Exploring the Intersection of Health, Place and Economic Justice

Oct 2, 2013, 2:54 PM

file Brian Smedley, Joint Center for Political and Economic Studies

On Wednesday October 2nd, the Joint Center for Political and Economic Studies held its third annual National Health Equity Conference, PLACE MATTERS: Exploring the Intersections of Health and Economic Justice. The Joint Center for Political and Economic Studies was founded in 1970 and is the only research and public policy institute that focuses exclusively on social justice issues of particular concern to African Americans and other communities of color.

The conference focused on the relationship between community development and the creation of healthy spaces and places, and convened key stakeholders, including grassroots leaders, elected officials, researchers, public health practitioners, policymakers, community development practitioners, and community organizers. The conference had several goals, including to:  

  • Illuminate the mechanisms through which neighborhood conditions directly and indirectly shape the health of children, youth, and families, and document differences in neighborhood conditions resulting from residential segregation;
  • Identify common goals and strategies of individuals and organizations working in the community development sector and the health equity sector;
  • Elevate promising strategies to improve and sustain neighborhood conditions for health that draw upon effective approaches employed in the community development and health equity sectors; and
  • Explore means to better communicate these strategies to key audiences, such as community-based development and health equity organizations, public health practitioners, planners, and elected officials.

Leaders at the Joint Center say that by convening national and local leaders, including individuals at the forefront of community development and health equity movements, they hoped to raise awareness regarding community conditions that shape health and develop policy solutions at the intersection of place and health, particularly as it pertains to people of color and health equity.

NewPublicHealth spoke with Brian Smedley, PhD, Vice President and Director of the Joint Center’s Health Policy Institute about the critical issues of community health and its relationship to health equity.

NewPublicHealth: What do we know so far about the impact of place on health, and what do we still need to learn?

Brian Smedley: There’s a large and growing body of research that demonstrates the relationship between the places and spaces where people live, work, study, and play and their health status, and what we’ve been able to determine is that there are many characteristics of neighborhoods, schools and work places that powerfully shape health.  Just as an example, more and more people are paying attention to this concept of food deserts — many communities in the United States that don’t have geographic access to healthy foods.  And not only do people have to travel a long distance to access these foods, but they’re often financially out of reach as well.

Many other communities face an assortment of environmental health risks, sources of air, water, and soil pollution primarily from polluting industries.  Still other communities don’t have access to safe neighborhoods or safe spaces for exercise and play, and are exposed to crime and violence on a daily basis.  From the perspective of closing racial and ethnic health gaps disproportionately these kinds of health risks are found in highly segregated communities of color.  So, we see a heavy concentration of health risks, be it in the form of  an abundance of vendors selling harmful products like fast-food stores or convenience stores, selling high-fat, high-sugar products all the way through a heavy concentration of environmental health threats, and other kinds of health risks that both directly, in the form of stress and environmental exposures and indirectly by shaping health behavior, have an influence on the health status of people who live in those communities.

So, with that growing recognition of the importance of place, this begins to point us to policy solutions and many communities around the country are working with elected officials and researchers and policymakers to better understand how to increase investments in communities so that they can enjoy health-enhancing resources while at the same time reduce the concentration of health risks. There are many very important and successful efforts underway, but we still need to learn more.  We need to understand more about the cost effectiveness of the interventions that are being used.  How cost effective is it, for example, to open a grocery store in a community that’s a food desert?  How do we know that this results in improvements in people’s diet and subsequently reductions in obesity and other kinds of risks associated with eating unhealthy foods?

We need to know more about how a number of strategies across sectors can improve health, so it’s important to not just intervene, for example, in one area, but often communities face multiple health threats, so we’ve got to address food, but we’ve also got to address the quality of housing, the availability of good jobs with wages high enough so that people can support their families and not lack access to basic resources.  We also need to, in many of these communities, increase access to healthcare services like primary care.  We’ve got to better understand how do we put together comprehensive strategies that address the range of health risks that are found, and then how do we know that there is a return on investment?  We have good reason to expect that if we can prevent illness and help people remain healthy in the first place, that we’ll save a lot of money in healthcare costs, but it’s also true that when people are sick and burdened by chronic disease and illness, that they’re often too sick to work. So, what’s the return in terms of having a healthier, more productive workforce?  What’s the return to businesses whose employees are able to be much more healthy and productive on the job?  And then, in terms of state and local and federal tax revenue, how much more can we expect to generate in tax revenue when we have healthier communities? 

There’s good reason to believe that these kinds of investments upstream to improve the conditions in which we live and work will save us money and produce a healthier population, but we’ve got to do a better job of quantifying that so that policymakers understand where we need to make our investments and the importance of addressing these kinds of neighborhood and workplace and school characteristics.

NPH: How will the conference help highlight these issues?

Brian Smedley:   We think the conference is important because it does several things.  It raises awareness about the importance of place for health, and the role of residential segregation.  The fact that we still have persistent residential segregation in this country is a big driver of the racial and ethnic health inequities that we see, so we need to raise awareness about these problems, but just as importantly, we need to raise awareness about solutions that work. And we’ll be highlighting the efforts of Place Matters teams around the country who are working to improve neighborhood and workplace conditions for health.

Another key goal is to connect different sectors that are often siloed from one another. At this third conference, the theme is exploring the intersections of economic justice and health equity.  We know that the work in the community development sector to stimulate the economies of these communities to attract private investment to create more attractive conditions for businesses and residents is also health equity work. But these sectors rarely collaborate together and we believe it would be very powerful to have the health sector, which includes public health and researchers and grassroots organizations working in collaboration with the community development sector, which often includes financial institutions, and well as grassroots and community-based organizations and others who are interested in trying to find ways to help communities to be economically vibrant.  So one of our key goals this year is to make sure that we disrupt those silos and help these sectors find ways to work together in order to be so much more productive.

This commentary originally appeared on the RWJF New Public Health blog.