A Time of Opportunity: Local Solutions to Reduce Inequities in Health and Safety
AUTHORS: Larry Cohen, M.S.W., Anthony Iton, J.D., M.D., M.P.H., Rachel A. Davis, M.S.W., and Sharon Rodriguez, B.A. Paper presented at the Roundtable workshop on State and Local Policy Initiatives to Reduce Health Disparities, Minneapolis, Minnesota (May 11, 2009)
: Good health is precious. It enables us to enjoy our lives and focus on what is important to us—our families, friends, and communities. It fosters productivity and learning, and it allows us to capitalize on opportunities. However, good health is not experienced evenly across society; heart disease, cancer, diabetes, stroke, injury, and violence occur in higher frequency, earlier, and with greater severity among low-income people and communities of color—especially African Americans, Native Americans, Native Hawaiians, certain Asian groups, and Latinos. (See Appendix A: Inequitable Rates of Morbidity and Mortality.) Health inequity is related both to a legacy of overt discriminatory actions on the part of government and the larger society, as well as to present day practices and policies of public and private institutions that continue to perpetuate a system of diminished opportunity for certain populations. Poverty, racism, and lack of educational and economic opportunities are among the fundamental determinants of poor health, lack of safety, and health inequities, contributing to chronic stress and building upon one another to create a weathering effect, whereby health greatly reflects cumulative experience rather than chronological age. Further, continued exposure to racism and discrimination may in and of itself exert a great toll on both physical and mental health. Inequities in the distribution of a core set of health-protective resources also perpetuate patterns of poor health.