The role of community development in improving population health and how paediatricians can help
A research paper Written by Build a network of healthy places and published by Academic Pediatrics, discusses the relationship between the postcode in which a child lives and the health implications of communities that carry over into adulthood. This includes the physical environment as measured by things like access to healthy food, places to be physically active, sanitation, and mental and emotional environments, including healthy relationships, communication with adults and school connectivity.
The effects of the environment in which a child is raised can be exacerbated by negative childhood experiences (ACE) such as exposure to violence or family instability and can have negative effects on the health of the child. child and into adulthood. The article examines the role pediatricians can play in promoting community development initiatives that foster healthy neighborhood conditions where children can grow and thrive.
What is Community Development?
Communautary development is a multi-faceted term that originated in the anti-poverty and racial justice movements of the 1960s. It began in part as a corrective response to racial segregation and redlining practices in the housing and housing markets. finance that have created and perpetuated low-resource neighborhoods. Organizations involved in community development work, often focused on generational wealth creation and neighborhood quality, are augmented through investments in affordable housing, grocery stores, health clinics, schools and daycares, and small businesses to provide local jobs. These are direct resources in the community that are also known to have a positive effect on reducing crime, substance abuse, and other risk factors.
the Conway Center in Washington, D.C. is an example. The Conway Center offers affordable family housing and housing for the homeless, green spaces and a playground, offices, a job-finding center and a community health clinic in a property accessible by public transit. commmon. The center has not yet been formally evaluated, but the authors of the article advise that when such programs are evaluated, evaluators should measure its impact beyond traditional measures of controlled or clinical experiments. For example, metrics that capture the real impact on people’s lives should be employed.
Other examples are the Villages neighborhoods at East Lake in Atlanta, GA and Columbia Park in New Orleans, LA. Both communities were the originators of public housing projects, which now focus on raising children and the economic success of the family by prioritizing mixed-income housing, education from cradle to college, access to healthy food, recreation, public safety, and neighborhood services like shopping and banking. Columbia Park has not been quantitatively assessed, but villages in East Lake, Atlanta have seen a significant decrease in violent crime, a 5-fold increase in household income, top-five standardized test scores for schools K-12 in the Atlanta metro area and a 97% high school graduation rate that was below 30% in the 1990s.
How can paediatricians support community development?
What a child experiences and its impact on their developing mind and body can endanger them well into adolescence and even into adulthood. Interventions are therefore most effective when they target the early stages of a child’s life.
The opportunity to be healthy in childhood is a bridge to other opportunities – for education, emotional well-being and employment, the article says. Health promotion should therefore be a priority consideration for community development, and health experts should be included in the community development process. As experts in child health, pediatricians are uniquely qualified to integrate health as a protective factor into community development efforts. According to the National Academy of Medicine, only 10 to 20% of the state of health is related to medical care; the rest is represented by the social determinants of health – opportunities for healthy behaviors such as access to healthy food choices and safe and accessible places for physical activity, socioeconomic factors such as education and health. employment, and the physical environment such as housing and pollution. It is not only beneficial, but necessary for a physician to consider this holistic and interactive context in which health operates, knowing that health can be altered by any of these non-clinical factors.
According to the article, a pediatrician therefore has a professional interest in understanding the family and community characteristics of his patients that influence health. Pediatrician input can help design community development initiatives that support the healthy development of families and children. Jutte, Badruzzaman and Thomas-Squance share concrete ways paediatricians can use their professional voice to drive neighborhood investment through a community development framework.
Next, pediatric researchers can study the effects of neighborhood investments on child and adolescent health, potentially by studying health variables in neighborhoods where investments have already been made but whose the impact has not yet been measured, like the Conway Center.
Political action is needed
The Build Healthy Places Network article highlights the need for political action. Community development should be a central value and initiative to improve neighborhood health and preventative services. Neighborhood infrastructure has lasting effects on children that persist into adulthood for both risk and protective factors. Pediatric professionals can use their expertise in the field to practice, educate, and advocate for the principles of community development that consider holistic wellness. Trust for America’s Health’s (TFAH) Promoting health and cost containment in States (PHACCS) includes several policy actions that paediatricians can support to advance pediatric health:
- School-based health centers that meet comprehensive pediatric primary care needs, including health care, oral care, behavioral health care, and health education in fixed, mobile, or telehealth settings .
- Universal preschool and pre-kindergarten programs that promote child development and reduce the likelihood of risk factors throughout life.
- Housing rehabilitation programs that make physical improvements to neglected properties, such as lead reduction, rehousing programs that provide homeless people with support services to transition into permanent housing, and policies that protect affordability housing such as tax credits and incentives.
- Infrastructure development like “complete streets” policies that promote physical activity, safer streets, and mixed-use land spaces that create inclusive, integrative, and healthier neighborhoods to live and grow in.
- Affordable and sustainable quality housing that provides stability, economic and social opportunities for families, and long-term health benefits that are protective factors for lifelong well-being.
For more details on these solutions and policies, see TFAH’s PHACCS initiative and accompanying reports.