Tuesday, December 04, 2012

New Prescription for Good Health

How much of good health results from our lifestyle? From our healthcare? From the environment in which we live? It might surprise you to learn the extent to which our health– good or bad –depends on our environment. In fact, experts assert that at least half of our health depends on our social, economic, and physical environment: the education we received; our income; our neighborhood; the quality of our housing; and other elements of our background and current circumstances.

In Minneapolis and St. Paul, people living in one neighborhood can expect to live as much as 13 years longer than people living just a few miles down the road. If you want to see how your zip code stacks up against others, take a look at the study which we at Wilder Research completed with the Blue Cross Blue Shield of Minnesota Foundation. Where you live, how much education you received, your income –all are factors that can shorten or lengthen your life; they influence your blood pressure, your susceptibility to chronic diseases, and other physical conditions.

Traditionally, public health practitioners and community development finance professionals have focused on these social determinants of health using different lenses. Public health has focused primarily on increasing awareness of healthy behaviors (eating nutritious food, exercising, not smoking, etc.), on policies which protect the public from harm (food handling laws, fluoridated water, smoking bans, etc.), and on increasing access to health services. Community development finance professionals have focused on designing living environments best suited to good health and on financing major projects which can offer access to health care, child care, housing, and better food, for example. Despite similar missions, these two sectors have largely worked independently.

Clearly, a convergence (as Dr. Risa Lavizzo-Mourey of the Robert Wood Johnson Foundation calls it) between these two disciplines makes a lot of sense. Individuals may seek to do all the right things – exercise, provide enriched child development experiences for their children, secure a good job with an income sufficient to provide stable housing to themselves and their families, and much more. However, the environment can inhibit them from accomplishing their goals. No matter what your skill level, for example, if no jobs exist, you won’t find a good job, you won’t have a good income, you won’t secure quality housing for yourself and your family.

Wilder Research collaborated with the Federal Reserve Bank of Minneapolis, the Robert Wood Johnson Foundation, and Blue Cross Blue Shield of Minnesota Foundation, to foster just such a convergence here in Minnesota. We brought together public health and human service people and community development finance people – in the hope that they might join forces. Our daylong conference showed representatives from the two sectors the benefits of collaborating with each other and gave each the “basic 101 level” understanding of the other sector – so they can talk with each other, understand opportunities and constraints for action, and ultimately engage in more joint projects.

Fortunately, we have already made some good strides in Minnesota. Andriana Abariotes of LISC, one of our advisers and seminar presenters, identified in her article, Community Development, Health’s New Partner, some outstanding existing local efforts. For example, she notes an initiative which both promotes better health care and addresses longer-term social determinants of health: Northpoint Health and Wellness, “where the continued expansion of its clinic and campus can not only provide quality health services but also serve as an anchor in the redevelopment of Penn and Plymouth Avenues in North Minneapolis, improving community safety and providing access to jobs.”

Abariotes also points to the Backyard Initiative (an effort in which Wilder Research had the good fortune to play a role during the design phase): “a community partnership led by Allina Health and the Cultural Wellness Center to engage residents in a completely different conversation and approach to their health. It is innovation playing out in real time, where deep listening and learning are core to changing the nature of the relationship between a major health provider and its patients and neighbors. Also changing are residents’ sense of ownership and efficacy and their own relationship to each other and to institutions in the neighborhood.”

Through our work at Wilder Research, we have the capacity to build understanding, kindle imagination, promote collaboration, change systems, and improve the lives of individuals, families, and communities by working “upstream.” Our society cannot sustainably deal with problems one by one after they occur. “Healthy Communities” – our partnership with the Federal Reserve Bank of Minneapolis, the Blue Cross Blue Shield of Minnesota Foundation, and the Robert Wood Johnson Foundation – offers the opportunity to build strengths (not just remedy weaknesses), lengthen and improve everyone’s quality of life, and prevent problems before they occur in this generation and in the future.

(A video of the keynote and resources from the Minnesota Healthy Communities conference are available here on our website.)

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