February 2016

How Employers Can Support and Promote Healthy Communities

There is an inextricable link between health, income and education.

In general, the more education you have, the more income you’ll earn over your lifetime and higher education can translate into better health. According to the Robert Wood John Foundation’s (RWJF) Commission to Build a Healthier America, “25-year-old college graduates, on average, live eight to nine years longer than people who have not completed high school. And the contrast is not just between the extremes—they can also expect to live two to four years longer than their counterparts who have attended but not completed college.”

What Determines Our Health?

So, where should we direct our focus? It turns out that our health is mostly determined by our behavior and environment. According to the RWJF and University of Wisconsin Population Health Institute,

• 40 percent of our health status is determined by our education, employment, income, family and social support and community safety,
• 30 percent of our health status is determined by our health behaviors, such as our tobacco use, diet and exercise, alcohol and drug use, and sexual activity, and
• 10 percent of our health status is determined by our air and water quality, housing and transit.

That means that only 20 percent of our health status is determined by our clinical care—in terms of access to care and quality of care. While this statistic may be surprisingly low, it does not trivialize the importance of medical care. Clearly, living in a healthy neighborhood is no consolation if you are sick and your illness could bankrupt your family financially, physically and/or mentally.

Location, Location, Location

What is crucially important to recognize is the extent to which ZIP codes matter. Our ZIP code tends to be a more accurate predictor of how long we live than our genetic code. As shown in the map of  New Orleans, babies born in a neighborhood not far from the French Quarter can be expected to live, on average, until the age of 55, while babies born a few miles northwest, in a suburban Lakeview neighborhood, can be expected to live up to a generation longer, until the age of 80.

This pattern is not unique to New Orleans. It is a pattern seen in communities across the country.

ZIP CODE MATTERS

Source: Robert Wood Johnson Foundation Commission to Build a Healthier America, . These data points are life expectancy at birth. Information prepared by Woolf et al., Center on Human Needs, Virginia Commonwealth University using Evans BF, Zimmerman E, Woolf SH, Haley AD. Social Determinants of Health and Crime in Post-Katrina Orleans Parish: Technical Report. Richmond, VA: Virginia Commonwealth University Center on Human Needs; 2012.

What Works

There are a number of organizations working with communities that are struggling with their health, income and education. Their investments and activities include:

• building housing that is affordable to low-income households;
• financing charter schools, child care centers, community centers, grocery stores, health clinics and other community facilities;
• providing training and small-dollar loans to entrepreneurs who are not yet creditworthy to access mainstream bank products and services; and,
• helping people build and repair their credit and access quality financial products and services.

All sectors—nonprofit, for-profit and public—and all disciplines—medical and nonmedical—must work together to build a culture of health. “Healthy” can become the norm when we design our environments—where we live, learn, work and play—to make “healthy” the easy and attractive choice.

Employers have an important role to play in this endeavor, and it extends beyond their four walls.

How Employers Can Support and Promote Healthy Communities

1. Prepare your story by putting it in a “healthy communities” perspective. Describe the complex link between education, income and health; explain why ZIP codes matter; illustrate how your work supports or promotes healthy communities; and highlight the economic, financial, social and environmental value of your work.

2. Reach out to organizations that focus on components of healthy communities that you’d like to learn more about; learn their goals, successes and challenges; identify their community and economic development activities and geographic markets; ask them about community collaborations that they’d recommend you join; and invite them to participate in your community collaborations. Consider bringing your top staff from government relations, market research, marketing, public relations, human resources, etc., so that they can share their expertise and learn others’ perspectives.Below is a list of the components of healthy communities. All are integral to healthy, vibrant and resilient communities. A list of experts for each component is in the Appendix of the Federal Reserve Bank of Dallas’ publication Healthy Communities: A Framework for Meeting Community Reinvestment Act Obligations.

Healthy Communities Components

• Access to healthy food
• Access to medical care
• Aesthetics: clean and well-maintained environment, landscaping, art, culture
• Air, soil and water quality
• Building financial capacity: financial literacy training, quality financial services and/or products that build/maintain assets
• Built environment (complete streets, housing, schools and workplaces, parks and playgrounds, pedestrian walkways and bike trails, brownfields and open spaces)
• Early childhood development: education, care
• Education
• Employment, creating and retaining jobs, job training
• Entrepreneurship
• Personal/public safety
• Physical activity
• Public transportation, including transit-oriented development
• Senior needs: accommodation, care, services
• Social networks/social environment, democracy-building, community engagement
• Social services

3. As you decide how to address health and well-being issues, engage community entities and residents. Residents can tell you what will work, what won’t and what kind of change is valuable and meaningful to them.

4. Use your expertise to promote a culture of health. Write an op-ed piece in the local newspaper, share your research findings in public forums (e.g., with the city council), or sit on boards of nonprofits that address one or more healthy communities components. 

5. Consider your own strategy for cultivating a culture of health.

• Do you promote a family-friendly workplace culture?
• Do you consciously try to reduce stress in the workplace, such as by enabling employees to feel empowered to make important decisions?
• Are most of the food and beverages in your cafeteria, vending machines and at meetings nutritious?
• Do you promote physical activity, such as by making your stairwells attractive and providing exercise classes on-premises?

6. Define success not only as learning what works but learning what doesn’t work. Reward partners for sharing these learnings and incorporate these learnings into the feedback loop. This process of continual improvement is vital to creating a culture of health.

Elizabeth Sobel Blum is a senior community development advisor at the Federal Reserve Bank of Dallas. The views expressed in this blog posting are hers and not necessarily those of the Federal Reserve Bank of Dallas or the Federal Reserve System. Data and facts cited in this blog posting are compiled from public and private sources deemed reliable at the time of publication.