Health Equity Starts In Neighborhoods

One of the most significant factors influencing our life expectancy is the neighborhood in which we are born. If you think that’s an overstatement, consider this: In Los Angeles County alone, life expectancy varies from 68.8 years to 88.4 years, depending on the street you live on. The implications of these vast disparities in life expectancies are profound, revealing systemic inequalities that affect not just individual health, but entire communities. Residents in neighborhoods with shorter life expectancies suffer higher rates of disease, a lack of preventative services, poverty, and limited educational opportunities – differences that can perpetuate cycles of poverty and ill-health that pass down from one generation to the next. Furthermore, the psychological toll of living in an underprivileged community can damage morale and engender distrust in public institutions, further destabilizing neighborhoods and society as a whole.

The Consequences of an Increasingly Isolated Population

We trust one another less today. Our friendship circles have grown smaller. Communities where people with different lived backgrounds learn to organize across those differences are giving way to online echo chambers of the like-minded. The decline of Americans’ social capital has led to less vibrant communities and a fraying social fabric.

Our increasing disconnection from our neighbors has wide-ranging negative health effects on individuals and communities alike. Residents living in neighborhoods with few social ties or little social support experience more stress, anxiety, and depression. National Academies of Sciences, Engineering, and Medicine (NASEM) studies have shown that social isolation significantly increases the risk of premature death from all causes, comparable to the perils of smoking, obesity, and physical inactivity. The Centers for Disease Control and Prevention (CDC) reports that poor social relationships were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke. In addition to these adverse physical health effects, the lack of a proper community support system can be the cause of an increase in crime rates and a decrease in the overall quality of life, further elevating stress and exacerbating health inequities.

A Comprehensive, Neighborhood-Level Approach is Needed

Achieving health equity requires a multi-pronged approach at the neighborhood level. By working together, health plans, healthcare professionals, and community organizations can harness the power of social connection among neighbors to improve the health of all populations through strategies such as:

Empowering Healthcare Professionals: The first step lies in equipping healthcare professionals with the knowledge and tools they need. Health systems can provide formal training and ongoing education programs on social isolation, including effective prevention and intervention techniques.

Incentivizing Social Connection: Health plans can play a pivotal role by recognizing the importance of social well-being. By ensuring adequate reimbursement for time spent addressing social disconnection concerns and integrating social connection assessments into electronic health records, insurance companies send a clear message: social connection is a vital part of healthcare.

Supporting Vulnerable Patients: Educational initiatives can empower patients, particularly vulnerable groups like those with chronic conditions or living alone, to understand the dangers of isolation. Technology can be an ally in this effort. Healthcare providers can leverage online platforms to create peer support groups for individuals with similar health challenges and facilitate inclusive social events, both virtual and in-person. Integrating social connection assessments into care settings allows for the identification of patients who need additional support.

Building Community Bridges: The healthcare system can’t tackle social isolation alone — partnerships with community organizations and social service providers are critical. Healthcare professionals can spearhead these cross-sector collaborations, fostering a robust support system that addresses the root causes of isolation, such as housing insecurity or food scarcity. Integrating social determinants of health (SDoH) assessments into patient care allows for the identification of these pressing needs, and referrals for essential services can bridge the gap and empower individuals to build a stronger social safety net.

Fostering Community Spirit: Beyond clinical settings, fostering a strong sense of community is essential. Initiatives like community gardens, book clubs, or volunteer opportunities provide avenues for interaction and a sense of belonging. Public spaces designed for interaction, like walking paths or community centers, can become vibrant hubs.

Closing these gaps and achieving health equity requires more than just ensuring access to care: it requires changing the conditions and cultivating new opportunities for good health in the places where people live, learn, work, and play, so that all people can experience comparable levels of health and well-being.