Did You Know Place Matters?: Blog

By Kristi Durazo

Interesting story about how place affects health factors. Twin brothers, both astronauts. One goes into space for 340 days. The other stays on the ground. Researchers are now studying the brothers’ relative health. Early indications are that there are very remarkable differences in their genetic and metabolic structures and other health factors.

SDOH-callout1The reality is that place matters on the planet as well as off. In New Orleans, life expectancy in one neighborhood is 55 years and only 5 miles away, it is 80. In Philadelphia, the gap in life expectancy between zip codes is 20 years. Just like the contrast of space vs. Earth, the differences in neighborhoods and their opportunity to access resources like healthy food, education, good jobs, banks, doctors, stable housing are just as stark.

Some experts suggest that your zip code is a bigger determinant of your health than is your DNA. And other research suggests that continued exposure to the stresses of poverty, unemployment, and poor housing can actually alter the structure of your DNA, compounded over generations. Here are some factors to consider:

  • Education–People with more education are likely to live longer and to experience better health outcomes. 50 percent of Asian and 31 percent of non-Hispanic white adults are college graduates, compared with 17 percent of non-Hispanic black and 13 percent of Hispanic and American Indian or Alaska Native adults. The Brookings Institute, in a report on the widening gap in SAT scores, stated, “Blacks in particular lag far behind, with an average score of 428 out of 800, significantly below the average score of 534 for whites and 598 for Asians.” “…as SAT scores predict student success in college, inequalities in SAT score distributions reflect and reinforce racial inequalities across generations.” Education matters.
  • Employment–Education provides the knowledge and skills necessary for employment, which can shape health in many ways. More education generally means a greater likelihood of being employed and of having a job with healthier working conditions, better employment-based benefits and higher wages. Where you work matters.
  • Housing–The shortage of affordable housing limits families’ and individuals’ choices about where they live, often relegating lower-income families to substandard housing in unsafe, overcrowded neighborhoods with higher rates of poverty and fewer resources. The results of this dynamic prevents families from meeting other basic needs including nutrition and health care. Additionally, rates of home ownership are lower for communities of color. Where you live matters.
SDOH-callout1All of these factors are intertwined with other related issues…access to transportation, lack of upward mobility, exposure to pollution, crime, incarceration, racism, social justice are all aspects of social determinants of health. AHA’s Scientific Statement on Social Determinants of Health states “…we must now broaden the focus (of health advancement) to incorporate a third arm of risk, the social determinants of health.” To do so, the AHA must remain true to its values to “meet people where they are,” because place matters for all of us.

February observes Black History Month, a time to honor and celebrate the rich culture and traditions of African-American people. When it comes to health matters, it’s no secret African Americans are disproportionately affected by heart disease and stroke. Therefore, it is especially critical for this community to continue to strive toward raising awareness about social determinants of health, sharing resources, uniting and advocating to prevent and beat cardiovascular diseases and risk factors that can be eliminated through simple healthy habits. To learn more, please visit www.empoweredtoserve.org and become an ambassador or access culturally relevant resources.  

–Kristi Durazo

Kristi Durazo is the Senior Strategy Advisor and social determinant of health expert at the American Heart Association. She has over 20 years of service with the AHA.
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