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Category: Social Determinants of Health

Doing Your Part to Combat Ageism

Posted on by dekiss4

My last post, Exploring and Overcoming Your Own Biases, reflected upon implicit or unconscious biases, how they are engrained in our brains, and how we can begin to overcome those biases – intentionality, learning about yourself and your biases, and putting yourself in uncomfortable spaces with the goal of learning and growing.  I encourage you to take a few minutes to read that before continuing this post.

On to ageism…

Put simply, ageism refers to assumptions made about people based on how old they are. In my field of work, aging, the term ageism is typically directed at how we discriminate against and treat older people differently than those that are younger. However, ageism can be present no matter one’s age and is also prominent against youth, teens, and “those kids these days.”

Regardless of one’s age, ageism can have significant impacts on one’s physical and psychological health and well-being. In the context of older adults, individuals who internalize ageism – or think that they can’t do certain things or act certain ways because of their age – are shown to have significantly shorter life expectancies, reduced access to health care, and higher rates of depression, to name a few.

More broadly, ageism can have considerable impacts on society, as well. Research shows that 1 in 7 dollars spent on the mostly costly medical conditions in the US can be attributed to negative effects of ageism; that’s approximately $63 billion in health-related costs to older adults. You can read the summary of that study here.

Ageism is a large area of study and there are a myriad of implications that could fill a book. Alas, let’s move on to a few ways we can contribute to combatting ageism.

  • Work toward changing your responses and reflect. Be mindful of your actions toward older adults – even if that’s yourself! Every time you have an interaction with an older adult, step back and reflect on that interaction. Did you treat them differently than you would someone who is younger than them? Did you treat them the way you would want to be treated as an older adult? What could you do to improve any ageist biases that slipped into your interaction?
  • Take a walk in someone else’s shoes. Think about what it would be like to be an older adult who is stereotyped. How would that make you feel and what can you do to make sure you are limiting that in our own behaviors and actions? Practice empathy – it makes a world of difference.
  • Purposefully increase your exposure older adults. When we surround ourselves with people who are different from us, we learn more about others and ourselves. Interact with more older adults, even if it’s just saying hello in the grocery store or going out of your way to have more meaningful conversations with older adults in your life. Perhaps you can even get involved in volunteering in long-term care facilities (when it is safe to do so), serving meals to homebound older adults, or engaging in other service projects such as mowing an older adult’s lawn, fixing their stairs, or shopping for their groceries. There’s so much we can do to increase our exposure to people who aren’t like us and help them out in the process.

These are just three ideas of how we can begin to reflect on ageism and begin to make a difference. Call to action: Give one of these a try.

Health Means…doing your part to combat ageism.

Contributor: Erin Yelland

Placemaking Benefits Rural Communities

Posted on by dekiss4

Every third Thursday of November, National Rural Health Day (NRHD) is celebrated by state health directors, local health leaders and advocacy groups as a time to recognize that “. . . small towns, farming communities and frontier areas are places where neighbors know each other, listen to each other, respect each other, and work together to benefit the greater good” (https://www.powerofrural.org/).  Another statement explains that National Rural Health Day honors the “selfless, community-minded spirit that prevails in rural America.”

These words conjure up memories of my childhood visits to a cousin’s dairy farm south of Salina for home-cooked dinners each Thanksgiving.  They also remind me of being on my uncle’s Iowa farm where, following a Veteran’s Day cookout, I joined family members on a walk around the property and talked about the price of feed for his hogs. I now wonder how those places continue to contribute to the people who now rely on them for income, safety, identity, and connection to rural communities. I wonder how places like these and others contribute to health and well-being of people who choose to live in rural places.

Health Means…placemaking.

A number of reputable reports reveal that persons living in rural areas generally have poorer health than do people living in urban places. The Centers for Disease Control (CDC) reports that, of the nearly 15 percent of the U.S. population living in rural areas, there are clear differences in health between rural and urban residents. People living in rural places are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than those living in urban places.  Unintentional injury deaths are approximately 50 percent higher in rural areas than in urban areas.  The fact that residents in rural places tend to be older and sicker than their urban counterparts contributes to poorer health outcomes in rural locations (https://www.cdc.gov/ruralhealth/about.html). Inconsistent access to health care due to distance, lack of transportation, inadequate housing, limited employment opportunities, questionable health insurance coverage, stress associated with farming and ranching professions, and high rates of COVID-19 transmission have been shown to lead to poor health among people living in rural places.  These social and economic determinants are not corrected with “one size fits all” solutions in places that are populated by conscientious and caring rural residents. What anchors people in these places that can test resilience generation after generation? Some of the explanation is the “place” itself and opportunities for intentional placemaking that is beneficial for all rural people.

Placemaking is typically associated with efforts to improve urban community’s walkability, safety and access to services. Urban planners spend much time and resources planning green-space, attractive venues and access points so that urban dwellers feel a sense of community and have places where they can reduce stress and improve personal health. However, placemaking benefits rural communities too. Supporters and funders of rural development understand the importance of place and its influence on the health and well-being of everyone. For example, the United States Department of Agriculture (USDA) recognizes that health improvements are linked to placemaking in rural places. This spring, USDA made $3 million available through the Rural Placemaking Innovation Challenge (RPIC) to foster placemaking initiatives in rural communities.

 

(Click on the image for more details.)

According to USDA, ”. . . placemaking is the process of creating quality places where people want to live, work, and play with the goal being to create greater social and cultural vitality in rural communities aimed at improving people’s social, physical, and economic well-being,” (www.rd.usda.gov/about-rd/initiatives/rural-placemaking-innovation-challenge). Communities could apply for funds to help create and sustain accessible and welcoming public spaces; broadband capability; transportation options; multiple housing options; preservation of historic structure; green space, recreation and respect for the arts, culture and all community cultures.

Contributor: Elaine Johannes

Passionate about placemaking? Let’s talk! Connect with Elaine in the comments or via email. A list of some of the best strategies is available at Project for Public Spaces (www.pps.org/article/grplacefeat).

Health Means Looking at the Bigger Picture, Getting Uncomfortable, and Addressing Wicked Issues

Posted on by dekiss4

According to the World Health Organization (WHO), the social determinants of health (SDOH) are the non-medical factors that influence health outcomes. “They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life”.

Point 1: The entire world around you – near and far, big and small – affects your ability to be healthy.

Next, consider this series of questions about each of the stages of life mentioned by the WHO. These questions can help you: 1) more clearly understand what a social determinant is, 2) recognize the positive and negative determinants in your own life, and 3) think about others’ determinants, especially those who are not as privileged as yourself. Before you read on, keep in mind that this is not an exhaustive list and the issues represented in the following questions only represent some of the SDOH.

  • Born. Did your mother have access to quality care, prenatal vitamins, birthing classes, and other resources? Did she live in a safe home during her pregnancy and have access to healthy foods? Was she positively and safely supported by her partner or someone else? Where were you born? Was that hospital properly staffed with quality medical professionals and amply supplied? Did the hospital staff prioritize three White patients before they would even look at your Black mother even though she was in distress?
  • Grow. Did you have access to a quality education? Did your parents read to you and were you able to communicate in a positive way with them? Or did you walk to school in constant fear of getting shot, raped, or robbed? Did the stress of living in poverty and raising siblings practically on your own adversely affect your brain development?
  • Work. Do you work and receive a living wage? Do you have transportation to get you to work on time every day? Do you have the proper clothes to wear? Is your workplace safe? Do you have childcare for your children while you’re away?
  • Live. Do you have positive and supportive family, friends, and community? Are you able to participate in civic organizations and clubs, visit a local library, or walk and bike around town? Do you have broadband internet, healthy air, and clean water with fluoride? Do you have access to mental health care, birth control, preventative visits, eye exams, dental cleanings, and cancer screenings?
  • Age. Do you have an entrance to your home without steps? Do you have access to quality and healthy meal delivery services, home health assistance, and transportation? Are you financially stable and able to pay your bills? Do you frequently fall, have asthma attacks, or visit the ER? Are you socially isolated and lonely? Have you been a victim of elder abuse, scams, or Medicare fraud? Are you able to live independently and age in place?

Point 2: The more positive things in your life and environment, the healthier you can be.

Sounds easy, right? Let’s tell everyone to swap their cheeseburger for a salad and we’ll be on our way to a health revolution! Well…no.

The reality is that no one can 100% control their health outcomes. And many individuals will never be able to check the boxes that bode well as social determinants because they, as an individual, simply cannot change them. It takes all of us – individually and systemically. Racism, poverty, social injustices, and accessibility are uncomfortable, complex, and wicked issues, but they’re not going anywhere. And it’s high time we embrace the uncomfortable, complex, and wicked.

Point 3: We can no longer ignore racism, poverty, social injustices, and accessibility. These are the major issues influencing our ability to be healthy and well, and nothing will change unless we all do.

Health means…increasing the proportion of children living with at least one employed parent year round, full time.

Contributor: Erin Yelland

We look forward to connecting with you in the comments. Join the conversation on Facebook, Twitter, and Instagram with #HealthMeans.