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Healthy Communities: The who, what and where of achieving health equity

Written by Christopher Smith on October 7, 2016

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For the Colorado Health Foundation, creating healthy communities goes to the core vision of making Colorado the healthiest state in the nation.

Read the full Expert Insight series!

Summarizing the Landscape of Healthy Communities: A Review of Demonstration Programs Working Towards Health Equity

A quick internet search of the phrase “healthy communities” returns more than 37 million results. Even “unhealthy communities” returns more than 13 million. Clearly, there are a lot of people thinking about what it is that makes the places where we work and live healthy – or not. At the Colorado Health Foundation, we are just as interested in understanding this question because realizing healthy communities goes to the core of our vision of Colorado as the healthiest state in the nation. So, we asked some questions of our own which are now part of a newly released report titled Summarizing the Landscape of Healthy Communities: A Review of Demonstration Programs Working Towards Health Equity published by the Build Healthy Places Network. Specifically, we wanted to know:

  1. What actions are communities across the U.S. undertaking to promote healthy communities?
  2. At the community level, what types of organizations are working to improve the health of their community?
  3. In what ways are foundations investing in this area?

38-healthy-community-programsThe impetus behind this all is the Foundation’s desire to continually improve our capacity to meet the health needs of all Coloradans. In 2012, we launched our Healthy Places Initiative, a five year, $4.5 million effort to help Colorado communities develop and implement transformative projects to improve their built environment and increase opportunities for safe, physical activity. By understanding the landscape of “healthy communities” efforts across the U.S., we would inform our project and make an already successful initiative even better.

I like to say that our built environment matters – a lot. But really, I’m not the only one. The Urban Land Institute’s report, America in 2015, showed that when choosing a place to live, quality of the environment is a top or high priority for 87% of adults, by far the highest community priority measured in the survey. The places we live matter – and they can either help or hinder our efforts to live active, engaging lifestyles. Another survey from the Urban Land Institute, Colorado in 2015, found that:

  • At 87 percent, Coloradans call the quality of the environment, including clean air and water, a top or high priority in deciding where to live
  • For lower-income Coloradans, many find their neighborhoods lacking in important ways – they are less satisfied with the quality of life in their communities, the limited range of affordable housing, the lack of accessible outdoor recreation space, and the concern that crime and traffic make it unsafe to walk
  • More than seven in ten Coloradans would prefer to live in neighborhoods with a mix of ages and cultural backgrounds over more homogeneous communities, and
  • 52 percent of Coloradans overall, including 63 percent of millennials, are drawn to areas where they would have less dependence on a car

To become healthy communities we must consider the interplay between the key factors that contribute to residents’ health.

These findings reflect the sort of needs and qualities that cities and small towns, both urban and rural, are best suited to deliver. But healthy communities are about more than just improving our physical environment. Much more. To become healthy communities we must consider the interplay between the key factors that contribute to residents’ health including social and community context, educational opportunities, economic stability, access to quality healthcare and yes, neighborhood and built environment. And we must acknowledge and commit ourselves to dealing with the intrinsic inequity that exists therein. For imagining that a healthy community can somehow exist without addressing the health equity of its residents is a dereliction of our duty as public stewards.

This expanded perspective and how people across the U.S. are applying it is the frame for Summarizing the Landscape of Healthy Communities (download the executive summary). The report tackles the question of health equity because we must tackle the persistence of health inequity. I encourage you to read it and ask yourself one more question – one that 37 million search results cannot answer: What are you doing to make your community healthy for everyone?

About the Author


Christopher Smith

Christopher Smith is a senior program officer in the Healthy Living philanthropy area at The Colorado Health Foundation where he is engaged in a variety of projects and initiatives to promote healthy schools and communities throughout the state. Prior to joining the Foundation in 2012, he was responsible for managing the City and County of Denver’s affordable housing programs. Christopher is a licensed Colorado architect and holds Master of Architecture and Master of Arts in Urban Planning degrees from the University of California, Los Angeles.