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Healthiest Cities & Counties Challenge

Study: Investing in the community improves health outcomes

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Whether it’s spending money on education or public welfare or making an effort to improve the environment or local economy, investing in both health and social services led to positive health outcomes within a community, according to a study by Emory University.

The study, which was discussed at the “Healthy Cities, Healthy Towns” forum in Washington, D.C., provides further evidence that factors unrelated to health, such as education, employment rate and the environment, can contribute to someone’s health. It’s this realization that led to the Aetna Foundation’s launch of the Healthiest Cities & Counties Challenge, which will award $1.5 million in prizes to communities that show measurable improvements in health indicators and social determinants of health.

“The new community health research discussed at this week’s forum is an important part of focusing on effective solutions and moving us forward toward building a healthier world,” said Garth Graham, M.D., MPH, president of the Aetna Foundation.

A need to focus on “underlying determinants of health”

The study, conducted by Kenneth Thorpe, a professor and chairman of the Department of Health Policy & Management in the Rollins School of Public Health of Emory University, examined the effect different determinants of health had on several health outcomes at the community level.

He used metropolitan data collected from 2008 to 2012, as well as health and demographic information gathered from The Behavioral Risk Factor Surveillance System and Selected Metropolitan/Micropolitan Area Risk Trends data, to reach the conclusion that there is a need to focus on not just the health sector, but also “underlying determinants of health.”

A change at the local level

A number of factors within a community can contribute to a person’s health; where they’re living can be a stronger indicator of health than their genetic code. By focusing on community-level changes to impact health, it can affect the health care industry by creating better patient care and reducing costs.

Education, transportation and the economy aren’t related to health, but it can have an impact

Communities that spent more on education saw a reduction in age adjusted mortality, monthly mental health days and the prevalence of cardiovascular disease. And if a community spent more on public welfare and social services, such as parks and recreation, there was not only an increase in physical activity, but also a reduction in the prevalence of obesity, diabetes and cardiovascular disease.

How long a person’s commute also had an impact on community health. Communities with a commute time of over an hour had a slight reduction in the prevalence of obesity and diabetes, compared to a commute time of less than 30 minutes.

Thorpe’s study also found communities with a higher rate of income had better health outcomes. High unemployment rate within a community was tied to increased rates of poor health outcomes. More pollution to the environment also contributed to an increased rate of age adjusted and cancer-related mortality, as well as higher diabetes prevalence.

Change in health behavior

Thorpe also looked at health-related factors within a community that could affect a person’s health. An increase of residents participating in physical activities, for example, was associated with a number of positive health outcomes, such as a reduction in obesity, reduction in cardiovascular disease, the number of days not in good physical health and a reduction in age adjusted mortality.

More physical activity and less smokers can result in positive health outcomes

Reducing the number of smokers in a community was associated with a reduction in age adjusted mortality and cancer mortality, as well as a decrease in asthma prevalence and diabetes.

Similar results were discovered if there was a 1 cent increase in the state tobacco tax. Increasing the state tobacco tax by 10 percent was associated with a reduction in obesity.

Addressing health disparities

While there continues to be investments in health care, Thorpe’s study reveals doing the same for social services and other factors at the local level can greatly impact the health of residents in a community.

“All health care is local, and Aetna and the Aetna Foundation is committed to working with communities to identify and implement unique solutions that will improve health at the local level,” Graham said. “Partnerships between businesses, non-profits, governments, and local citizens are the most effective ways to build healthier communities.”