January 30th, 2014
When I see people walking, jogging, or biking—no matter where I happen to be, whether it’s at home or somewhere I’ve traveled—I feel the urge to go outside and join them. Feeling that desire and having the ability to act on it is the essence of what it means to have a healthy choice be the easy choice.
Everyone wants to live a long and healthy life. Yet one-fifth of all Americans live in environments that compromise their health—where there are no sidewalks or trails for people to walk and bike; where there are no playgrounds or parks for children to play; where crime and violence discourage not only outdoor activity, but also social interaction; and where communities lack affordable access to fresh fruits and vegetables.
In such places, it is difficult for anyone to pursue good health, even if they are highly motivated. And although there is a tendency to associate unhealthy environments with poor, urban neighborhoods, people in rural and suburban communities often face many of the same health challenges. Making the healthy choice the easy choice is one of the harder obstacles we face in the state of Colorado and across the nation.
We know that where you live matters greatly to your health. In fact, how long and how well you live have more to do with your ZIP code than with your DNA code. The health of the community you live in directly impacts your own health.
That is why the recommendations released this month by the Robert Wood Johnson Foundation Commission to Build a Healthier America, of which I am a commissioner, are so important. The commission first convened in 2008 and then reconvened to address specific areas in which targeted investment would yield the greatest improvements in overall health now and for generations to come. These recommendations urge us to fundamentally change our approach to improving health, recognizing that we need to do more than treat illness—we need to keep people healthy. The recommendations call for prioritizing investments in our youngest children, encouraging leaders in different sectors to work together to create communities where healthy decisions are possible, and broadening the mission of health care providers beyond treatment.
Building healthy communities is an essential component of the commission’s blueprint for improving the nation’s health. This is an exciting idea that is gaining traction around the country and among many sectors. Consider the influence on how communities are built when the car is the priority. What if walking, biking, and other forms of transit were the center of how a community functions?
In Colorado, we already have several examples of this new approach to community revitalization—examples of leaders in public health, health care, education, transportation, community planning, business, and philanthropy working together to turn neighborhoods around and integrate health-related goals into all aspects of community development.
When the Denver Housing Authority recently redeveloped a seventeen-acre low-income housing project in the La Alma/Lincoln Park neighborhood near downtown Denver, it commissioned a health impact assessment. This type of assessment helps evaluate the potential health effects of a development project or a policy before it’s built or implemented. The result: a mixed-income community that has become a national model, with a health-conscious built environment that includes open staircases, natural lighting, sidewalks, neighborhood gardens, and demonstration kitchens for teaching residents how to cook more nutritious meals.
Another initiative, Mile High Connects, is a broad partnership of organizations from the private, public, and nonprofit sectors committed to increasing access to better housing choices, good jobs, high-quality schools, and essential services via the Metro Denver regional transit system. Mile High Connects has produced a Regional Equity Atlas that shows where critical points of opportunity—like schools, jobs, housing, and health care—lie in relation to Metro Denver’s current transit system. In this way, the partnership will work to ensure that low-income residents can use Metro Denver’s expanded mass-transit system to reach these areas and the services and resources they offer. By informing policy and working with residents and Metro Denver officials, Mile High Connects is addressing challenges that affect the health of low-income families in and around Denver.
In addition, the Colorado Health Foundation has launched Healthy Places, a five-year, $4.5 million initiative to inspire and support the development of healthy communities. We have partnered with the Urban Land Institute and leaders and residents in three communities—Arvada, a suburb in northwest metro Denver; Lamar, a small, rural town in southeastern Colorado; and Westwood, an urban neighborhood in southwest Denver—to create built environments where it is easier, safer, and more appealing to walk, play, and engage in daily activities that encourage movement, connection, and fun. In all three communities, we have engaged a diverse group of partners to expand opportunities for walking, biking, and other forms of recreation. We are excited about the potential for these improvements to help reduce obesity, particularly among our youngest residents.
In these kinds of partnerships, local leadership is essential. Local leaders can make health a part of the agenda. In addition, community members must provide their input on what they need to be healthy. What do they want their neighborhoods to look like? What do they want for their children? Getting and building upon such input requires not only strategic outreach but a serious commitment by all partners to listen. And, finally, responsive, well-informed, and well-designed policies are needed to make these changes become reality.
Colorado is not the only place where these kinds of healthy community partnerships are spurring improvements; across the country, there are pockets of progress. Every community should get the opportunity to be a healthy community—a place where everyone, for generations to come, has the opportunity to live a long and healthy life.
Think about it: what if we considered health when developing the buildings we live in, the places we shop, how we get to work, and where we play and exercise?
If we carry out the commission’s recommendations, and strive to incorporate health into all aspects of our lives, I am confident that one day we will reach that goal.
“Health Beyond Health Care: RWJF Commission Issues New Report,” by Chris Fleming and Tracy Gnadinger, Health Affairs Blog, January 15.
“Foundation Funding to Prevent Obesity,” by Lee L. Prina, Health Affairs, GrantWatch column, June 2013 issue.
“Health Impact Assessments Are Needed in Decision Making about Environmental and Land-Use Policy,” by Aaron Wernham of the Health Impact Project (a collaboration of the Robert Wood Johnson Foundation and the Pew Charitable Trusts), Health Affairs, May 2011 issue.
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