The Payoff From Focusing Locally on Health

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Confronted with pockets of poverty, inequality and poor health in one of the most prosperous communities in America, leaders in Seattle’s King County, Washington, gathered granular data from 400 census tracts and used the information to target “Communities of Opportunity.” Using the data, leaders invested in basic services, such as food innovation districts, to bolster the local economy, energize community development and build a foundation for improved public health.

King County is one of two detailed case studies included in the Urban Institute and Federal Reserve Bank of San Francisco collaboration, “What Counts: Harnessing Data for America’s Communities.” In the second case study, San Francisco’s Chinatown, the Chinese Progressive Association joined forces with the University of California— Berkeley’s School of Public Health to gather data and tackle local problems.

One critical issue was wage theft: Half of workers reported being paid less than a living wage. Two-thirds of workers whose wages were withheld for any reason reported never receiving the back pay. And almost one-third said their boss takes some of their tips. That left most of Chinatown’s restaurant workers living in poverty in one of the most expensive cities in the nation, making it difficult to pay rent, buy necessities and get needed health care.

In 2011, The San Francisco Board of Supervisors tightened wage theft regulations and created a task force to combat the problem. Within two years, workers for a local pastry company had won back $525,000 and back pay and penalties and a restaurant, Yank Sing, settled with community organizers for $4 million, the book says.

Armed with these data, the San Francisco Department of Public Health began to consider worker health and safety in its assessments of communities citywide.

In other examples of initiatives in which a broad spectrum of organizations, some involved in healthcare and some in other activities, have banded together to address social issues such as poverty, nutrition and prevention that affect community health:

  • In Nashville, the Chamber of Commerce, former Republican Sen. Bill Frist, the leadership of the for-profit Hospital Corporation of America (which owns nearly 175 hospitals) and community organizers have come together to talk about equity and how to deal with concentrated poverty.
  • In the city of Kent, Washington, population 127,000, a coalition largely made up of immigrants, called LivingWellKent, parlayed a 2014 CDC grant into a successful effort to create farmers markets, reduce health inequities and help newcomers fit in.
  • In Indiana, a hospital and YMCA have teamed up to pool their resources to improve health for hospital cases and members of the community. The hospital, called Hendricks Regional Health, and the YMCA aim to “break down barriers to a healthy lifestyle” by combining traditional health care services with fitness and wellness activities in the same facility. Staff of both organizations work together to offer diabetes prevention and care, nutrition counseling, weight management, health screenings and other services.