HE HEALTH H HA HAPPENS NS IN N NE NEIGHBOR HBORHOOD HOODS (A (AND WHAT WE E CAN TO DO ABOUT IT IT) DAVID ERICKSON, FEDERAL RESERVE BANK OF SAN FRANCISCO DOUGLAS JUTTE, MD, MPH, BUILD HEALTHY PLACES NETWORK Building Healthy Communities Ohio, October 2014
THE FEDERAL RESERVE SYSTEM
REDLINING Community Reinvestment Act of 1977 (CRA) Philadelphia, 1949 3
AMER MERIC ICANS H S HAVE WORSE H SE HEA EALTH TH A AND SH SHORTER TER L LIV IVES ES
$2. $2.9 TRI TRILLI LLION ANNU ANNUALL ALLY
Hea Health ≠ Hea Health Ca lth Care
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” Preamble to the Constitution of the World Health Organization June 1946
9.9.13 Health and Community Development
CONTR TRIB IBUTIO TIONS T TO PREMATU TURE D DEATH TH Environmental Exposure 5% 5% Health Care 10% 10 Behavioral Social Patterns Circumstances 40% 40% 15% 15% Genetic Predisposition 30% 30%
HE HEALTH = H = ED EDUCATION
HE HEALTH = H = IN INCOME ME
AC ACROSS ALL RA RACIAL/ L/ET ETHNIC GR GROUP UPS
…BU …BUT P POVE VERTY I IS CO CONCE CENTRATED
IN IN C CLIMB IMBIN ING TH G THE IN E INCOME L ME LADDER ER, LO LOCATION MATTERS RAJ C CHE HETTY, E ECONOMIST
HEA EALTH TH HA HAPPENS NS IN IN NEIGH EIGHBOR HOOD HOODS
HE HEALTH H HA HAPPENS IN IN NE NEIGHBOR BOR HOOD HOODS
IN IN DETERMIN ININ ING YO YOUR HEALTH… 94131
PEOPL PEO PLE G E GET ET S SICK BEC K BECAUSE O E OF T THEI EIR R SOCIAL AL AN AND PH PHYSICAL AL EN ENVIRONMEN MENTS Schools Grocery Stores Housing Jobs Transportation Parks and Playgrounds
Small Business: Market Creek Plaza COM OMMUNI NITY DEVEL EVELOP OPMENT ENT INVES NVESTMENT ENTS Housing: Solara Charter Schools: KIPP
HEAL HEALTH S H SOL OLUTIONS ONS HAP HAPPEN I EN IN NEI NEIGHB HBOR ORHOOD HOODS
WE ARE MAKING PROGRESS
CO COMMUNI MMUNITY DE DEVELOPME MENT A NT ATT TTACK CKS THE THE CO CORR RROSIVE E EFFECT CTS O OF P POVERTY
HI HISTOR ORY OF OF COM OMMUNI NITY D DEVEL EVELOP OPMENT ENT 1960’s 1970’s 1980’s 1990’s 2000’s 2010+
“We are likely to look back at this time and wonder why community development and health were ever separate industries.” RISA LAVIZZO-MOUREY PRESIDENT AND CEO, ROBERT WOOD JOHNSON FOUNDATION WHATWORKSFORAMERICA.ORG
STATE OF E OF T THE AR HE ART Comprehensive Place-based Evidence-based Cross-sectoral
TH THE COM OMMUNI NITY QU QUAR ARTER ERBACK
CA CASA DE M E MAR ARYLAND AND
PR PROGRE RESS SS TO TOWARD CO COLLABO BORATIO ION
PR PROGRE RESS SS TO TOWARD CO COLLABO BORATIO ION • NEW F FUNDS C S CRE REATED • He Healt lthy F Futures F Fund nd • He Healt lthy N Neig ighb hborho hoods E Equ quit ity F Fund nd • EXPAN ANDING SO SOCIAL AL I IMPACT BO BONDS • Early ly C Child hildho hood: South Carolina, Orange County, New York State, San Francisco • Di Diabetes: New York State thma: Fresno and Alameda County, California • As Asth • Specia ial E l Educatio ion: n: Salt Lake City, Utah
SCOPE OF THE PROBLEM
TH THE PR E PROBLEM EM IS ENORMO IS EN MOUS 3, 3,570 70 Census t tra racts h have po poor r po popu pulations a abo bove 40% 40% 20.4 .4 millio million Ame Americ icans liv live in in d deep p poverty 80% O OF C COUNTIES IN AM AMERI RICA H A HAVE F FAL ALLEN BE BEHIND T THE L LIFE E EXPECTAN ANCY A AVERA RAGE O OF THE W WORL RLD’S T ’S TOP 1 10 C COUNTRI RIES 1,700 American high schools have dropout rates above 40%
ENT ENTIRE S E STATES ES HA HAVE B VE BEC ECOM OME E DROP OP OU OUT F FACTOR ORIES ES
SOLUTIO SO TION SC SCALE ≠ PROBLEM SCO PR EM SCOPE PE 1 CASA de de M Maryla land 1 ReFresh Pr Project 1 Neighborhood C d Centers, In , Inc 10 Pu 10 Purpose B Built lt C Communities How a are re t these se i individua ual efforts g s going t to so solve suc such a a big, b , big p problem?
WE NEED SYSTEMS CHANGE
WE HA E HAVE T VE THE HE BUILDING NG B BLOC OCKS IDEAS PARTNERS MONEY SHARED CAPACITY CREATIVITY VALUES
WHO AR HO ARE T E THE P HE PAR ARTNER NERS? Banks • • Community Development Financial Institutions • Public health departments State and local government • • Hospitals and Community Clinics/FQHCs Foundations • • Public Safety • Legal professionals Insurance companies • • Religious organizations High net worth investors • • Social entrepreneurs • Community activists
WH WHAT S T SYSTEMS N STEMS NEED EED T TO CH CHANGE T GE TO CR CREA EATE A TE A WEL WELCO COMIN MING EN G ENVIR IRONMEN MENT T FOR TH THE JU E JUMP? MP? HOW D W DO WE B WE BUIL ILD A AN ECO ECOSYSTEM TH STEM THAT T FOSTER STERS H S HEA EALTH THY Y CO COMMU MMUNITIES? ITIES?
DA DATA: WE A WE ALL N NEED EED TO U USE TH SE THE E SA SAME CO COMP MPASS SS
PO POLICY ICY: BREA EAK D K DOWN WN SIL SILOS A S AND ROW IN W IN TH THE E SA SAME DIR IRECTIO ECTION
FIN FINANCE: CE: CR CREA EATE A TE A MARKET MA KET TH THAT V T VALUES ES HEA EALTH TH
RES RESOUR URCES CES Inves estin ting in in W What W t Wor orks f for A or America merica’s Commu ommunities ities wh whatw twor orksfora oramerica merica.org org Build ild H Hea ealth lthy P y Pla laces ces N Netw twor ork build ildhea ealth lthyp ypla laces ces.org org Partn tner ers in in P Prog ogres ress partn tner ersin inprog ogres ress.org org
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