Health Equity and the Role for Community Development
At the Build Healthy Places Network, we believe that community development plays an integral role in America’s efforts to improve health equity.
By Douglas Jutte, MD, MPH and Colby Dailey, MPP Directors, Build Healthy Places Network
Equity is a hot topic these days as our nation struggles with what is fair and just, and for whom. In philanthropy, equity is high on the agenda among major players, for example, the Ford Foundation, Kresge, Kellogg, the California Endowment, and many others. The Robert Wood Johnson Foundation’s new push for a Culture of Health places health equity central to its goals.
Similarly, in public health we’ve seen health equity named as this year's theme for the National Association of City and County Health Officials (NACCHO) and as a guiding priority for the American Public Health Association (APHA). This year’s Association of State and Territorial Health Officials (ASTHO) President's Challenge is to “Advance Health Equity and Optimal Health for All.” And in the Community Development sector the Opportunity Finance Network (OFN) frames equity like this: “We believe in opportunity for all. CDFIs—Community Development Financial Institutions —align capital with justice. We invest in opportunities and transform lives and places for disinvested people.”
So why do we believe that equity is fundamentally at the intersection of community development and health? Let’s start with some definitions.
“Equity” means fairness. No matter your race, ethnicity, ability, gender, or sexual identity, having an equal opportunity to achieve the American Dream is an intrinsic value in our United States. “Health equity” means a fair and equal opportunity to achieve the long and healthy life we all aspire to live. What stands in the way? For some of us, there are hurdles too high to jump even when personal motivation is strong. Barriers such as lack of access to good jobs, quality education, affordable housing, a safe environment—all are determinants of health.
This brings us to our sweet spot at the Build Healthy Places Network: working at the intersection of community development and health. Because the determinants of good health are also the determinants of living a happy, productive, and successful life, and all people should have the opportunity for both.
So let’s talk about the flip side for a moment – the lack of opportunity to achieve a healthy and rewarding life. One root cause of this is poverty. And addressing poverty is the focus of community development work and investments. But too often, many Americans face a double-whammy. Not just poverty, but poverty plus sustained, systemic discrimination. Poverty combined with discrimination has even greater adverse effects on the health and well being of people across race, ethnicity, gender and sexual identity. As evidence, a new report from The Prevention Institute describes how discrimination has exacerbated the impact of poverty to create a vicious cycle of denied opportunity and poor health.
Poverty + discrimination is complex and intractable. But we believe that greater collaboration, utilizing the strengths of different sectors to maximize impact, can overcome it.
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