By Stephanye R. Clarke
Now THAT is an attention-seeking opening if I ever saw one, but it is from the heart, nonetheless.
Like many, I’ve been entranced by what’s happening in Baltimore. Last week, I read an article titled, “Health Problems Take Root in a West Baltimore Neighborhood That is Sick of Neglect.” Earlier today, I saw another article titled, “15 Baltimore neighborhoods have lower life expectancies than North Korea.”
These articles got me to thinking about two things:
- How long before a series of similar articles is written about a city in Connecticut?
- What can we do to prevent that from happening?
The first article mentioned above cites some bleak statistics about Upton-Druid Heights in West Baltimore:
“Its residents die from every major disease at substantially higher rates than the city as a whole—nearly double the rate from heart disease, more than double the rate from prostate cancer, and triple the rate from AIDS. Life expectancy here is just 68 years, one notch above Pakistan.”
The other article offered a hypothetical scenario regarding the outcomes of two babies born in Baltimore:
“For another illustration, let’s look at a hypothetical case of two babies born on the same day this year in Baltimore. One is born in Roland Park, a wealthy neighborhood in the north of the city. The other is born just three miles away in Downtown/Seton Hill, one of the city’s poorest neighborhoods.
The Roland Park baby will most likely live to the age of 84, well above the U.S. average of 79. The Seton Hill baby, on the other hand, can expect to die 19 years earlier at the age of 65. That’s 14 years below the U.S. average. The average child born this year in Seton Hill will be dead before she can even begin to collect Social Security.”
The second article ends by setting a powerful, compelling and equally heartbreaking scenario:
“Imagine being a child and knowing that you could expect to die 20 years earlier than another kid who simply had the good fortune of being born just a few miles up the road from you. For Baltimore’s poorest, that’s the reality they’re living in.”
I cannot imagine any child growing up with that reality, but no matter, it is playing out in cities across America and in Connecticut. But this doesn’t have to be the reality if we provide better health and life outcomes for them.
HRSA (Health Resources and Services Administration) has focused much of their Maternal and Child Health work on the Life Course model. The site states, “the interplay of risk and protective factors, such as socioeconomic status, toxic environmental exposures, health behaviors, stress and nutrition, influence health throughout one’s lifetime.”
Simply stated, it is a tale of how the social determinants of health shape health outcomes.
Communities that are starving for resources and opportunities are likely full of stress, void of hope, with their residents on track to premature death via many causes including chronic disease morbidity and violence. People living in these communities typically find themselves entangled in systems over which they have no control: inadequate school systems; early introduction to the criminal justice system; poverty; demonization/dehumanization via media outlets; and the list continues.
Lack of opportunity and capacity to overcome these conditions puts them in danger.
At our recent Reform to Transform event, an item we explored was how a greater investment in social support, combined with quality, affordable care could improve health outcomes. One of our panelists talked to us about a client of hers named Mary.
Here’s a quick snapshot of Mary’s life:
- 68 year-old woman of color living on Garden Street in Hartford, Conn
- Health issues
- diabetes (feet & vision problems)
- worsening respiratory and ambulation problems
- congestive heart failure
- arthritis in knees
- Environmental issues:
- Absentee landlord
- Hallways are poorly lit
- Not enough trash cans for the all residents’ garbage
- Constant plumbing issues
- Cracks in walls
- Food desert
- Additional factors:
- Mail is habitually stolen, causing disruption in services and care
- No transportation
- Extremely limited communication
- Primary caretakers of two teenage grandsons
- Limited self-advocacy skills
Let’s face it—we all know a Mary or of a Mary, living in our respective cities. How might have earlier interventions shifted the trajectory of her life or those of her grandsons?
There are many different approaches to keeping Connecticut residents healthy, from the State of Connecticut Department of Public Health’s Living Healthy Connecticut plan to smaller, more community-based and targeted efforts. We must continue the important dialogue regarding meaningful and sustainable ways to improve health outcomes by addressing the root causes of poor health, exploring the connection between the built environment and health outcomes, transforming our health care delivery system, and creating policies and practices that are in concert with helping Connecticut residents achieve optimal health.
I started by stating that I am worried about our children.
My youngest daughter is 12 and my oldest daughter is 23, and they both know that I am their most enthusiastic cheerleader. Any day now, I will join my daughter and her husband in the delivery room as they welcome my first grandchild into this world.
I’ve always taught my daughters how to advocate for themselves in case I’m not around when they’re experiencing a hardship; a lesson I believe my daughter and son-in-law will pass to their child(ren).
Like most parents, I want the trajectory of all of their lives—health, wealth, a measure of success, peace and happiness—to be favorable.
I don’t only want this for my family, though—I want it for my fellow New London residents, my fellow Connecticut folk and for Baltimore, Ferguson and beyond.