When one mentions the term “public health,” economic development isn’t usually the first thing that comes to mind. You probably think instead of children being vaccinated, senior citizens being urged to get their flu shots or scientists working to rid the food supply of something that’s causing an illness. Economic development and public health, however, have had a long relationship in this country. During the late 1800s and well into the 1900s, American business leaders worked hard to give more prominence to public health issues. There were numerous efforts at the federal level, including the establishment of the Food & Drug Administration. Some of the most effective, creative initiatives occurred at the local level as communities linked public health with economic development. Progressive communities in the last century:
• Established parks that provided residents a respite from the grit of the industrial parts of their cities.
• Implemented building codes and standards designed to improve housing conditions.
• Introduced land-use zoning to force a separation of industrial and residential areas.
In these progressive communities, public health issues were held up as the foundation for future economic development. Due to the success of those initiatives in the 20th century, we too often take public health standards for granted in the 21st century. As a result, Americans don’t understand the fundamental link between public health and economic development. This lack of understanding is happening at a time when poor eating habits and inadequate exercise have led to an obesity epidemic, a problem that’s particularly acute in the 252 counties and parishes served by the Delta Regional Authority. Obesity increases the likelihood of diabetes, heart disease and other health problems. And there’s a direct economic link. That’s because unhealthy employees miss more days of work, require additional medical attention and command higher health insurance premiums. Parents with unhealthy children must also miss work in order to stay home when their children are sick.
A healthy Delta region can prosper economically in the years ahead. By the same token, an unhealthy Delta will face insurmountable obstacles in an era when prosperity is dependent on workforce quality and availability. The community leaders across our region who are serious about connecting public health and economic development must engage those in the private sector. Proper nutrition and exercise in our daily lives have never been more important. It’s an issue that can’t just be left to government. Local task forces dedicated to a healthy workforce should be established by chambers of commerce and other business organizations. Members of such task forces then can identify private-sector stakeholders such as retailers who might provide free in-store health services along with health insurance companies that want to control their costs by focusing on prevention.
There are many aspects to the health problems we face. For example, two non-profit institutions, the Food Trust in Philadelphia and DC Hunger Solutions in Washington, recently studied the health of people living in specific neighborhoods. They found the health problems to be greater in those neighborhoods that had a dearth of grocers offering fresh produce and other healthy food options. Healthy eating options in low-income areas therefore must be part of the equation as we battle the obesity epidemic. Public awareness campaigns that urge residents to demand healthier food choices are one option for communities that are seeking to improve the health of their workforce. To elevate the public’s awareness of any issue, you must first capture people’s attention. A website or billboard might not be enough. These campaigns must:
• Entertain: For decades, the state transportation agency in Texas has had a successful anti-litter campaign that has attracted the attention of people across the country. The slogan “Don’t Mess With Texas” is widely known. The campaign’s public service announcements have included musicians ranging from Willie Nelson to the late Stevie Ray Vaughan.
• Provoke: Provocative campaigns create enduring impressions. Many people still remember the public service announcement from the 1980s featuring the egg (“this is your brain”) and the hot griddle upon which it was cracked (“this is your brain on drugs”).
• Repel: One public service announcement that runs in movie theaters features an obnoxious man who takes cell phone calls and speaks loudly while others are trying to view the movie. The message is clear: This isn’t the behavior you wish to emulate. Turn off your cell phone. A similar approach can be used to convince people to change their nutrition and exercise habits.
There’s no need for each community to reinvent the wheel. Local leaders can seek out results-oriented campaigns that already are in place and then adapt those campaigns to their residents. The key is to do something at the local level. A growing body of research suggests that improving health literacy is a critical piece in the public health puzzle. In its report “Healthy People 2010,” the U.S. Department of Health and Human Services defined health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and the services needed to make appropriate health decisions.” Research points to a direct correlation between a person’s ability to understand and follow health-related information and that person’s overall health.
Initiatives designed to improve public health make fiscal sense at the state level since it’s likely to be cheaper to promote incentives for low-income residents to adopt healthier behaviors than it is to pay their Medicaid bills later. At the local level, there’s also a case to be made for targeted activities since healthy employees spend more days at work and cost their employers less money in insurance premiums and lost productivity.
Of course, improving workforce health at the local level must consist of more than just public awareness campaigns. The truly progressive communities of this century will:
• Rethink local planning and zoning ordinances to ensure they encourage healthy practices.
• Provide more diverse transportation options.
• Establish design guidelines that promote walking and alternative forms of transportation.
• Engage the private sector in providing no-direct-cost solutions (such as discouraging smoking and promoting the use of stairs over elevators) and marginal-direct-cost solutions (such as providing gym discounts) to workforce health issues.
Local economic development organizations also can encourage businesses to:
• Replace soft drinks and processed snacks in vending machines with healthier selections.
• Provide financial incentives for employees to bike or walk to work.
• Sponsor company sports teams for employees and their children.
• Provide organized fitness programs before work, during lunch hours and after work.
• Supply discount coupons and gift certificates for healthy food.
Just don’t ignore the problems we face. When employees and members of their families suffer from poor health, the results are absenteeism, turnover and reduced on-the-job performance. Until we tackle these issues, the Delta will never achieve its economic potential.
Pete Johnson of Clarksdale is the federal co-chairman of the Delta Regional Authority. He was appointed by President Bush and confirmed by the U.S. Senate in 2001.