The $1 billion bet in California
The California Endowment is investing $1 billion between 2010 and 2020 in 14 low-income communities in the California Bay area to improve health outcomes. Tony Iton, MD, JD, MPH, former director of the Alameda County Department of Public Health and now Senior Vice President, Healthy Communities at The California Endowment leads the effort. For over a decade in the Bay area, Dr. Iton, who focuses on public health practice, has studied the link between social, economic and political constraints on communities and health outcomes. His findings corroborate over 30 years of international research that show morbidity (how people feel when they are alive) and even death can be socially determined.
Using this rough explanatory model as a guide:
- Segregation + Socioeconomic Inequality »» Poverty »» Stress »» Disease *
Dr. Iton’s teams have rigorously assessed community needs and are working with residents to—among other things—achieve more political participation in driving policy change to reduce socioeconomic inequality. It appears to be an incredibly well thought out plan. For example, Iton has hired health journalists and is training them to become experts in crafting impactful narratives around “equity, fairness and values” to promote community concerns. In addition to examining such things as healthy school programs and land use policies the initiative is working with youth leaders to develop solutions to youth violence that are more restorative and less punitive. Not exactly an agenda that come to mind when thinking about the mission of public health. It is a comprehensive program and bears watching.
Read more about this initiative and the 14 communities here .
* Douglas S. Massey (2004). SEGREGATION AND STRATIFICATION: A Biosocial Perspective. Du Bois Review, 1 , pp 7-25