A Call for CEOs and Officials to Step Up and Take On Health Inequalities

It’s a fact many Americans may be shocked to hear: We live shorter, sicker lives than people in other developed countries, despite the fact that we spend a lot more: nearly 17.5 percent of our gross domestic product in 2014. Not only that, there are there are steep health gaps within our borders – by income, education, race and ethnicity, geography, sexual identity and disability status, just for starters.

A landmark report released today by the National Academies of Sciences, Engineering and Medicine says these health inequities are costing us big time, from lost lives to squandered resources. And, perhaps most important, the report stresses that this is not a problem that doctors and patients alone can solve: Leaders from across sectors – education, transportation, housing, planning, business, and others – have critical, interwoven roles to play; ensuring that everyone has the opportunity to reach their full health potential is crucial for the nation’s economic and growth prospects, for its national security and for its communities’ well-being and vibrancy. 

So, where to start? Health officials have known for a long time that social factors – the ways that our social and physical environment affect us – matter a lot more to our health than genetics or medical care. This new report reinforces that wisdom, and points to clear steps for businesses and other institutions with key roles in communities, like universities and hospitals.

First, these local institutions should make expanding opportunity in their communities a strategic priority, not just the responsibility of the community relations department. That means joining the mulitsector partnerships critical to positive change, the report notes. In Louisville, for example, local businesses – including the utility company and a major law firm – joined government agencies, community organizations, churches and educational partners to form a program to add 55,000 postsecondary degrees to the area by the year 2020. Those businesses recognize that a better-educated workforce is good for everyone.

In Camden, NJ, longtime corporate resident Campbell’s Soup committed to investing $1 million a year for ten years to cut childhood obesity and hunger by 50%. Local hospitals have stepped up, too, partnering with the Camden Coalition of Healthcare Providers, which uses real-time data to connect residents cycling in and out of emergency rooms with personal help to address their complex needs. The results of this “hotspotting” effort – with much of the important work happening outside the hospital – are healthier, happier people, and much lower costs.

Local policymakers play an important part, too. The report calls on them to work with the community to examine every potential project for unintended consequences that might increase inequities, starting with housing, land use, and transportation. It highlights efforts in Boston, where a committee of the Dudley Street Neighborhood Initiative reviews housing, open space, economic development and environmental proposals with just that lens.

And in Minneapolis, residents and community groups are collaborating with the police to prevent youth violence, while local health officials have partnered with 40 organizations on an obesity and tobacco prevention initiative that includes smoke-free housing units, corner stores stocked with produce, and a renowned infrastructure and culture of biking and walking.

These examples, and others highlighted in the Academies’ report, show just how important it is for all of a community to come together, and they give us a good model for getting started.

When Congress and President Lincoln created the National Academy of Sciences in 1863, they never could have imagined the America we live in now – but they were wise enough to know we’d always need the nation’s best scientific minds studying critical issues and guiding us on the best way forward.

More than a century and a half later, we would do well to heed their urgent call for health equity – from exam room to board room to City Hall – and to work together to make it happen.