• Wed, Mar 6 2013

What Makes For A Healthy Community?

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What makes a city, community or neighborhood a healthy place to live? Lindsay Abrams tackles this at the Atlantic Cities today, with help from a survey conducted by the publication and GlaxoSmithKline.

For the survey, some 1,000 Americans were asked to rate various community health resources by order of importance. Overall, “good air and water quality” was ranked highest (97% said it’s “very important”), followed by easy access to doctors and dentists (82%), healthy food choices (81%) and nearby hospitals or urgent care facilities (74%).

Participants were less keen on the importance of “kind, supportive neighbors” (just 39% said this was very important to good health), open parks and green spaces (59%) and nearby gyms or recreation facilities (41%).

The results show “our priorities for building healthy communities are inextricable from our reliance on institutions,” writes Abrams. “Many of us tend to put the responsibility for our community’s’ health in the hands of doctors and hospitals.”

But while access to medical care is obviously important in any community, it may not be the healthy-living panacea Americans seem to think it is.

“There are broader contextual factors in communities that are definitely driving health outcomes more” than access to care, says Jason Purnell, PhD, MPH, an assistant professor at Washington University’s Brown School. “That understanding seemed to have been missing from the survey results.” The World Health Organization insists, “to a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.”

“The health care system caters to people who are already ill,” says Purnell. “There’s a mismatch between the structure of the health care system and what’s actually killing people.” Population health, he adds, is better served by prevention measures and by attention the factors, like place, that impact well-being.

As Steven Woolf wrote in Journal of the American Medical Association in 2009, “To focus on health care comes naturally to physicians, who work largely in this area, and it resonates with the public and their leaders, who view medicine as the front line in the war of disease.” But “health is much more than health care,” he continues, and “whereas health policy gives some attention to public health issues, it deals little with the social context of life, which exerts profound influence on health.”

Go read the whole thing for more insight on what’s making Americans healthy and unhealthy versus what we think is making us healthy and unhealthy.

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