We often accept the simple fact that some people are simply healthier than others. But the reality is that health has much more to do with the way we’ve designed our policies and built our neighborhoods than our individual genetics.
Our policies shape our neighborhoods, and our neighborhoods fundamentally impact our health. We can have longer, healthier lives with our families, in our communities, across our region, and in our country if we focus on improving the environments we live in. Shifting policy has the power to do so.
Local policies dictate where our schools and sidewalks are located and even the air we breathe. They are highly variable from neighborhood to neighborhood.
Historically these policies reinforce racism and economic segregation, keeping us apart and causing harm. Each of these has a huge impact on our health.
In Johnson County, the wealthiest county in Kansas, we see a 12-year gap in life expectancy from neighborhoods that are just five miles apart, but economically segregated.
History and modern evidence make clear that racism was and is an important factor in designing, building, and maintaining our neighborhoods.
More than 150 years ago the Kansa and Osage indigenous tribes were forcibly displaced from their homes along the Missouri River and forced to move inland.
Banks offered mortgages to people of color only to purchase homes in approved neighborhoods — a practice called redlining — and city councils did not build those neighborhoods with wellness in mind. Today, modern redlining occurs through disinvestment in neighborhoods that have been built without access to whole foods, quality goods and services, and well-paying jobs.
The gap between wealthy and poor continues to grow, and with that comes devastating consequences for those trapped in cycles of intergenerational poverty.
How do we begin to fix this massive problem? It’s time to grasp it at the roots and ask different questions about what makes us healthy or sick.
Our neighborhoods, schools, jobs, the water we drink, and the food we eat all contribute to our long-term health.
To create healthier environments, we need to reckon with historical and contemporary racism and economic segregation that people in power baked into our systems and policies.
A landmark study by Raj Chetty and colleagues found that since 2001, life expectancy has increased by about 2.5 years for the top five percent of the income distribution, but there have been no gains for those in the bottom five percent.
In Kansas and Missouri, we have the resources to pay people a living wage in support of their livelihood and wellness. We also have the vision to imagine a society without racism, and we see that racism harms everyone. We have the ingenuity to solve deeply entrenched health issues that have plagued our counties and communities for decades. We have the power to shape our reality and mold a future where people who are working hard to make ends meet can prosper, where people of color are free from the structural racism that creates disparate health outcomes, where we thrive together in harmony with our communities.
“Curb Cuts” demonstrates how a policy designed for people with diverse abilities has ultimately benefited the entire community. In this video, a teacher describes how he used the curb cuts lesson to alter his teaching approach.
While this video uses the education system as its example, the same lesson applies for all who center equity in their work. Focusing on solutions and policies that uproot racism and build wealth for historically marginalized communities can lead to better health and wellness for our entire community. Racism seeds our society with hate and scarcity rather than acceptance and abundance, which touches all of us in negative ways, from the least privileged to the most.
By addressing the most pressing issues our communities face, we’re improving the conditions for everyone. Better schools, cleaner air, and safer streets mean healthier, economically stable neighbors, expanding what is possible for everyone in our region.
A Bolder Humboldt: Building creative pathways to live a longer, healthier life
Humboldt, Kansas, is more than 100 miles away from specialized care. This can be a matter of life and death for people seeking emergency medical assistance and for many others who could have prevented or treated an illness or condition if they had had access to regular screenings and information. Through community outreach and support, A Bolder Humboldt identified a real need for more accessible health education, and opened the Humboldt Fitness center, a 24/7 facility for B&W Trailer Hitches employees of the local Humboldt community, offering a free, local, easily accessible place to exercise, learn more about their bodies, and prioritize their health. This piqued the interest of other local businesses who were interested in offering their employees the same benefits. The facility quickly expanded. Today, Humboldt, with a population of 1,800, now has 800 residents (44%) enrolled and active at the Humboldt Fitness Center. Since its opening, the health of B&W employees has noticeably improved: Insurance rates have dropped, and doctor visits have decreased.
Recognizing the role that city infrastructure plays in health inequity, A Bolder Humboldt also launched Base Camp, an initiative to transform 21 acres of underused land into a community hub and playground. Base Camp will have trails that connect to downtown, making the town more accessible for people without access to transportation and improving walkability. By promoting health education, making exercise accessible and shifting infrastructure, A Bolder Humboldt is creating educational and physical pathways to help community members live longer, healthier lives.
MADE MEN: Expanding health literacy improves health equity
Communities in Kansas City are working to build their own health and better understand health care systems. MADE MEN provides educational tools and resources to support and improve health literacy among those needing assistance navigating their health in Kansas City, Kansas. MADE MEN offers a Community Health Worker Training Program, where members of the community are able to obtain their GED and Community Health Worker (CHW) training certificate simultaneously. Program participants have the opportunity to not only become more health care literate, but to become public health paraprofessionals who play crucial roles in promoting the well-being of others in their community. Their unique experience and insight into their community allow them to serve the community on the front lines, while also serving as a reliable voice their peers can trust, relate to, and understand. By providing individuals with support and educational resources, MADE MEN is removing barriers to health literacy and cultivating people’s trust in health information, which is a crucial step toward fostering health equity and social justice.
Office of Racial Equity and Reconciliation: Including race equity in policies
The KCMO Health Department has been a long-time advocate for the city to address how society and politics impact the health of communities, and to do so in a way where we all see improved community health outcomes. As a pathway toward healthier communities, the health department recommended including race equity in all policies adopted by Kansas City elected leaders.
The KCMO City Council, with Health Forward’s support, heeded that recommendation and created an Office of Racial Equity and Reconciliation.
This new office will focus on developing and implementing a citywide race reconciliation plan and a new, inclusive budget process that incorporates community input. In tandem with assessing the content of new resolutions and ordinances to ensure equitable foundations and antiracist language, the office will also begin reviewing existing city policies to remove embedded structural racism and discriminatory practices that prevent communities from achieving the best possible health outcomes.
In concert with this new office, the council also created a community task force that will partner with the race equity officer while ensuring the office’s accountability to the residents it serves.
In our effort to achieve racial equity and economically just systems, it is the creation of powerful oversight entities like the Office of Racial Equity and Reconciliation that will drive change in our communities, build community power, and create equitable places for healthy people.
MORE2: Ending biased disciplinary action in schools can improve health outcomes
In Kansas City, students have ambitions to graduate high school and attain a good education but data shows that Black students are disciplined in schools more than their white peers, and over-represented in out-of-school suspensions, which hurt their aspirations. These suspensions for such young children had a direct impact not only on their self-esteem and education, but also their health and well-being. MORE2 is working to end the bias in disciplinary action. Education has a direct correlation to health: having a high school degree can increase life expectancy by 11 to 15 years. Because of MORE2’s efforts, Kansas City, Missouri, Public Schools Board of Education updated its policies on out-of-school suspension for students in fifth grade and below. MORE2 is fundamentally shifting the education system to improve the health of its community. MORE2 helped establish a new bus route in South Kansas City, which takes residents to healthier grocery stores, works collaboratively with Kansas City corner stores to ensure healthier food options for residents, and engages voters on health, public education, and voter suppression issues. These efforts, along with MORE2’s dedication to educational justice issues, are having positive impacts on the community and helping dismantle discrimination to build a new pathway to health equity.
