About CoH – Why Communities of Health?
Communities of Health recognizes that health is determined not just by individual behavior and medical care, but also by the social contexts in which people live and work. Here are just a few examples of how the rapid rise in diseases is influenced by social and environmental factors that our current system of care is powerless to control:
Social Cohesion: A nine-year study of nearly 7,000 adults in Alameda County, California, found that people with few social ties were two to three times more likely to die of all causes than were those with more extensive contacts. (Source: Berkman, Syme. American Journal of Epidemiology. 1979.)
Neighborhoods: In predominantly white neighborhoods with high playground safety scores, the prevalence of obesity is half that of non-white neighborhoods with low playground safety scores. (Source: Cradock, Kawachi, et al. American Journal of Preventive Medicine. 2005.)
Availability of supermarkets is more than three times greater in high income neighborhoods than in low income neighborhoods. (Source: Morland et al. American Journal of Preventive Medicine. 2002.)
Culture: Although England has a higher prevalence of smokers and heavy drinkers than America and spends 50% less per capita on health care, they have lower rates of diabetes (6.1% vs. 12.5%), hypertension (33.8% vs. 42.4%), heart attack (4% vs. 5.4%), and stroke (2.3% vs. 3.8%) (Source: Banks, Marmot, Oldfield, Smith. The Journal of the American Medical Association. 2006.)
Workplace: Those who say they have low or intermediate control over how they meet the demands of their jobs had over twice the incidence of coronary heart disease as those who reported having a high level of control at work. (Source: Bosma, Peter, Siegrist, Marmot. American Journal of Public Health. 1998.)
Socioeconomic Status: Societies with the smallest income differences between rich and poor, such as Sweden and Japan, tend to enjoy the highest life expectancy (80.5 and 82.3 years respectively). The United States, by comparison, in spite of having one of the highest standards of living, has greater income disparities and a lower life expectancy (77.9 years). (Source: Kawachi, 1997. Life expectancy data from: The Human Development Report 2007-8.)