Tuesday, June 26, 2012

Addressing health inequities means doing things differently

Parks are great but not if they aren’t located in neighborhoods that face high obesity and diabetes rates. Bike paths are awesome, but they won’t have much of an impact in the community if they aren’t well distributed across the city. And just because we’ve done something a certain way for 20 years isn’t a good reason to keep doing it – particularly when it comes to improving health.

Once again, public health leaders at APHA’s Midyear Meeting are talking about how they are doing things differently to tackle the problem.

A Tuesday session, “Achieving Health Equity: Solutions from the Field,” highlighted local initiatives to underscore health as an issue of justice.

“When we look at what is causing inequities in health, we come to accept it based on evidence. That really, social determinants of health play an enormous role in determining health outcomes,” said Barbara Ferrer, executive director of the Boston Public Health Commission.

Ferrer says the heart and soul of Boston are people of color.

“In those neighborhoods, you will see much worse outcomes. Be it foreclosures, elevated blood levels, higher hospitalization rates."

She and her colleagues have developed a health equity agenda to rid the city of these prevailing health equities that center on reducing low birth weights, tacking obesity, lowering chlamydia rates and building community capacity.

“We’ve really entered into areas where we’ve traditionally not been active,” Ferrer said.

And those efforts are starting to see results.

In 1999, the city was home to 90 dumpster storage lots. Today, there are only 12. Two hundred community garden plots are now in its place. The city has done more work around gun laws, paid sick leave and tobacco control.

“Policies that are good for health aren’t always health policy.”

APHA President-elect Adewale Troutman underscored this notion for the audience. He stressed the need to recognize structural factors that improve health conditions – be it land space, jobs, transportation, air quality.

“You have to ask yourself, can you do this work or do you need to change it and find another mechanism to make it work? Are we willing to take a risk changing society and structure?”

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