missed Dr. Smedley’s presentation, or would like to share it with others, it is available on our website. We hope you will join us for our next Health Equity Learning Series. On July 25, Adewale Troutman, MD, Director of the Public Health Practice Program, University of South Florida, will speak about social determinants of health. Please sign up for more information if you are interested in attending the event or live-streaming it online.
