How Local Advocates are Shaping Health Equity
Living in poverty can be hazardous to your health. A recent study found that life expectancy in the United States ranges from as high as 87 in some affluent counties to as low as 66 in poor counties, and researchers have noted serious health disparities by race and income. In response, advocates and community leaders are increasingly focused on health equity — a comprehensive approach to building healthy communities that includes jobs, transit, housing and more, targeted to the residents that need it most.
A new report from the Robert Wood Johnson Foundation aims to define “health equity” for the field and highlights communities working to advance health equity. On a webinar last week, the foundation discussed its definition of health equity and showcased the work of organizations in Indiana and New Jersey.
Paula Braveman, director of the Center on Social Disparities in Health and one of the report authors, explained the foundation’s definition:
“Health equity means that everyone has a fair and just opportunity to be as healthy as possible,” said Braveman. “This requires removing obstacles to health such as poverty, discrimination and their consequences — including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
IndyCAN is one example of a local organization on the cutting edge of this vision of health equity. The Indianapolis-based nonprofit works with faith leaders and other community partners to push for policies that support low-income and minority Indianans. Last year, IndyCAN led a successful campaign for a ballot initiative to expand public transit to thousands of low-income people of color in Indianapolis.
“Transit access is the single strongest factor in escaping poverty,” said Shosanna Spector, executive director of IndyCAN, “yet access to transit is deeply racialized. We looked at the relative locations of jobs, transit, race, and poverty, and found that there are very few jobs where people of color live, and that public transit doesn’t take them to where the jobs are.”
Spector noted that the lack of reliable transit options for poor families has serious health implications. Families with young children can’t easily access doctor’s offices or healthy food without sacrificing significant time and money. She also said that organizers shouldn’t be afraid to make race central to their public outreach.
“We learned that you can lead with racial equity and win, and in fact you must,” said Spector. “When you put community leaders at the center of the fight and give people the chance to stand up and help their poor neighbors, they will do it.”
Bill Lovett, executive director of the New Jersey YMCA State Alliance, echoed the call to empower local leaders in the push for health equity.
“In the poorest neighborhoods in New Jersey, there are thousands of people who live in a community with a single supermarket, but plenty of corner stores,” said Lovett. “So we’ve started a project to connect corner stores to healthier food and public transit. We’re looking for local solutions that are scalable to the state or even national level.”
In addition to public transit and food access, the speakers pointed to mass incarceration and mental health treatment as significant public health issues that should be addressed through the lens of health equity.