By Robert K. Ross, MD
We were fortunate to have First Lady Michelle Obama join The California Endowment in the recent kick-off our 10-Year Building Healthy Communities plan for the state of California. This $1 billion plan is likely our nation’s most robust strategic effort at confronting the thorniest of public health challenges: the social determinants of health.
For definitional purposes, we understand a “healthy community” as a place where children and youth are healthy, safe, and ready to learn. Since our foundation’s mission focuses on the health needs of underserved communities, we now find ourselves in the business of community change and transformation, from a disinvested, unhealthy place to one that is healthy and where young people can thrive.
The public health data and literature tells us that on the matter of health disparities, “place” matters. Access to healthy foods, fitness opportunities, public safety, quality housing, good jobs, and quality schools are as critical to attaining good health as is affordable health insurance and community health clinics. Hence, comprehensiveness is critical. This is why we have selected 14 low-income, underserved communities to focus a decade of support in by working with community leaders and residents. We invite their ideas, creativity, energy, voice, and passion in the transformation of their neighborhoods.
But while “place” and grassroots involvement are important, linking grassroots and local action to advocacy for broader policy and systems change is vital. Policy and environmental changes constitute the most sustainable path towards establishing a real “culture of prevention” in underserved communities and beyond. So, place and policy are the twin pillars of our Building Healthy Community plan. We are planning to invest roughly 60% of our grantmaking in grassroots-level activities and 40% of our resources in broader regional and statewide policy advocacy, organizing, and communications work. The “true north” of all of this: the results. We are looking at ten-year improvements in children’s health coverage, childhood obesity reduction, youth violence prevention, and school attendance.
The combination of the passage of national health reform legislation, unacceptable spiraling health costs, and a stubborn and pervasive epidemic of child and adult obesity demands that public health leaders (and other advocates for prevention) stand up and stand tall with community and civic leaders around our nation. Americans at the short end of the health equity stick need us to be bolder and more powerful on their behalf. At the California Endowment, we join public health--and community health--minded colleagues in the battle.
Robert K. Ross, MD, is president and chief executive officer for The California Endowment.
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