The Committee on Community Based Solutions to Promote Health Equity in the United States has released its report called Communities in Action: Pathways to Health Equity.
The Report addresses the social determinants of health – where people live, learn, work, play, pray, and age. Where you live, how much money you make, and the color of your skin can matter more than health care, insurance, and individual practices.
“Across the country, there are communities with insufficient access to jobs, adequate transit, safe and affordable housing, parks and open space, healthy food options, or quality education—the necessary conditions and opportunities to fully thrive. . . . It is the committee’s hope that this report will inform, educate, and ultimately inspire others to join in efforts across the nation so that members of all communities can enjoy life, liberty, and the pursuit of happiness undeterred by poor health.” Committee Chair James N. Weinstein.
The Committee reports in brief:
1 Health equity is crucial for the well being and vibrancy of communities (Chapters 1 & 2)
2 Health is a product of multiple determinants (Ch. 3)
3 Health inequities are in large part a result of poverty and disparities in income and wealth, structural racism, and discrimination (Ch. 3)
4 Communities have the capacity to promote health equity (Ch. 4 & 5)
5 Supportive public and private policies (at all levels) and programs facilitate community action (Ch. 6 & 8)
6 The collaboration and engagement of new and diverse (multi-sector) partners is essential to promote health equity (Ch. 7)
7 Tools and other resources including civil rights laws exist to translate knowledge into action to promote health equity (Ch. 8 & 9)
The Committee recommends supporting education, compliance, and enforcement related to civil rights laws (Recommendation 7.1).
The Committee highlights WE ACT’s work on environmental justice and civil rights in Harlem as one of nine communities promoting health equity (Ch. 5), as well as national work by WE ACT, the Environmental Justice Leadership Forum, GreenLatinos, and others on climate justice.
The gains in health outcomes for people of color and non-Hispanic white people “were the direct result of desegregation and the Civil Rights Movement” according to Stanford Prof. Gavin Wright’s work cited in the report (Ch. 6).
The Committee cites best practices from federal agencies. This includes the National Park Service, US Army Corps of Engineers, US Forest Service, US Department of Housing and Urban Development, and the US Environmental Protection Agency. The Committee also cites best practices from the states and local agencies. This includes California standards for distributing equitably the benefits of publicly funded resources, and physical education compliance by the L.A. County Department of Public Health and others.
The Committee recognizes that to “sufficiently examine and ultimately address health disparities affecting Native Americans, it is essential to understand the unique historical and legal context of Native American communities in the United States.” Appendix A.
Dr. Robert Bulllard, Dean, School of Public Affairs, Texas Southern University, and Marianne Engelman Lado, Clinical Professor of Law at Yale Law School, testified before the Committee on environmental justice, health, and civil rights compliance. Megan Haberle of the Poverty and Race Research Action Council (PRRAC) served as one of 14 independent reviewers.
Marianne Engelman Lado testifies before the Committee
Community based solutions to promote health equity focus on health and wellness, and not just medical care and insurance, as well as state and local laws and policies. This is vital in light of discussions to repeal the Affordable Care Act and other efforts to cut back health and safety net protections at the federal level.
The Robert Wood Johnson Foundation supported the Committee’s work to inform its initiative on a culture of health. Indeed, there can be no culture of health without law.
James N. Weinstein, Dartmouth-Hitchcock Medical Center, Chair
Hortensia De Los Angeles Amaro, University of Southern California School of Social Work and Keck School of Medicine
Elizabeth Baca, California Governor’s Office of Planning and Research
B. Ned Calonge, University of Colorado and The Colorado Trust
Bechara Choucair, Kaiser Permanente
Alison Evans Cuellar, George Mason University
Robert H. Dugger, ReadyNation and Hanover Provident Capital, LLC
Chandra Ford, University of California, Los Angeles, Fielding School of Public Health
Robert García, The City Project
Helene D. Gayle, McKinsey Social Initiative
Andrew Grant-Thomas, EmbraceRace
Sister Carol Keehan, Catholic Health Association of the United States
Christopher Lyons, University of New Mexico
Kent Mcguire, Southern Education Foundation
Julie Morita, Chicago Department of Public Health
Tia Powell, Montefiore Health System
Lisbeth Schorr, Center for the Study of Social Policy
Nick Tilsen, Thunder Valley Community Development Corporation
William Wyman, Wyman Consulting Associates, Inc.
James N. Weinstein and study staff members Amy Geller, Alina Baciu, and Yamrot Negussie served as Editors.
This summary reflects the views of The City Project and not necessarily of the Committee or the National Academies of Sciences, Engineering, and Medicine