How reporters can make crucial connections between local policies and people’s health

For years, residents of Summit County, Ohio, were having a hard time staying healthy. In 2008, 39 percent of kids in the county were obese or overweight, and 22 percent had asthma (at the time, the national averages were 27.4 percent and 8.9 percent, respectively). Many adults struggled with diabetes or prediabetes. And like many communities around the country, the county’s low-income neighborhoods and communities of color consistently faced higher rates of chronic disease.

But the reasons for these health issues went beyond genetics or lack of access to health care. The root causes of many chronic diseases are environmental. Throughout Summit County, convenience stores and fast food restaurants far outnumbered grocery stores. Less than 1 percent of residents biked to work, and only 1.5 percent walked. Local advocates and officials realized those conditions weren’t happenstance, but the unintended result of long-standing county policies, including zoning ordinances that kept grocery stores out of some neighborhoods, and plans that didn’t prioritize building bike lanes.

Recognizing that a few one-off programs wouldn’t effect meaningful change, Summit County turned to Health in All Policies, a collaborative, comprehensive approach to crafting policies that promote health. Summit County may still be a work in progress, but it has joined the ranks of communities that are creating a healthier, more equitable future for their citizens.

How policy affects health

All government decisions affect health, but we don’t always realize it. News stories often focus on genetics or disparities in health care, and those that do examine the environmental conditions that affect health typically don’t zero in on the government policies that contribute to those conditions. Here are three lenses through which reporters can analyze how policies shape health in their communities:

Sustainability: In the policy context, promoting sustainability provides an opportunity to promote health. Policies that invest in public transit, bike lanes, and sidewalks can reduce car emissions and help people be physically active. Ordinances that affect storm water management, such as Summit County’s new “green streets” initiative, can reduce pollution in rivers, streams, and ponds and keep the water supply cleaner. Even decisions about where housing is built can affect the environment as well as residents’ health.

Though it’s not always easy to connect the dots, patterns emerge when we consider how our environments are linked to health. Journalists might ask how government decisions – highway expansions, storm water management, housing code enforcement procedures – may contribute to chronic health issues. Are government agencies regularly assessing the impact of policies on health in addition to the environment?

Opportunity: Communities should create opportunities for residents to eat well, be physically active, and lead healthier lives. Local policies can determine whether healthy foods are accessible and affordable, parks are built, and schoolyards are open for public use. But lack of job options, educational opportunities, and quality, affordable housing can also force people into circumstances that work against their health. In Akron, the Summit County seat, investment in bike lanes and sidewalks as well as community events like the Better Block event are aimed at promoting health and economic development.

Reporters can gauge the presence of health-promoting opportunities in their own communities: Is produce easy to buy and housing affordable and pest free? Are certain policies – zoning constraints that forbid farmers’ markets, permitting hurdles for small businesses, limited funds for parks – keeping people from achieving good health? Are government agencies collaborating to promote health along with economic growth and social mobility?

Equity: African-Americans are far more likely to die as infants, die from heart attacks and stroke, and be murdered than whites. Low-income populations are more likely to suffer from asthma, be hospitalized for preventable causes, and be diagnosed with diabetes than wealthier people. In Summit County and across the country, toxic exposure and policies that limit healthy opportunities disproportionately impact poor neighborhoods and communities of color, making residents more likely to suffer worse health outcomes.

Reporters should remember to look at the distinct differences between populations and areas, and identify where chronic diseases are most prevalent. How evenly are grocery stores, bike lanes, and good schools distributed? Where are streets, buildings, and parks maintained or neglected? What policies could be creating such dramatically different environments, and, in turn, different health outcomes? How do government agencies engage the community so all residents’ voices are heard, regardless of where they live?

Why government collaboration matters

A growing understanding of how government decisions affect health has led communities like Summit County to call for a new, collaborative approach to policymaking. The goal is to ensure government more effectively addresses local needs and improves health outcomes. 

Collaboration helps government agencies work better together and with the community. A transportation department, for example, may expand a roadway without consulting with the environmental agency about how the added car emissions might affect air quality. By coordinating their efforts to promote health, agencies can be sure they’re on the same page, which makes government more efficient. A community’s public health, housing, and public safety departments, for instance, could join forces to keep local housing safe, clean, and smoke free. Jurisdictions can formalize collaboration to ensure policy decisions aren’t made in a vacuum.

Government agencies have an important role to play in helping people be healthier, and quality reporting can hold those agencies accountable for their decisions while bringing to light the important links between health, place, and policy.

Interested in learning more about policies that promote health? Visit me at my session at the American Public Health Association’s annual meeting this week and I’d be happy to answer your questions.

Photo by Mark Turnauckas via Flickr.