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Notes from the Field

Connecting health and community development in the Rust Belt

Addressing startling health disparities within small geographies was the focus of the latest "Redefining Rustbelt"

The views expressed in this report are those of the author(s) and are not necessarily those of the Federal Reserve Bank of Cleveland or the Board of Governors of the Federal Reserve System.

You’ve probably heard by now that your zip code tells you more about your chances at a long, healthy life than your genetic code. This unfortunate geography of health is motivating the community development and health industries to work more closely together. Take Cuyahoga County (home to the City of Cleveland), for example, where the average life expectancy varies by up to 20 years depending on where you live within the county—20 years! Similar disparities exist when it comes to other health indicators, too.

Obesity. High blood pressure. Heart Disease. Diabetes.

Addressing these startling disparities was the focus of the latest “Redefining Rustbelt: A City Exchange of Strategies.” The event was the sixth in a series convening leaders by videoconference in Rust Belt cities (in this case Cleveland, Detroit, and Philadelphia) to discuss innovative solutions for cities facing economic and community development challenges.

Around 30 participants, primarily from public health agencies, local nonprofits, and academia, discussed how building healthy communities requires interventions at multiple levels: access to healthy foods and health services, empowerment of individuals to make better, healthier choices, and the physical neighborhood environment. All three cities are doing work on these fronts.

In Philadelphia, the Food Trust, a nationally recognized nonprofit, has worked with 660 corner stores across the city to carry healthier products. Typically providing limited fresh food options, corner stores are often thought of as barriers to healthy eating, especially in low-income communities where they are frequently the closest option for residents to purchase groceries. Since the Philadelphia Healthy Corner Store Network was launched, the Food Trust has documented a 60 percent increase of produce sales in some stores.

In Detroit, a 4-month pilot program called Health Rx—a partnership between the Ecology Center (a local nonprofit), Eastern Market (a 4.5 acre indoor/outdoor food market), and Community Health and Social Services (a federally qualified health center)—provided health screenings for at-risk patients of diet-related medical problems including obesity, diabetes, and hypertension. Patients are then helped by a nutritionist and provided food vouchers along with opportunities to attend cooking demonstrations of healthier dishes at a neighborhood market.

In Cleveland, similar multi-level interventions are increasing access to healthy foods and health services. Another important component of healthy communities is, of course, the built environment. Dilapidated structures, water-damaged buildings, and lead paint in old houses, to name a few, all pose hazards to our health. Among lead-poisoned children in Ohio, half live in Cuyahoga County. Environmental Health Watch, a local nonprofit, is using grant monies to inspect and remediate homes posing such hazards. Their project, “Engaging the Community in New Approaches to Healthy Housing,” will focus on Cleveland’s Stockyards, Clark-Fulton, and Brooklyn Centre neighborhoods.

The above are but a few examples and certainly don’t cover every corner at the intersection of health and community development. Participants also discussed financing strategies, Medicaid expansion, and the potential role of hospitals and insurance companies in community health initiatives, among other topics. They also emphasized the importance of addressing entrenched racial and economic barriers that hinder individuals from leading healthy lives.

For information on these topics and more, I encourage you to explore resources provided by the Healthy Communities Initiative, spearheaded by the Federal Reserve Bank of San Francisco with the Robert Wood Johnson Foundation, and the Build Healthy Places Network website.