By: Hannah Barker, Dietetic Intern, with assistance from Rebecca
This week I participated in a webinar called, “Looking Upstream: How Income, Education and Racial Disparities Shape Health.” Robert Wood Johnson Foundation was the host. The expert panel included: Dr. James Marks from the Health Group at the Robert Wood Johnson Foundation, Paula Braverman from the University of California in San Francisco, David Williams from the Harvard School of Public Health and Harvard University, and Steven Woolf from the Virginia Commonwealth University.
We Spend a Lot on Healthcare for Such a Sick Country
I learned that the United States spends so much on health care, yet ranks poorly in terms of several health indicators, like infant mortality and life expectancy. However, the cause of the United States’ poor health cannot just be attributed to the factors we normally consider – medical care, genetic make-up, natural environment, behaviors and nutrition; rather, the cause of poor health can also be attributed to “upstream” factors such as race, income, and education.
You might have heard that non-Hispanic whites are likely to have a five-year greater life expectancy than other races and poverty is linked to poor health. But while this may seem unsurprising to you, the solutions to these problems may come across as unique and inspiring.
Policies Needed to Prevent Disease in Communities
The panelists urged prevention. They advocated to support policies that promote more walkable cities, affordable housing and worksite wellness programs – just to name a few – to help promote the health and nutrition of our communities.
Currently, the poorest neighborhoods are the least likely to have access to recreation centers, playgrounds and even sidewalks. Why is that? Why are we not investing there? American communities need walkable cities to help ensure that more children and families have space to walk, ride their bikes and achieve the necessary physical activity to prevent chronic disease. You can’t bake a cake without eggs and you can’t drive a car without gas – how can people exercise without fun and safe places to do so. Imagine, a working mom takes an odd shift to be home with her kids, wouldn’t it be great if they could play together before dinner at a nearby park, which they walked to on the sidewalk. It’s basic.
I think D.C. does a good job at providing access to physical activity to residents. We have programs for kids and families, recreation centers and indoor and outdoor pools! Check out their website: DC’s Department of Parks and Recreation
Healthy Employees, Happy Companies
Worksite wellness programs should be implemented in all fields of employment. Are there incentives for small businesses to educate and motivate their employees? What about the local deli owner or dress shop? They may have 5 or so employees – is there incentive for them to help keep their employees healthy?
Take a Page from Community Programs
Organizations like Operation Frontline and Brain Food currently lead programs to teach parents and children about cooking nutritious (and delicious) meals and eating healthy on a budget; however, these organizations cannot do it alone. They rely on the kind hearts of volunteers to make a difference in the lives of those with the greatest NEED by the statistics.
Be the Change!
You can make an “upstream” difference by just volunteering for one of these organizations, or attending local meetings (town halls, open local government sessions etc.) to support policies related to health and nutrition. You can help be a solution to these statistics!
What do you think is needed to improve the health of our communities?
Filed under: exercise, nutrition, obesity, overweight, policy Tagged: | community wellness, corporate wellness, healthcare, income disparities, nutrition, obesity, physical activity, poverty, racial disparities



My employer offers one extra day of vacation if you can do 36 sit ups, 36 push ups, run 3 miles in 36 minutes and have a normal BMI.