Community health is about much more than healthcare, said panelists at the April edition of Southface Institute’s Sustainable Atlanta Roundtable. In fact, it depends on an entire network of factors to support the well-being of its members, with each participant playing a specific role.
The April 12 panel focused on “Healthy Homes, Healthy Families,” and gathered local experts that gave a broad vision of what is needed to improve the health of every member of the community, especially the underserved.
“Southface started out with energy, but we are rapidly moving to an understanding that sustainability is not only about the quality of our buildings but their ability to support human health,” said event moderator Liz York, a Southface board member and Associate Director for Quality and Sustainability & Chief Sustainability Officer at the Centers for Disease Control and Prevention (CDC).
Breanna Lathrop, CEO for Good Samaritan Health Center and a healthcare clinician, highlighted the 13-year difference in life expectancy in Atlanta, depending on which zip code someone lives in, and the need to provide communities with personalized solutions to their own particular health challenges.
“Medical care itself prevents only 10 to 12 percent of premature deaths,” she said, and other social determinants like access to quality food, education, housing and a safe neighborhood, all greatly impact a person’s longevity as well. “I can’t prescribe affordable housing. I can’t give someone a career trajectory,” she said. “…But as we talk about what is my role, what is my organization’s role in addressing this, and how do I link with people working on those other determinants, we can create communities that thrive and narrow that life expectancy gap,” said Lathrop.
Joel Kimmons, PhD, Senior Nutrition Scientist and Epidemiologist at the CDC, focused on the balance we need to find between the external and internal influences on the choices we make regarding health:
“The myth of our society is that we balance the rational and emotional because we’re so internally stoic,” he said. But when someone goes to the grocery store, their food choices are not always rational; it’s that “Don’t go to the store when you’re hungry!” rule, he said. When people go to the grocery to buy food, marketing is very influential; economic motivation is there, but less than people think, he said. Instead, “Why don’t we try to ‘sell’ healthy food?” he proposed. To balance the outer and inner worlds, we need to grow both personal skills and knowledge with policies and legislation and legislation, he said.
Kathryn Lawler, Executive Director, ARCHI (Atlanta Regional Collaborative for Health Improvement) expressed the frustration that comes from living in a metropolitan area that spends $12 billion annually on healthcare and yet still has such a high disparity in life expectancy. Her organization has determined several factors needed to dramatically change the future of health in the city, including expanding economic opportunity, affordable housing, insurance coverage, healthy lifestyles and sexual health education, and shifting more public dollars to preventative care.
Lawler found one factor above all to be the greatest health determinant: “If we could only ever do one thing for you in Atlanta for your health, it is to help you successfully graduate from high school and get a good paying job, because that has the biggest influence on your health,” said Lawler.
Veronica Squires, Chief Administration Officer for Good Samaritan Health Center, said what is needed is a narrative shift in our thinking about the circumstances that impact healthcare for the underserved: “Moving from thinking of poverty as a consequence of bad behavior to thinking of poverty as a social problem for which we are all responsible.”
She and her team undertook an exercise to better understand the challenges of those in low-income zip codes in metro Atlanta. They embarked on a two-hour bus tour of the area.
“We were shocked,” she said. “In that time, we observed zero grocery stores and seven liquor stores.” With limited access to healthy foods and the preponderance of predatory businesses, like pawn shops, Squires observed, leading a healthy lifestyle in these communities is extremely difficult.
York began the Q & A with the example of an architect building stairs: “Think about the stairs you’re about to design,” she said. “You might think of architecture as dimensions and materials, but it matters what dimensions and what materials you choose. You have a person who can’t read. How will you make sure they know where the stairs are? How do you make a stairway more inviting in a neighborhood that is scary to live in? You provide good visibility in that stairway, you give good lighting and you make the colors bright.”
She then turned to the speakers and asked their advice about how each person can make an impact on community health daily.
Lathrop encouraged attendees to ask themselves: “What are the skills and services that I have and who is missing them? And how can I find partnerships that bring my skills and expertise to the people missing them?”
For Kimmons, helping individuals process trauma is an important part of the picture:
“I got into this whole area to work with the Department of Defense and the VA around post-traumatic stress disorder. Because—you’re talking about stressors and how that leads to poverty, and how those connect. Those are conditioned effects. PTSD is a conditioned effect. Most people on the planet probably have some degree of PTSD. Environments can relieve PTSD. So the conditioning we’ve all experienced since childhood or from car wrecks or from other adverse events—I think it is the responsibility of the people in this room to build environments that facilitate people letting go of that past trauma and waking up into a present where they have the ability to make choices.”
Lawler said, “We’re here today to talk about health and housing. And one of our biggest challenges to advancing change at any substantial level is that in America we still view both of those things as deeply personal. It doesn’t matter how much data there is and what trend lines show, we still have the idea that health is about taking personal responsibility and making better decisions. So the most important thing is to challenge yourself and someone you know about your own biases about your own health and your community’s health.”
In addition to asking what will make ourselves or our families healthy when making decisions that impact our communities, Squires suggested asking one more question: “What will make my neighbors healthy?”