Healthy Communities

Community Matters

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Our quality of health is tied to the places where we live, learn, work, and play.

Adverse social and environmental conditions in our neighborhoods can contribute to social isolation and a lack of social support which can exacerbate stress, anxiety, depression, and other behavioral health disorders.

Globally, individuals who live in lower-resourced communities have shorter life expectancies and experience more mental and physical health problems than more affluent individuals.

These types of health disparities are a social injustice, highlighting the sensitivity of our health to our social environment. We call the factors or conditions in our environments that impact our health or well-being social determinants of health (SDOH).

Conditions like poor school quality, insecure employment, polluted air, lack of access to grocery stores, and unsafe or hazardous housing are all social determinants that negatively impact health. Certain communities have higher concentrations of these types of conditions, leaving the same families vulnerable to multiple disadvantages. The resulting stress and anxiety associated with stressful circumstances lead, in turn, to poor mental health and even premature death.

Because of the detrimental impact that stress can have on our health, the quality of the social environment and security of a community are vital to overall health. For the benefit of the population, it is important to consider, not only access to care, but the powerful social and economic conditions that contribute to the need for that care.

Building healthy communities and environments is a form of prevention

Some areas to consider:

• Early childhood development — The foundations of physical, cognitive, and emotional functioning are established before birth and in early childhood. Supporting mothers and young children can have enormous benefits for a lifetime. Poor prenatal and developmental outcomes are more common in low socioeconomic status (SES) areas. Investing in preventative prenatal and postnatal health care and early childhood education are two important steps in improving long-term physical and mental health in low-resource communities.
• Social inclusion and support — Social inclusion, support, and positive interpersonal relationships are vital to individual health and the health of a community as support networks tend to provide emotional support and material resources and aid in reducing stress. On the flip side, poverty is often associated with social exclusion and affects certain social groups—racial minorities, those with disabilities, and immigrants, for example—more than others. Racism, discrimination, stigmatization, hostility, and unemployment can also lead to social exclusion. When an individual is relegated to the fringes of society, their risk of divorce, disability, illness, and addiction increase.
• Employment — Employment typically produces a positive impact on a person’s health. However, having a job in which one has little control, low decision-making power, and rare opportunities to use one’s skills can actually result in negative health consequences. Facing the threat of an impending job loss, as well as unemployment, also produce negative health consequences, highlighting the negative effect of anxiety and insecurity on health.
• Addiction — Alcohol and drug use are associated with social and economic disadvantage as they provide a perceived escape from adversity and stress. Access to affordable treatment for addiction is necessary, as are policies that address the social and economic disadvantage that often leads to addiction.
• Food security — There are many communities that have limited access to healthy, affordable food. This often leads families to rely on cheaper, processed foods, which have a negative impact on health. Additionally, food insecurity can lead to anxiety and stress.
• Transportation — Good transportation options promote community health. Sidewalks that allow walking and biking as well as accessible public transportation improve health by encouraging exercise, increasing social contact, and reducing pollution.

Rural communities and mental health

Those living in rural communities tend to face a variety of physical and mental health disparities. They often suffer from higher rates of heart disease, cancer, unintentional injury, chronic lower respiratory disease, stroke, and suicide—while access to primary care, preventative care, and mental health services is limited. Due to the decrease in agriculture and manufacturing over the past few decades, those living in rural areas are increasingly likely to be involved in part-time, low-wage work with limited opportunities for economic mobility.

At particular risk in rural communities are:

• Older adults — Stigma, coupled with a belief that they “should not need help,” often deters older adults in rural communities from seeking needed mental health care. Public health campaigns targeted at seniors that normalize mental health care are one strategy for reducing the stigma.
  
  Senior volunteer programs can be an effective way to improve mental and physical health amongst older adults, as well. According to a study by the Corporation for National & Community Service’s (CNCS) Senior Corps, 46% of volunteers reported improved health and well-being after one year of volunteer service. Notably, 63% of the older adult volunteers in the study reported a decrease in feelings of isolation.
• Immigrants — For immigrants, a history of trauma, an increased vulnerability to exploitation, a lack of access to Medicare or Medicaid (for those who are undocumented), and/or a language and cultural barrier, among other factors, can contribute to a greater need for, but less access to, physical and mental health care. Communities must seek ways to intentionally extend culturally-responsive services to rural immigrants, while also educating them on the services that are available to them.
• Children — According to the CDC, about 1 in 7 children between 2-8 years old has a mental, behavioral, and/or development disability (per parental reporting). For families in rural communities with lower levels of social support, fewer neighborhood amenities like parks or libraries, and often lower income levels, parents are more likely to report their own mental health as poor or fair.
  
  To support rural families, affordable access to mental and behavioral health care for all ages is critical. Children need opportunities for play and socialization, while parents need adequate support for caregiving, financial hardship, and their own mental health.