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Three Local Policy Solutions That Can Advance Park Equity

Jul 27, 2022, 1:00 PM, Posted by Pamela Russo

Urban parks are a smart investment for health, but not everyone has a park nearby. These local policy solutions can help bring parks to every neighborhood.

Park Equity Graphic

When I want to get some fresh air, exercise outdoors, or connect with the healing power of nature, I go to one of the many green spaces close to my home. These local parks contribute to my mental and physical health, and improve my quality of life considerably.

We all need parks, but not everyone has one nearby. Black, Latino, and other communities of color have fewer parks than white, wealthier neighborhoods. And the parks they do have are half the size and five times more crowded. It’s time to fix this inequity and create parks and green spaces that will serve generations to come.

The Power of Parks

The pandemic underscored just how important parks are to creating strong, healthy communities. Parks protect health and promote mental wellbeing by providing people of all ages and abilities opportunities for physical activity, time in nature, social connection, and respite. Research shows that time in parks can decrease levels of stress and anxiety by 50 percent.

Parks and green spaces also have environmental benefits that can help guard against the health harms of climate change: they cool temperatures, cleanse air, filter stormwater, and replenish groundwater. Research reveals that neighborhoods within half a mile of a large park are six degrees cooler than neighborhoods without nearby parks.

Simply put, urban parks are a smart investment for health and essential community infrastructure that should serve every neighborhood.

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Better Tobacco Control Policy Starts Locally

Jul 14, 2022, 1:45 PM, Posted by Cynthia Hallett, Delmonte Jefferson

To advance health equity, we must fight preemption and restore local control over tobacco regulation.

Tobacco and Housing Illustration.

This post is the third in a blog series (the first on preemption as a policy tool and the second on strengthening public health authority) that explores how preemption has served as a double-edged sword in either supporting or undermining efforts to advance health equity. We explore how some states have limited tobacco control at the local level and why local policies are critical to advancing health equity and protecting communities from commercial tobacco.

“By introducing pre-emptive statewide legislation we can shift the battle away from the community level back to the state legislatures where we are on stronger ground.” —Tina Walls, Philip Morris, July 8, 1994

The U.S. Food and Drug Administration is poised to ban menthol cigarettes and flavored cigars later this year. In 2019, the federal legal age to purchase tobacco products increased from 18 to 21.

These are significant public health victories that will save lives. The use of commercial tobacco products undermines health and continues to be a leading cause of preventable death in our nation. Decades of predatory marketing has targeted Black communities with menthol advertising, driving health disparities.

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A Generational Opportunity to Invest in Our Children

Jul 5, 2022, 2:00 PM, Posted by Charles Bruner, Martha Davis

We identified exemplary practices to help foster the nurturing, stable environments that children need from birth through adolescence to thrive.

2017 Culture of Health Prize Communities: Garrett County, MD

The United States has the most advanced medical care system in the world and spends the most per capita on healthcare. Yet we lag behind other developed nations on important health indicators, including infant mortality, child wellbeing, adult disability, and overall life expectancy. The status quo is failing our kids, denying them a healthier and brighter future. More kids than ever face the prospect of growing up less healthy and living shorter lives than their parents. Children are more likely than any other age group to be poor and live in medically underserved and socially vulnerable communities. Unless we collectively take significant steps to improve our children’s health and development, we will face adverse consequences for years to come.

There is growing evidence on how to improve children’s wellbeing. With support from the Robert Wood Johnson Foundation, the Integrated Care for Kids-InCK Marks Initiative spent the last six years bringing together pediatric practitioners, health administrators, policy experts, and advocates. InCK Marks’ advisors assessed pediatric healthcare practices and innovations, metrics, finances, and culture to identify tangible solutions that advance a culture of health for kids.

This work continually pointed us to—and eventually rooted us in—the value of early investments in preventive health and health promotion. While the return on investment may not be immediate, the dividends are lifelong, with ripple effects into all facets of life. The needed investments encompass more than just medical treatment; health systems must respond more proactively to the determinants that play a lasting role in children’s health, including economic (housing, food, and basic income) and social (relational supports and opportunities) factors.

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A Community Vision of Mental Health

May 19, 2022, 12:00 AM

Centering the community in making its own decisions, confronting a long legacy of trauma and violence, and honoring genuine emotion are among the pathways to mental health that many residents of Palm Beach County are embracing.

In Palm Beach County, Florida residents are tackling neighborhood challenges together. Teamwork and a commitment to inclusiveness and civic participation helped the county earn an RWJF Culture of Health prize.

Six communities that comprise the Healthier Together place-based initiative are asking local people what they care most about. Their questions sometimes surface surprising answers. Many residents say they want to focus on mental health and that “feeling whole in mind, body, and spirit” is what really matters to them. But the way they think about mental health often differs from the way a clinical provider considers it. “It’s not a traditional definition, it’s their definition,” said Jeanette Gordon, whose Healthier Neighbors Project in Riviera Beach and northern West Palm Beach is all about fostering engagement, empowerment, and balance.

Organizing a multi-generational street cleanup may not at first blush seem deeply connected to mental health, but the Healthier Lake Worth Beach community saw it as a natural fit. “They wanted to create the conditions where their kids could thrive,” explained Pat McNamara, CEO of Palm Health Foundation, which funds Healthier Together. And what could be better for emotional wellbeing than that? Under the umbrella of mental health, Palm Beach County communities are activating other priorities as well, each one identified by those who live there—including gaining access to healthy foods, confronting the root causes of trauma and violence, and creating opportunities for youth.

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What Nurses Can Teach Us About Health Equity

May 5, 2022, 1:00 PM, Posted by Nacole Riccaboni

I talked to a fellow nurse about inequities in healthcare settings, our own experiences with bias, and the importance of acknowledging and confronting the harms associated with structural racism.

Nurses wearing masks.

In Manhattan’s financial district, the average resident can expect to live until the age of 85. In East Harlem, life expectancy is only 76 years. Ten stops on the subway and a nine-year drop. That’s what Jasmine Travers, a nurse and New York University assistant professor, told me when we talked about the importance of digging out the root causes of health disparities.

As Black women in the nursing profession, both of us understand the need to “get real” about structural racism because we’ve seen how it plays out at the patient’s bedside and in our own professional lives. In fact, Jasmine left hands-on nursing to pursue research into the policies, practices, and structures that impede good outcomes. Talking about the realities of racism isn’t easy, but being uncomfortable isn’t an excuse to avoid tough conversations. The goal is not to accuse or shame anyone, but rather to shine light on enduring inequities, the forces that perpetuate them, and the ways we can heal the damage they do.

As an example, Jasmine described differences in how hospital staff sometimes approach pain control. The immediate response to a White patient’s complaint tends to be “let’s see how we can ease the pain.” But patients of color face more scrutiny. Too often, the first question a healthcare provider asks is, “what’s really going on here?”—the assumption being that pill-seeking behavior needs to be ruled out before considering the use of pain meds.

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Good Things Happen When Nurses Lead

May 2, 2022, 11:00 AM, Posted by Najaf Ahmad

A retired nurse CEO says we need nurses in government, on the boards of for-profits, and mentoring the next generation given their powerful role in influencing people, policies, and systems.

Mentor the Next Generation of Nursing illustration.

Maria Gomez has had her finger on the pulse of our healthcare system and the people it serves throughout her storied, 30+ year career running a community health center that serves a low-income, immigrant community in greater Washington, D.C. Maria entered the United States at age 13, started Mary’s Center after becoming a nurse, and helped grow it into a powerhouse serving 60,000 people each year. Mary’s Center helped pioneer an integrated model of healthcare, education and social services to put people on a path to good health, stability and economic independence. In 2012, President Obama presented Maria with the Presidential Citizens Medal. She retired in late 2021. Here, in the second part of a two-part interview, she reflects on the challenges facing our healthcare system, how nurses can continue leading efforts to meet them, and what we can learn from the pandemic.

What are the greatest challenges facing our healthcare system?

Today, it’s all about the numbers—the number of patients you see and the number of minutes it takes. Because that’s how you get paid. To transform lives, we need to change how we address patient needs. Providers can’t do it all in 15 minutes. Some are so overwhelmed by the numerous demands on them that they’ve grown numb to what their patients are feeling. Too many smart, incredibly passionate people who devote themselves to healthcare have become disheartened, burned out, and are even leaving the workforce. This is the most discouraged I’ve seen providers in my career.

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Understanding the Link Between Affordable Housing and Structural Racism

Apr 21, 2022, 10:00 AM, Posted by Rev. Eric Dobson

Creating inclusive communities requires more than fair housing laws. We need enforcement to end residential segregation and the disinvestment that shortchanges so many communities of color.

Understanding the Link Between Affordable Housing and Structural Racism

To this day, I still choke up when I remember the moment, two decades ago, that changed my life. As part of the Martin Luther King Day of Service, I had volunteered to help feed some folks who were homeless. At the end of the afternoon, I turned to one of the women who ran the sponsoring program, and said, “That was great, I look forward to doing this again next year.”

She paused, looked directly at me, and said quietly, “We do this every week.”

In those words, I suddenly heard a calling. My Dad was a church pastor and I had always expected to follow his path. But now I wondered, “Am I going to preach about this, or am I going to actually do it?” And so I signed up to work among people who were living mostly on the streets. Some struggled with mental illness or substance use, others had been forced from family homes because of their sexual identities. All were poor and most were Black or Brown. I learned to listen, not judge, and to think more broadly about how poverty and race intersect.

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This Policy Tool Can Advance–Or Impede–Racial and Health Equity

Apr 14, 2022, 1:00 PM, Posted by Kate Belanger, Matt Pierce

There is great urgency to ensure local governments are able to enact policies that protect and enhance the health of their communities.

Illustration for Health Equity blog

This post is the first in a blog series that explores how preemption has served as a double-edged sword in either supporting or undermining efforts to advance health equity.

On a host of issues ranging from commercial tobacco regulation to public health authority, paid sick time to advancing the health of children and families, a policy tool known as preemption can impede local decision-making. Preemption is when a higher level of government, such as a state legislature, restricts the authority of a lower level of government, such as a city council. Depending on how it is used, preemption can either support or undermine efforts to advance health equity.

In one example of the latter, we know that health and economic well-being are intertwined, which is why raising the minimum wage has been used across the United States to advance health equity for workers in low-wage industries. In 2016, the majority-Black city council of Birmingham, Ala., passed an ordinance raising the minimum wage from $7.25 to $10.10 per hour. But the new minimum wage never took effect because the majority-White state legislature responded with a law preventing municipalities from setting their own minimum wages. It effectively nullified Birmingham’s ordinance.

Eight years later, Alabama still follows the federal minimum wage of $7.25 an hour. At that wage, someone working 40 hours a week, 52 weeks a year, earns about $15,080. Birmingham decision-makers recognized in 2016 that $7.25 an hour is not a living wage. Yet to this day the state still prevents the local government from acting.

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Why We Need Healthy School Meals for All

Apr 11, 2022, 12:45 PM, Posted by Jamie Bussel

Healthy School Meals for All offers students and schools the stability and support they need as they continue adapting to pandemic-driven change amidst ongoing challenges. Now is not the time to let this policy expire.

Student being served lunch in cafeteria

Families around the country, mine included, are feeling fortunate to have our kids back in school after a turbulent, unpredictable couple of years. Students, teachers, and school officials were forced to navigate unexpected changes.  For most, the ongoing shifts from virtual to in-person learning were stressful and added to many other pandemic-induced hardships. Through it all, school districts quickly spearheaded innovative approaches to ensure they could continue to serve much-relied-upon school meals to students. They implemented “Grab and Go” models allowing parents to pick up meals in school parking lots or other community hubs; loading up school buses with meals and dropping them off at stops along neighborhood routes; and delivering meals directly to students’ homes.

Schools were able to offer this continuity and flexibility because when the Covid-19 pandemic forced nationwide school closures—and hunger and food insecurity spiked—Congress passed the Families First Coronavirus Response Act and CARES Act in 2020. 

Provisions in these laws provided the U.S. Department of Agriculture (USDA) with authority and funding to implement waivers that permit schools nationwide to serve meals to all students free of charge (also known as universal school meals). The measures also allowed schools flexibility to help ensure that meals are provided safely during a public health emergency. That includes distributing meals to families outside of the school setting and temporarily serving meals that meet the less stringent nutrition standards of the Summer Food Service Program, which require fewer fruits and vegetables than USDA’s current nutrition standards for school lunch.

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How Can We Use Local Data to Address the Impacts of Structural Racism on Community Health?

Apr 4, 2022, 10:45 AM, Posted by George Hobor, Oktawia Wojcik

Thirty-five local non-profits will be awarded up to $40K to work with local data to dismantle structural racism via a new funding opportunity.

Editor's note: This funding opportunity is now closed. 

Columbus, Ohio redlining map. A redlining map from 1936. In communities throughout the nation, there is strong correlation between redlined places and worse health outcomes.

The COVID-19 pandemic reinforced how place matters for health. Some communities have the conditions needed to help their residents thrive—like safe streets and parks, safe and affordable housing, and access to healthy foods. But too many communities—particularly places where people of color and those with low incomes live—have lacked these resources. This lack of resources is a result of the legacies of structural racism, such as redlining that shaped the socio-economic trajectories of communities, and modern-day racist practices, like systemic disinvestment from communities of color.

To inform efforts to improve community conditions shaped by structural racism, the Robert Wood Johnson Foundation (RWJF) has released a call for proposals (CFP). In order to best represent the voices of those most impacted by societal injustices, we aim to meaningfully engage community organizations. Up to 35 local non-profit organizations will be awarded up to $40,000 over nine months.

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