Health isn’t only about health care. Where we live, what job we have, our diet, our housing–these all affect our health and our lifespans.
With this in mind, the Robert Wood Johnson Foundation highlights cities that create a “culture of health”–that is, work to improve the wider ecosystem around health in a community. Its prize recognizes that “there’s an enormous amount of change that can be driven locally” and “that it looks different community to community,” says Abbey Cofsky, who oversees the contest.
RWJF recently announced six winning cities for 2015 from a field of 340 applicants. “[These cities] all have a broad view of health. It’s not just what’s happening in the doctor’s office. It’s about building health into green development, into housing, into schools and education,” Cofsky says.
The areas featured in this year’s prize include the Bronx, which through the the Bronx River Greenway project is providing new fitness and recreation for local people. The borough’s revitalization has lifted life expectancy by 9.7 years for men and 6.5 years for women since 1985, proving RWJF’s point about the place-health relationship.
The prize takes a wide view of “public health,” framing what’s normally a law enforcement and social service issue as a health one. For example, Kansas City, Missouri, is praised for its AIM4Peace program, which enables health workers to intervene to stop gang violence. “They’re able to think about violence as a public health issue. They interrupt retaliations by working with the trauma part of the hospital,” Cofsky says.
Other winners include the Menominee Nation, in Wisconsin, which is bringing health-related services to schools; the Waaswaaganing Anishinaabeg Tribe (also Wisconsin) which is drawing on cultural traditions to strengthen tribal members’ physical, emotional, and spiritual well-being; and Lawrence, Massachusetts, where old textile mills are being restored into affordable family homes.
To Cofsky, the line between health and social services is too strict: Blurring it might help get at the underlying problems people face, not just their symptoms.
“Often the folks who need the most health care are the folks who need the most social supports and services,” she says. “By thinking holistically, it allows us to provide better care and create better opportunities for individuals and families.”
The RWJF also supports the County Health Rankings, which track social determinants for health across 3,000 counties in the U.S. See the results mapped here.