Now Viewing: Social Determinants of Health

New Narratives of Hope This Black History Month–And Beyond

Feb 5, 2020, 4:00 PM, Posted by Dwayne Proctor

More than 50 years after the civil rights movement we still have a lot to do to reduce discrimination and increase health equity. Dwayne Proctor reflects on the role of stories in the search for solutions.

An older student plays around with a younger student in a school auditorium.

Note: This piece was originally published in February 2018.

One of my earliest and most vivid childhood memories is watching from my bedroom window as my city burned in the riots that erupted after Dr. Martin Luther King Jr.’s assassination 50 years ago.  

The next afternoon, my mother brought me to the playground at my school in Southeast Washington, D.C., which somehow was untouched. As she pushed me in a swing, she asked if I understood what had happened the day before and who Dr. King was.

“Yes,” I said. “He was working to make things better for Negroes like you.”

My mother, whose skin is several tones darker than mine, stared at me in surprise. Somehow, even at 4 years old, I had learned to observe differences in complexion.

That is particularly interesting to me now, as I eventually came to believe that “race” is a social construct.

Of course racism and discrimination exist. They are deeply embedded in America’s history and culture—but so too is the struggle against them.

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Why Neighborhoods—and the Policies that Shape Them—Matter

Jan 23, 2020, 2:00 PM, Posted by Dolores Acevedo-Garcia

The Child Opportunity Index 2.0 uses contemporary data to measure and map inequities in all 72,000 neighborhoods in the United States. The tool helps researchers, city planners, community leaders and others identify and address inequities in their metros.  

Boys and girls run and play in the park. Image credit: iStock

The Tale of Two Boys Growing Up in Cleveland

Let’s ask two hypothetical 9-year-old boys a question: What is it like to grow up in Cleveland? 

Each boy attends school, and enjoys riding his bike and playing with Legos. Both live in Cleveland. Beyond these similarities, their life experiences are—and will continue to be—starkly different based on multiple, complex factors that lie within their neighborhoods.

Neighborhood A 

The boy living in Neighborhood A faces a host of obstacles to opportunity and well-being. 

Economic adversity is the norm. One in four families struggle with poverty, and nearly 83 percent of his peers in school need free or reduced-price lunch.

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A Holistic Approach to State Policymaking That Strengthens Families by Advancing Equity

Dec 16, 2019, 1:00 PM, Posted by Monica Hobbs Vinluan

A multi-state laboratory explores the interconnectedness of programs and policies to find ways for all families to thrive.

Kids jumping on an interactive exhibit at a museum.

Families don’t live in silos—one silo for health care, one for child care support, and yet another for food assistance. They need all those things—and more—to build strong and healthy futures for their children.

That’s why at the Robert Wood Johnson Foundation (RWJF), we're supporting a multi-state laboratory for advancing policies that strengthen families across a range of issues. The Center on Budget and Policy Priorities (CBPP) is the hub for this initiative. We are administering $2.65 million in grants to state-based organizations working to ensure that children and families get the support and resources needed to raise healthy kids through policy and systems change.

That means instead of addressing one issue at a time—e.g., child care supports or family leave—an array of issues are being addressed simultaneously. These include child care and family leave and minimum wage and job training and other policies that can help families get ahead. These policy levers are interconnected, playing off each other, which is why a holistic approach is needed to make real progress in families’ lives.

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The Power of Local Data in Action

Aug 22, 2019, 12:00 PM, Posted by Marc N. Gourevitch

With the City Health Dashboard, communities across the United States are using data presented on a feature-rich website to create healthier and more equitable communities. Lessons learned will help more community leaders pinpoint local health challenges and close gaps in U.S. cities and neighborhoods.

A meeting facilitator refers to a bar chart.

If you knew children born and raised in one neighborhood of your city tend to live 10, 20 or even 30 years longer than those raised in another, what kinds of questions would you ask?

Local data on social, economic, and health factors can help city planners, policymakers, and community advocates illuminate approaches to such challenges and drive change.

We heard from city leaders that there was a lack of data at the city and neighborhood level clearly showing which factors have the greatest influence on their community’s health and well-being. So we got to work and created the City Health Dashboard. Launched in 2018, the Dashboard integrates city- and neighborhood-level data from multiple national sources, providing 37 measures that address health, such as obesity rates and life expectancy, and conditions that shape health, such as child poverty, unemployment, and residential segregation. The country’s 500 largest cities—those with populations of approximately 66,000 or more—are all represented in the Dashboard, which also includes a rich set of resources to help cities take action to improve health.

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Home Is Where Our Health Is

Jul 22, 2019, 12:00 PM, Posted by Jessica Mark, Najaf Ahmad

Where we live affects how long and how well we live. Yet, affordable housing is out of reach for too many. RWJF is addressing housing stability, equity, and health through data and research.

Everyone should have the opportunity to live in a safe community.

There is growing evidence that safe and secure housing is a critical factor in achieving good health. Where we live can determine whether we’re connected to: safe places to play and be active; quality jobs and schools; and transportation to get us where we need to go. Yet millions of people in America live in substandard or overcrowded housing, temporary shelters, in cars, and on streets. Disadvantages also exist for the many living in residentially segregated neighborhoods isolated from opportunity. For them and others, the inability to access quality housing and neighborhoods deepens challenges and makes it much more difficult to be healthy and break out of poverty. 

Housing’s profound effect on health is often overlooked and misunderstood. This year, the Robert Wood Johnson Foundation (RWJF), led by President and CEO Richard Besser, MD, is shining a light on the link between housing and health. In his Annual Message, Besser discusses how safe and affordable housing supports positive outcomes across the lifespan—and how unsafe and insecure housing can deepen inequity and undermine a Culture of Health. 

He shares stories from housing initiatives across the country—from Boligee, Ala., to Chelsea, Mass., to San Antonio. These examples show that when we improve the quality and affordability of housing—health and lives also improve. Creating safe and affordable housing—as an essential part of comprehensive efforts to transform impoverished neighborhoods into places of opportunity—becomes a pathway to helping communities thrive.

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Where Mental Health and Social Justice Meet

Mar 11, 2019, 1:00 PM, Posted by Dwayne Proctor

A leader committed to the mental health and healing of black communities shares his insights.

Face graphic.

A few years ago, I read a painfully insightful account in the New York Times of what it means to be a black American struggling with mental health. The author vividly describes how socio-historical “trauma lives in our blood,” materializing in our daily lives, and ultimately affecting our mental health.

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Data Maps the Impact of Where a Child Grows Up

Jan 9, 2019, 2:00 PM, Posted by Kerry Anne McGeary

The Opportunity Atlas allows users to interactively explore data on children’s outcomes into adulthood for every Census tract in the United States. This can inform local efforts to build equitable, prosperous, and healthier communities.

U.S. Map for Opportunity Atlas.

In the Boston Edison neighborhood of Detroit, black children raised in low-income households have grown up to have an average household income of $28,000/year as adults, and under 1 percent of that population has been incarcerated as adults. In contiguous Dexter-Linwood, just one census tract to the north, the average earnings for the same group is $17,000/year, with adult incarceration rates hovering close to 8 percent.

If some neighborhoods lift children out of poverty, and others trap them there, the obvious next step is to figure out how these communities differ. Travel to Charlotte, N.C., which has one of the highest job growth rates in America. But data reveals (surprisingly) that availability of jobs and a strong regional economy do not translate to upward mobility in this region. Children who grew up in low-income families in Charlotte have one of the lowest economic mobility rates in the nation. What does help, according to the The Opportunity Atlas (the Atlas), is growing up with less discrimination, around people who have jobs and higher incomes—but only when those factors are found in their immediate neighborhood. If they are present a mile away, it doesn’t seem to matter much according to the data.

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Creative Communities Are Addressing Social Isolation

Jan 7, 2019, 3:00 PM, Posted by Maryjoan Ladden

Social connections are not just nice to have—they can significantly affect our health and well-being. Inspired by creative approaches abroad, communities across the United States are taking steps to reduce social isolation and increase residents’ sense of belonging.

It’s only January and already, I’m counting down the days to spring when warm weather will arrive. The long, cold months of winter can be isolating—the snow and subzero temperatures make it difficult to get out and about. Winter is particularly tough for children who can’t go outside to play, and for newcomers from warmer climates who are not accustomed to the cold. For people who don’t have meaningful social connections, the cold weather season can exacerbate the isolation they face year-round.

Social isolation is a serious problem for many. It can lead to anxiety, depression, substance abuse, and even suicidal thoughts. Social isolation can impact our health in other ways too—by escalating unhealthy habits, stress, lack of sleep—and putting us at higher risk for coronary heart disease and stroke.

Fortunately, there are many creative ways in which communities across the United States are tackling social isolation and building a sense of community.

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Lifting the Weight of Incarceration

May 3, 2018, 3:00 PM, Posted by Michael Matza

If your organization is creating a healthier community through sport, learn about the RWJF Sports Award. InnerCityWeightlifting, a 2016 Sports Award Winner, helps at-risk youth and former inmates restore their standing in society.

InnerCity Weightlifting

An hour before his next client is due, Edgardo “Chino” Ortiz is in the glass-walled break room of InnerCity Weightlifting (ICW) in Cambridge, Mass., poring over a study guide to become certified as a personal trainer. Fiercely focused on achieving that goal, he is rarely separated from his worksheets.

“Prescribe RICE,” he says, circling the acronym for “rest, ice, compression and elevation” on a sample quiz question about injury.

All across America, men and women with similar ambitions are prepping for careers in physical fitness. But few share the unique drive that fuels 33-year-old Chino’s determination. For him, getting certified as a fitness trainer is a life-changing turning point, built on his smarts, his talent, and his grit.

Chino recently completed a sentence of five years in a Massachusetts state prison for shooting a man in the leg over drugs. For most former inmates, finding a good job is notoriously difficult. But Chino’s future looks promising because of his connection to ICW. 

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Surgeon General Jerome Adams and the Power of Partnerships

Apr 26, 2018, 11:00 AM, Posted by Najaf Ahmad

The 20th United States Surgeon General Jerome Adams joined RWJF President and CEO Rich Besser to discuss how the power of partnerships can help transform communities and advance equity.

SG Jerome Adams, Richard Besser

As a child, the United States Surgeon General Jerome Adams, MD, MPH, suffered from asthma so severe that he spent months at time in the hospital, even once being airlifted to a children’s hospital in Washington, D.C. During these stays he was struck by the fact that he’d never encountered a black physician. That finally changed when as an undergraduate he met a prominent African-American doctor who had overcome his own significant life obstacles. Seeing another African-American making important contributions to the field of medicine inspired the young Jerome Adams to decide, “I can do that too.”

With that resolve, he embarked on a path that led to becoming an anesthesiologist and culminated in his appointment as the nation’s 20th surgeon general.  

Reflecting on his journey, Dr. Adams notes, “that’s why your efforts at the Robert Wood Johnson Foundation (RWJF) are so important. You’re providing mentorship and leadership opportunities to those who wouldn’t otherwise know how to navigate the world of public health.”

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