This article is written by Kate Schroder, President and CEO, Interact for Health Kate Schroder.
As the third panel of this graphic shows, people situated differently need different support. The tallest person doesn’t need a crate to see the game over the fence, while the shortest person needs to stand on two crates to see. The crates are helpful and needed – and ensure that everyone has the opportunity to see the game. This is what we mean by equity. But is it enough?
Social service agencies, community organizations, government, churches, foundations and other groups often provide the “crates” – shelter, food, transportation assistance, job training, health services, etc. – that help individuals and families make ends meet. These supports are vital and often lifesaving. But it’s important to step back and question the social conditions that continue to create inequities that have persisted for many years. These conditions are represented by the fence in the graphic. As I wrote in a previous column, the inequities caused by the “fence” lead some in our region to live far shorter lives – up to 26 years from one neighborhood to another.
To achieve health justice, we must go further than equity. We must address the underlying conditions so that over time we can reduce and ultimately eliminate the number of support services needed. The realities of these inequities play out daily in small and large ways. For example, the Smith family may have kids with respiratory illnesses due to the mold and lead paint exposure in their rental home and air pollution in their neighborhood. They know that asking the landlord to fix the issues would likely lead the landlord to end their lease and rent to someone who wouldn’t complain. Although the kids are falling behind in school, the Smiths stay put – relying on tutoring for the kids, a food pantry and transportation assistance to make ends meet.
In our community, thousands of families are like the Smiths. And millions of dollars are spent helping families cope with such challenges. But the “fence” in the Smith’s case – their neighborhood’s environmental issues, limited affordable housing and lack of legal protections for renters – must be addressed so that they have a chance to live less stressful and longer lives like those in other neighborhoods.
At Interact for Health, we are focused not only on the needs of today, such as mental health and well-being, but also on long term solutions that will create conditions for all people in our region to be healthy and thriving, regardless of who they are and where they live. We, like many organizations, have learned that policy and systems change and increasing voice and agency in communities that have historically been furthest behind are effective ways to build healthy communities.
Better policies can lead to lasting change in a community. To reduce air pollution and surface temperature in neighborhoods, we must plant more trees. To reduce homelessness and evictions, we must incentivize creating more affordable housing and support renters and landlords to resolve issues before evictions occur. While change does take time, policies that help municipalities promote safe and thriving neighborhoods have been proven to work. Examples of such policies can be found at CityHealth.
Investing in civic engagement and leadership in priority neighborhoods also works. A report by the California Endowment on Building Healthy Communities found that “plugging the voice of community into the right kind of political power grid will do more to create health and wellness than any other single intervention.” This is what we are striving for in our region – communities where those most impacted are part of the policymaking process, leading and deciding what’s best for them.
While advancing health justice may seem daunting, it is possible – if we all work together. And it is not only the work of municipalities or nonprofits. Individuals can help, too. You can get outside your comfort zone and build relationships with people with different backgrounds. You can think about different policies and practices within your job or community that perpetuate inequities. You can learn what your school, employer, church or neighborhood is doing in regard to health justice and stay informed about housing, transportation and education issues. And you can attend your community council or town hall meetings and ask questions or become a member yourself.
If we all come together to invest our time, energy and resources, progress is possible. As Margaret Mead reminded us, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”