Why Do We Care About Health Equity?
The fight for health equity—for everyone to have a roughly equal shot at the potential and choice that good health offers—is of course, similar to the fight for economic justice and the work of community development.
By Miriam Axel-Lute -
This piece appears in the Winter 2018 edition of Shelterforce magazine. Subscribe here.
Though it may seem a silly question, what is the point of being healthy? There are many ways to answer that question—we want to avoid pain, keep our spending on copays and hospital bills down, and be available to our loved ones for a good long time. But in the end, it's about things like wanting to be able to fulfill our potential and having as much choice as possible about what we do with our lives.
Phrased that way, the fight for health equity—for everyone to have a roughly equal shot at the potential and choice that good health offers—is of course, similar to the fight for economic justice and the work of community development. Economic and housing stability, access to education, a neighborhood full of opportunity and connected to more—these things also are about dignity, choice, and an equal chance to fulfill our potential.
Of course we've learned along the way that many of those latter things also affect physical and mental health, compounding their effects.
As we launch a "Health and Community Development" desk here at Shelterforce, I thought it was important to start the conversation by reminding ourselves of our goals. After all, no one ever wanted to improve their own personal health in order to reduce the cost burden of health care in America, relieve the pressure on their local hospital ER, or even to "reduce health disparities."
Even though those are important angles to take as we try to redirect resources and shift the way that we think about health on a systems level, I find it useful to stop every once in a while and remind myself that this is just another path toward justice.
Diabetes rates matter for the same reason housing affordability matters—their effects on the people experiencing them. And where there are disparities in who bears the brunt of those problems, it ripples outward into disparities on many other fronts that create deeper injustice. As in community development, one of the most common ways that manifests is along racial lines.
It can feel sometimes like everyone is talking about the intersection of health and community development. And yet, the actual work is mostly at the very beginning stages. It's an exciting moment, and we're looking forward to helping you stay in the loop.
In this issue, and from our health desk going forward, you'll find articles that will:
help you make the case to potential partners and funders about why you all should be working at this intersection
explore what is being learned about how community development and health care sector partnerships work, both challenges and successes
examine how the community development field is changing its own practices to take health factors into account more directly
share the latest innovations in metrics and evaluation
promote good policy that supports this work.
Case making can be statistics, expert arguments, or stories. Partnerships can range from art projects on a clinic lawn, to funding partnerships (here and here), to placing clinics in housing developments. There are many lessons to be learned from some of the first ones (here and here).
You may have heard the argument that the health care sector should support community development to save money—as when a supportive housing development reduces ER visits and readmissions and improves health for formerly homeless patients. The argument for reduced cost is strong in many cases, but there are dangers in leaning on it too heavily. Better outcomes without added spending is a better way to focus. Meanwhile, Georgia has adjusted its tax-credit allocation plan to take health into account, an example of what can be done when housers and public health professionals collaborate on policy work.
Justice and better outcomes for everyone is what we all work toward. Together, the health care and the community development sectors can move toward this goal faster than either can alone.
Shelterforce is always interested in hearing about your work and your reactions to what our authors have to say. If there's a trend, challenge, or solution you think we should be looking into, let us know at miriam@shelterforce.org
Note: It took many people to advise and support us as we launched the health and community development desk and produced this issue. Some of them can be found here.
Miriam Axel-Lute
Miriam Axel-Lute is editor of Shelterforce and associate director of the National Housing Institute. She lives in Albany, New York, where she serves on the Community Development Alliance board.