The root causes of unhealthy communities
By Keon L. Gilbert and Keith Elder
Sixty-two percent of Americans say they are very concerned about their health. It’s unsurprising that those who express the most concern are most vulnerable, underserved, and lacking economic means and educational gains.
By contrast, a national poll conducted by Robert Wood Johnson Foundation in partnership with Harvard School of Public Health and National Public Radio surfaced another predictable finding: Those who rank their health high and are economically stable are likely to have more control over their health. The more control, the more effort people put into improving their health.
Health is a matter of individual, community, and national priority. The factors that contribute to our health remain a part of daily conversations at home, work, school, and where we worship. A healthy life begins in childhood, and factors such as child abuse or neglect, lack of high-quality medical care, personal behavior, viruses/bacteria, stress, and environmental pollution increase the risk of illness and premature death.
But additional threats identified by underserved Americans include living in segregated neighborhoods, where there is often less access to health care facilities, quality education, full-service grocery stores, and recreational outlets.
Many studies describe the influences of community structures on the chronic stress that many racial, ethnic, and lower socioeconomic groups experience. Witness the recent devastation of communities lacking equitable social, economic, and policy structures.
The factors that prevent low-income communities and communities of color from accessing health care also prevent them from accessing other valuable resources that decrease the risk for poor health. Poor-quality housing, limited public transportation, high crime rates, and other socially disrupted conditions reduce sense of community, access to health care, and the ability to manage chronic diseases properly.
Children suffer the most damaging effects of these inequities. Poor childhood experiences and exposures can lead to poor adulthood outcomes, as the unhealthy circumstances that negatively affect children have a similar impact on adults and lead to concentrated poverty and unhealthy communities.
We know that eating fruits and vegetables, reducing stress, limiting consumption of fast food, and limiting alcohol, sports drinks, and sugar-sweetened beverages will help to improve health. On a broader scale, however, the environments we live in should offer access to healthy food, reduced exposure to drugs, less environmental pollution, greater access to quality medical care, and more economic opportunities through jobs.
We need a greater emphasis on improving our social, economic, and living environments so that all Americans can be healthy from childhood to adulthood.