Public Health in Oregon - Join The Conversation

This study is further evidence that there is a relationship between the neighborhood one lives in and one’s health. In addition to the study above there have been studies that show how low SES neighborhoods have an increased risk of mortality (Winkleby 2003) and that African American neighborhoods had fewer healthy fruit, low-fat chip, and low-fat/moderate baked/sweet snacks compared to white and racially mixed neighborhoods (Odoms-Young 2009), in addition to numerous other studies.

The complexity of this issue is daunting because the correlation between neighborhood and type-two diabetes is only one tiny aspect of the relationship between neighborhoods and health. A solution must come from many places- both from within and outside of the unhealthiest communities.

The vouchers for farmer’s markets noted previously are just one part of the solution. Here in Multnomah County they are looking at another potential solution- The Oregonian published an article on October 18th about a 15 year food initiative that includes a grow-your-own food movement.

However, food isn’t the only issue- diabetes risk and other health issues have numerous causes. Solutions need to come from the community- What do we need? How do we get it? How can we work together?- but it must also come from city planners and politicians. According to Wallack (1992) a variety of social, political, cultural, and economic groups are key to gaining a full understanding of a city or neighborhood’s health. It is clear that it will take a group effort to solve something that is bigger than the neighborhood or the illness.

As made statistically evident by Deborah in the above posting, the treatment of diabetes results in significant costs.  The method of creating “healthy neighborhoods” seems to be a very hopeful approach to preventing diabetes in our communities, and in turn, cutting health care costs.

With that said, will this method be possible for the “unhealthiest” of neighborhoods, where the occurrence of type II diabetes might be most prevalent?  In order to really save in diabetic treatment costs, this “healthy neighborhood” idea would need to address feasibility in low-income neighborhoods, in which fast food and convenience stores are physically and financially accessible.  Millstein et al (2009) found trends in their study illustrating that those living in low-income neighborhoods with convenience stores readily available had poorer “dietary habits.”

Adler (2001), as part of the National Policy Association, highlights the fact that any sort of health promotion is socioeconomic status dependent.  The $10 vouchers in Texas, as mentioned in the previous post, are a fantastic start in addressing the correlation of socioeconomic status and the number of people diagnosed with type II diabetes.  It is a strategy of making healthy foods available to populations of all financial backgrounds. 

By creating ways to make the development of “healthy neighborhoods” financially feasible, especially for low-income neighborhoods, there could be an astounding impact on health care costs in the prevention of diabetes.

Even more dramatic than a 38% decrease in the incidence of Type 2 diabetes in “healthy neighborhoods” is the potential long term savings to our nation’s health care bill.  Consider these facts from the American Diabetes Association:

  The total annual economic cost of diabetes in 2007 was $174 billion of which $116 billion was for medical expenditures alone.
  The medical costs to treat diabetes has risen over $8 billion each year since 2002.
  One out of every 10 health care dollars is attributed to diabetes.

It could be that investments in “healthy neighborhoods” with the simple addition of a farmer’s market might be a fairly simple and low cost avenue to decrease the cost, and incidence of, diabetes for future generations.

Consider the Brownsville Farmer’s Market which was conceived by the University of Texas School of Public Health with funding for a voucher system by the Texas Department of State Health Services.  Brownsville’s farmer’s market included not only fresh fruit and vegetables, but also distribution of $10 vouchers allocated for the purchase of the fresh produce.  A $10 voucher each week can go along way in the purchase of produce to support healthy diets, with the potential to save billions of dollars in reduced medical costs related to diabetes.