Think Local and Give Thanks
Sara Gardner, MPH
November is the month of Thanksgiving, a time of year when Americans pause and give thanks. In this current political environment, and considering the events of the last few months—hurricanes, mass shootings, and the recent terrorist attack in New York City—I am having a hard time finding something good. Typically, I am a glass-half-full kind of person, though as we move closer to this Thanksgiving season, I have found it hard to shake this malaise.
Luckily, after my routine run this morning and some time for uncluttered thought, I have reconsidered. Sometimes you have to back off from the big picture and focus on individual wins and progress to remind yourself that there are a lot of good things happening.
For starters, in New York City, we just re-elected Mayor De Blasio for a second term. From the public health perspective, this is a very good thing. Mayor De Blasio is a public health mayor whose signature initiatives focus on what we call the social determinants of health: affordable housing, education, especially early childhood education, and jobs—all foundational to good health. Under Mayor De Blasio, we launched the Building Healthy Communities (BHC) initiative and Thrive NYC, both priority efforts to address critical public health issues that will thankfully continue during the next four years.
Building Healthy Communities is a multi-faceted, public-private partnership designed to improve health outcomes in 12 chronically underserved neighborhoods across the five boroughs by increasing opportunities for physical activity, expanding access to healthy and affordable food, and improving public safety. Launched in 2015, the initiative has leveraged millions of dollars in public capital investments to improve parks, renovate recreation centers, add street improvements for bikes and pedestrians, and transform public plazas. In addition, through community engagement efforts, we invested private funds to pilot and scale interventions to expand free exercise classes, support schools to become more green and active, and to transform underutilized space to create urban farms at public housing developments.
Championed by the First Lady of NYC, Chirlane McCray, Thrive NYC is a city-wide strategy that takes a broad public health approach to the challenge of mental illness. Launched in 2015, the initiative aims to change the way people think about mental illness and how City government and partners deliver mental health services. Thrive NYC is based on six key principles with a total of 54 different initiatives designed to drive change and align action to improve the mental health of the population. Over the last two years, Thrive NYC achieved many milestones including establishing mental health clinics in community schools, providing training in Mental Health First Aid, launching a city-wide campaign to raise awareness and reduce stigma, and launching a mental health help line.
In both cases, the initiatives are examples of the power of public-private partnership and the importance of multi-sector stakeholder engagement to advance public health. Neither is a quick fix and both will require ongoing effort and support to achieve systems level change. We must stay the course.
Earlier in the month, I was in Atlanta Georgia attending the annual conference of the American Public Health Association. The conference is the single largest gathering of public health professionals with over 12,000 attendees from the US and around the world including public health leaders, advocates, academics, researchers, activists, practitioners and students. It was good to hear about the work happening in other places.
The issue of health equity was front and center at the conference with clear evidence that health equity is becoming a driving theme and a priority focus of local health departments as well as other community based groups across the country. There is clearly a renewed commitment to confront racism and other forms of discrimination and exclusion. I heard about many successful examples of programs designed to address the social, economic, and environmental conditions which create unjust differences in health and engage communities in new ways. Efforts like the BUILD Health Challenge, an initiative to improve community health by aligning funding, capacity building, and multi-sector partnerships to target upstream factors that impact health, increase health equity and lower healthcare costs. BUILD was launched in 2014 by a consortium of funders and has supported work in close to 40 communities nationwide.
The conference was an injection of hope and confidence that across this nation there is transformational public health work happening. Despite the dysfunction in Washington, DC and ongoing efforts that threaten current public health and healthcare legislation, there is momentum at the local level. Individual citizens, organizations, towns, and business are making progress. I left feeling a renewed sense of optimism and thankful that across our great nation there is an army of smart, dedicated public health professionals working to make our world a healthier place.
Now that is something to be thankful for.