It’s a sad fact that we don’t all start out with an equal chance for a good, rewarding, healthy, long life.
There’s also ample evidence that where someone lives has a lot to do with how well and how long they live. Some people find themselves mired in an uphill struggle, bearing heavier burdens than those who live in neighborhoods only a few miles away.
A study in progress by Virginia’s Joint Commission on Health Care has the mission of coming up with proposals that could lead to better health care for vulnerable populations across the commonwealth.
A major focus of the commission’s study is investigating ways that Virginia can improve what the World Health Organization and the federal and state governments call the Social Determinants of Health. This is a critically important effort that has the potential to lay the groundwork for legislative proposals that could change people’s lives for the better.
Considerable research has found that these social factors have a profound effect on people’s lives and well-being. SDOH, as the agencies that deal with health problems call them, are such basics as economic stability; access to good education; and access to good, affordable health care.
The neighborhood where a person lives has a great deal to do with a person’s quality of life and health.
Where someone lives can determine so many other factors: How likely is a person to be a victim of crime? Is adequate housing available? What are the schools like? Is there good health care, including a pharmacy, nearby? Are there safe places to relax and exercise? What kind of jobs are available, if any? Is the air or water polluted? Is there a nearby grocery store selling healthy foods at reasonable prices, or is it a “food desert”? The list can go on and on, because so many things play a role in whether a person is healthy.
People who are not able to meet basic needs such as affordable housing, enough nutritious food and reliable health care are at increased risk for heart disease, stroke, cancer, diabetes, depression and other serious illnesses.
How much difference can a person’s neighborhood make when it comes to health? A lot, apparently. Recent data show that in the greater Hampton Roads region, Williamsburg’s life expectancy is 88 years. Compare that to Newport News and Hampton, where the life expectancy drops to 77 years. Or go farther west, to Franklin, where it’s 69.
And the differences aren’t just from one city to another. One neighborhood in a large city such as Norfolk or Virginia Beach can be a much healthier place to live than another just across a river or expressway.
The problems aren’t exclusive to urban centers, either. Many rural Virginia communities experience similar problems.
Some early suggestions as the commission was midway through its work early in June included fairly easy remedies such as doing more to spread the word about free immunizations and other available medical resources.
Other ideas address more intractable problems and will require more complex legislation. Many inequalities are part of a historic pattern of discrimination and segregation, much of it based on race and sometimes gender. Redlining — refusing to give even an otherwise qualified person in a low-income (often Black) neighborhood a mortgage loan — is supposed to be illegal now, but it lingers in subtler forms. Many stores shun poorer neighborhoods.
Often, SDOH problems — inadequate education, poor job prospects, financial and housing insecurity — are a sad legacy, handed down from one generation to another. But identifying these issues can help develop strategies to address them.
Virginia’s Joint Commission on Health Care is right to tackle the difficult and entrenched problem of great disparities in these social determinants that play such a large role in the health of many of our neediest people.
We look forward to seeing the commission’s final report, and for the General Assembly to consider its strong and innovative legislative proposals next session.
