neighborhoods. Overall, 37% of community survey respondents chose “safety and low crime” as one of the most important factors for a healthy community. Frequently, survey respondents recognized safety and low crime as one of the greatest strengths in a community, however, safety and low crime was also the most mentioned area for improvement in communities.
Housing Poor housing conditions are associated with a wide range of health conditions including respiratory infections, asthma, lead poisoning, injuries, and mental health (Krieger & Higgins, 2002). As a result, addressing housing issues offers a unique opportunity to address an important social determinant of health (Krieger & Higgins, 2002). Existing research has confirmed that there are at least four direct pathways in which housing impacts health: stability, affordability, quality and safety, and neighborhood. (Taylor, 2018). Assessment findings indicate that: • Providing individuals and families with stable housing can improve health and reduce health care costs (Taylor, 2018). • Community-based programs and policy interventions have been shown to be extremely effective in improving health through improvements in the quality and safety of housing. • Within Cook County there are several regions where more than 40% of households are considered cost-burdened. These regions are primarily concentrated in the far Northwest, West, and South Sides of the city and county. Programs examples from across the country demonstrate that increasing access to affordable housing is associated with improved health outcomes and decreased need for emergency care, increased household discretionary income, increased rates of insurance coverage, decreased personal debt, and increased savings for home ownership and education. • There has been extensive research on the impacts that physical surroundings have on health. Access to public transportation, proximity to grocery stores with healthy foods, and safe spaces to exercise have all been correlated with reduced chronic disease and improved health outcomes (Bell, Mora, Hagan, Rubin, & Karpyn, 2013; Djurhuus, Hansen, Aadahl, & Glümer, 2014; Ou et al., 2016). Community Input: Major themes that rose to the top of focus group discussions related to housing included: segregation prevents communities from having diverse economics, racial/ethnic groups, and resources; gentrification pushes low-income families out of communities; safe, quality housing is often not affordable and affordable housing is often not safe or good quality; older adults are still struggling to recover from the housing crisis; and oversight of landlords and homeowners is lacking in many communities.
Food Access and Food Security Food security is a household-level social and economic condition of limited or uncertain access to adequate food (U.S. Department of Agriculture, 2018). Food insecurity can impact health in several ways: • the combination of stress and poor nutrition can make individuals more susceptible to developing chronic diseases and make management of chronic diseases more difficult; • worsening health problems and the associated medical care puts additional strain on household budgets and leaves less money for essential nutrition and other basic needs; • chronic disease can lead to decreased employability and lower overall household income (Weinfield et al., 2014). Related to food insecurity, access to healthy foods is another important factor needed to support chronic disease prevention. Low-income communities of color are less likely to have access to supermarkets and healthy foods and tend to have a higher density of fast-food restaurants and other sources of unhealthy food such as convenience stores (N. Larson, Story, & Nelson, 2009). Programs such as the Supplemental Nutrition Assistance Program (SNAP), local food pantries, summer meal programs, after school programs, shelters, and food banks provide important assistance to low-income individuals and families that struggle to access adequate nutrition. However, approximately seven percent of households in Cook County overall are below the poverty level and not receiving SNAP benefits. Summer meal programs also play an important role in food access for low-income children and their families during the summer months when schools are closed and Alliance for Health Equity15