We Have to Solve This Together

The tumultuous events in Charlotte after the death of Keith Scott almost a month ago have sparked an explosion of ideas on what we should do next.

Elected officials are proposing multiple plans, some with detailed interventions related to particular needs like affordable housing, others emphasizing universal pre-K to address underlying disparities, still others focused on providing enhanced training to police officers to deescalate tense situations.

The Opportunity Task Force is in the final stages of an 18 month discovery process, and the Task Force is now poised to bring insights and recommendations on a variety of ways we might improve economic opportunity and social mobility for all in Charlotte.

Some of our leading thinkers, including James Ford with the Public School Forum of North Carolina, counsel it is way too early to rush in with solutions. Ford argues we must first address and accept root causes of inequality that create a system that favors the well-off, before rushing into solution mode.

I think Mr. Ford and others like him are on the right track.

“If you want to lower my blood pressure, help me pay my electricity bill”

As an executive at a health and wellness agency serving individuals with very limited resources, I have my own set of suggestions to address disparities in health care access and health care outcomes. There are multiple health care policy and practice interventions that could help – from adding new federally qualified health centers in underserved neighborhoods to improving access to affordable nutritious food options to expanding proven poverty fighting programs, like our own Nurse-Family Partnership.

But as I reflect on the causes of unrest in our city and the challenges that those with the least face in living in Charlotte, I am struck by the fact that any solution we bring must come at this problem holistically.

We should not splinter into favoring one tactical intervention at the expense of other promising tactics.

Simply addressing one very clear symptom of the unrest, like lack of access to affordable, quality health care, without also recognizing that folks who lack health care access also are disadvantaged in securing adequate housing, paying for child care, accessing affordable transportation and much more would be a mistake.

Dr. James Purnell, in his recent piece “Financial Health is Public Health,” for the San Francisco Federal Reserve, leads with a quote from an individual that captures the challenge. An individual shares that “If you want to lower my blood pressure, help me pay my electricity bill.”

Our patients have difficulty keeping the lights on at home, they typically have poor or nearly nonexistent transportation options, they often cannot access or afford healthy foods.

Stressed to keep their heads above water just to keep their electricity bill paid, a cascade of negative, “toxic health” conditions arise. As Purnell writes, “…those who experience high levels of stress related to their finances are more likely to cope by smoking, eating, drinking alcohol, and watching television in excess, all of which increase their risk for chronic conditions like diabetes and heart disease.”

We know one’s physical health is closely related to one’s financial health. And there are even larger systems impacting the health of those with the least in our city, including inequities in our educational system for those born into poverty, neighborhood housing patterns highly segregated by race and ethnicity, and much more.

No one agency or individual has the single, fool-proof magic bullet intervention that will “solve” once and for all inequalities in our city or our country.

So as our community wrestles with next steps to improve conditions for those who have felt neglected for decades, I suggest we each need to put aside advocating exclusively for solutions that narrowly address our own sliver of the issue, regardless of how powerful or proven any one program may be.

What we need to do is to be better advocates for each other.

#PublicHealth #DonJonas #healthcare #OpportunityTaskForce #NurseFamilyPartnership #NFP #PublicSchoolForumofNorthCarolina

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