My husband and I were both raised in Pennsylvania, in the cities of York and Pittsburgh, respectively. These places shaped our earliest memories, social connections, and educational opportunities, as well as our parents’ jobs and the resources available to help provide for us. It turns out that they also could affect our life expectancies.
In September, the Robert Wood Johnson Foundation released an interactive tool to help communities calculate life expectancy. For the first time, residents, researchers, and decision-makers can access census-level data to measure and compare how long people live in nearly every neighborhood across the country.
Pittsburgh and York are approximately 240 miles apart. The average life expectancy for the state is 78 years. However, in my home ZIP Code of 15217, life expectancy is 80 years, while average length of life in my husband’s home ZIP Code, 17401, is 73 years.
This 10% difference in expected lifespans across hundreds of miles is far from the most shocking example of place driving divergent outcomes. Life expectancies in the same city may differ drastically. In Cleveland, the average life expectancy for babies born to mothers in different neighborhoods can vary by as much as 20 years. In New Orleans, the gap is more than 25 years.
But why? What can be so different between one neighborhood and another?
Research shows that neighborhood characteristics such as housing, nutrition, education, and community safety, collectively known as the social determinants of health, can significantly influence how well and how long we live. Our health risks, choices, and outcomes are shaped by the opportunities that exist in the environments that surround us. What the data from the RWJF life expectancy estimator illustrates is that people do not have the same opportunity to be healthy where they live.
Transforming the environments we live in so that everyone can lead a healthy life requires significant public, private, and philanthropic capital to finance economic development, affordable housing, small businesses, community centers, and other elements of healthy communities.
This is why the resources, relationships, and expertise of the community investment field are essential to improving health outcomes. A broad array of stakeholders make up this field, including mission-driven investors, Community Development Financial Institutions (CDFIs), banks, community leaders, foundations, developers, and public officials. Each brings unique expertise and resources to mobilize investment capital to improve the various aspects of communities that contribute to poor health (i.e. contaminated drinking water, poor housing conditions, aging infrastructure, etc.).
For decades, the community investment field has been working to drive capital to disadvantaged communities that are not well served by mainstream markets. Their efforts help to finance many of the social determinants. For instance, Bridgeway Capital, a CDFI serving Western Pennsylvania, provides flexible financing to organizations such as Community Kitchen Pittsburgh to create jobs and increase food access in high poverty neighborhoods in Pittsburgh, which are often considered “too risky” for traditional investors.
Unfortunately, in many places, the community investment system lacks the capacity to produce the level and type of investment needed to address all the social, economic, and environmental conditions that contribute to poor health.
Increasingly, health institutions such as hospitals are exploring ways they can help improve the conditions that lead to poor health/short life expectancies by engaging in community investment. Our Accelerating Investments for Healthy Communities (AIHC) initiative, which is supporting eight health systems, focuses on affordable housing. These institutions have an array of assets—financial resources, land, and expertise—that can be harnessed to help the community investment field expand opportunities in communities. For example:
Bon Secours Richmond has invested $500,000 to support the creation of the Maggie Walker Community Land Trust, which aims to promote long-term housing affordability for residents in the East End of Richmond, Virginia. They also provided a low-interest loan of $150,000 for land acquisition.
Boston Medical Center invested $500,000 in the Healthy Neighborhoods Equity Fund, a private equity real estate fund designed to promote transit-oriented development (TOD) projects in Massachusetts, creating significant community, environmental, and health benefits.
The University of Pittsburgh Medical Center invested in Omicelo, a minority-owned real estate fund, that is focused on creating affordable housing in gentrifying neighborhoods to help residents avoid displacement.
Explore the data for yourself and see how life expectancies vary in your community. Then consider looking into how hospitals in your community might support the community investment field in addressing the root causes of poor health and improving the length and quality of lives for all people.