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Healthy Communities: Everyone Deserves the Same Opportunities for Health

November 17, 2014

This is part of an ongoing blog series that celebrates PHI's 50th anniversary in 2014.

Pediatrician Doug Jutte was vaccinating children at his low-income clinic on schedule, testing them for lead and anemia, examining them annually and tending to their earaches and sore throats – when he had an “alarming realization” that there were staggering limits on what doctors can do to assure that their young patients grow up healthy. Too much of health is influenced by conditions outside the exam room, he found, and his medical training never touched on that.

Jutte, MD, MPH, is executive director of the national Build Healthy Places Network, a new program at the Public Health Institute, which works to highlight successful strategies that bring community development and health together. The idea is that the people most involved in shaping where roads, jobs, parks, stores, schools and industry are located can make decisions that are healthier for the people who live and work there. “You may not change the level of poverty or even the three jobs or the three kids or the lack of support, but if some of these systems are in place that can make one’s life easier within that context it’s going to reduce the wear and tear on the body that results in disease,” he said.

PHI has long recognized that our health is largely determined by the quality of our housing, the availability nearby of grocery stores well stocked with fresh produce and of places to be physically active, our air quality, and the safety of our streets and sidewalks. Nearly all of PHI’s work over the years can be viewed through the lens of improving the health of communities to prevent chronic disease and create a culture of health.

For example, back in 1988, PHI launched the California Healthy Cities and Communities program, the largest and longest-running statewide program of its kind. Thousands of city and public health officials as well as community leaders have been addressing the leading health threats through programs, policies and environmental interventions. Many other programs at PHI have marshalled the resourcefulness of communities to engage residents in reengineer their towns, cities and schools to better meet their needs around health, safety and overall well-being

Since 2010, PHI has overseen the work of the California Health in All Policies (HiAP) Task Force, the first organization of its kind in the nation working to give health a seat at the table in all state decisionmaking, from where roads are laid to creating safe affordable housing. It has become a model across the nation. PHI also led one of the largest statewide efforts to implement the Community Transformation Grants program, supported by the Affordable Care Act’s Prevention and Public Health Fund. The PHI program, CA4Health, worked in 42 rural and small California counties to combat disparities and chronic disease by empowering communities to address the social determinants of health.

PHI president and CEO Mary Pittman, long a prominent voice in the healthy communities movement,  continues to contribute to mounting momentum to address the social determinants health both with PHI initiatives and service on influential bodies. Pittman was appointed to the prestigious Institute of Medicine’s newly formed Roundtable on Population Health Improvement in 2013, which aims to address the root causes of disease that occur outside the doctor’s exam room.  She also served as an expert advisor on the then-new Let’s Get Healthy California Task Force. The task force issued a 10-year plan for making California the “healthiest state in the nation” by addressing the upward spiral of chronic disease and racial and ethnic disparities as well as containing health care costs.

PHI programs have changed not just the towns or regions where they have dug in but have contributed to healthier communities and reduced risk factors for chronic disease beyond their borders. Some key examples:

  • A California Project LEAN survey showing the state’s largest school districts had lucrative contracts with soft drink companies to sell their beverages to students spurred legislation to ban the sale of soda in California schools.
  • PHI's Breast Cancer Mapping Project developed maps identifying new California communities with elevated breast cancer rates.
  • A 2008 BARHII report revealed stark inequities in people’s health and how long they can expect to live based on where they reside, how much they earn, their race and their level of education. The report made more tangible the impact of the social determinants of health.
  • Berkeley Media Studies Group found that marketing of soda and fast food was targeted to communities of color that are at increased risk of diabetes, hypertension, heart disease and other chronic illnesses.
  • 265,000 kids and adults can choose water and other healthy beverages through healthier vending machines as a result of CA4Health; nearly 5,000 kids can walk and bike to school safely thanks to Safe Routes to Schools strategies at 100 schools.
  • The Network for a Healthy California helped drive a 92% increase in the number of low-income Californians eating recommended levels of fruits and vegetables over a 10-year period from 1998-2007.
  • The Center for Public Health and Climate Change established the US Climate and Health Alliance to build a national network of health and public health practitioners and organizations dedicated to addressing the threats of climate change to health.

After decades of working in social determinants, PHI now finds unprecedented momentum from nearly all fields to improve environmental conditions so that every person has the same opportunities to live a long and healthy life. We are dedicated to this fight. The time is now.

[Photo by Tim Wagner.] 

The PHI 50 timeline, shown below, provides even more examples of our half-century of achievements in healthy communities and preventing chronic disease.