Adequate healthcare starts in our communities
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“Nothing in life is inevitable.” My mother repeated this phrase over and over to my siblings and me throughout our childhoods, pushing us to remember that we have the ability to chart our own course and create opportunities for ourselves.

That drove me to become a physician and help others. One challenge as a physician is that when clinicians see patients, what they see during the visit is only a glimpse of their overall health. It’s the things that individuals experience in their everyday lives outside of the doctor’s office that really tell their story.

There are social determinants of health such as: where you live, your access to fresh, healthy foods and your ability to walk and travel safely. Those factors can affect your life expectancy and they also can vary between communities from across the country, but even between zip codes within the same city and neighborhood. In some urban areas, convenience stores and fast food establishments may vastly outnumber grocery stores where people can purchase nutritious foods.


Take two men, John and Joe, for example. Both are 40-year-old males who live in Boston, but John lives in Roxbury, and Joe lives only a few zip codes away in Back Bay. In Back Bay, Joe feels safe to run outside on the sidewalk, his children have easy access to nearby parks and spaces to play, and a grocery store with healthy food options is within walking distance of his home.

In Roxbury, John lives in a food desert, relies heavily on public transportation to get to the grocery store and doesn’t feel comfortable letting his kids play outside after dark. These factors play into startling statistics: In Roxbury, the average life expectancy in some zip codes may be as low as 58 years, whereas in Back Bay, some residents can have a life expectancy of about 90 years.

According to the Journal of the American Medical Association, your zip code can impact your health just as much as your genetic code. These statistics may sound alarming, but when I look at this, I am reminded of my mother’s words of wisdom. Nothing in life is inevitable and we can all play a role in ensuring that people like John don’t have their lives cut short due to things we can address.  

U.S. communities need to create healthy opportunities

It will take more than just one organization stepping up to the plate to make a change. The prescription for change is an overarching approach to bring this all together. One way that some communities are helping to tackle the disparities in their area is by bringing together leaders to look at a broader definition of health and looking at the addressable determinants of health including safety and community wellness.

Look at Waco-McLennan County, Texas, where the Waco-McLennan Public Health District is working with nine local partners, including Baylor University, the City of Waco and the Waco Downtown Farmers Market, to increase the consumption of fruits and vegetables. The project comes at a critical time when, according to their 2013 Community Health Needs Assessment, more than 65 percent of county adults were considered overweight, and more than 50 percent were not eating the recommended servings of fruits and vegetables. The Public Health District is working with partners to offer monthly cooking demonstrations, add most fresh produce to food pantries and establish more locations to their mobile “Veggie Van.”

In Hillsborough County, Florida, the Garden Steps program is working together with the several community organizations including the Hillsborough County Metropolitan Planning Organization, the City of Tampa, the Department of Health of Hillsborough County and the Community Garden Coalition to increase access to local community gardens. The collaboration will increase pedestrian, bicycle and transit access to three new gardens in areas with low access to healthy foods.

Sustainable healthcare doesn’t come from a government agency or a political party: it starts in our homes, in our schools and in our communities. And that’s where the solutions also come from if we are to improve health disparities and reduce healthcare costs. It’s time we realized that we all have a vital role to play in improving the health of our nation, and it will take working together to make it happen.

Garth Graham M.D. is the president of the Aetna Foundation, cardiologist, professor of medicine at University of Connecticut and a former deputy assistant secretary at HHS.

The views expressed by contributors are their own and not the views of The Hill.