This week’s focus looks at “healthy people” and the elements that go into the development of individuals capable of thriving in urban environments. There are many, and health is not merely vital signs. It is education (so people can be empowered in an economy), culture (so people can have identity and enjoyment), political efficacy (for people to have participatory democratic governments), and it is religion (part of human life since the beginning). We have also learned that creating effective public policy to reflect these values is not easy. In order to have successful policy, in this regard, those ordinances need to first and foremost promote people’s freedoms, help their ability to participate, and have an ethos of respect.
Human flourishing and its complexities was illuminated and expanded by my specific study on the Gateway neighborhood. Through focusing my approach on the social determinants of health, I examined the neighborhood for signs of humanity deficiencies. Sure enough, I found several data sets that seemed to indicate many of the social determinants of health were not being met such as food accessibility, education, transportation options, walkability, affordability and so on. What I saw was an extremely “stressed” population that had significant biological, social, and political concerns that need to be addressed before they can flourish. Combining that analysis with the readings from Deneulin this week, a more illuminating picture was found. The cause of the social determinants of health deficiencies stems, in part, from the institutional and political underpinnings of the Gateway neighborhood. Rather than sustainable investment, Gateway is left to crumble. Rather than policies being created to further the population, no backward looking, cause and effect analysis is being done. When policies are designed, implementation isn’t followed through. Looping in the previous module on history furthers the story. As the landscape of the Gateway neighborhood changed, the community was left on its own. Eventually inner city, low income folks were encouraged to leave as rents increased, pushing these families into Gateway. Now, the process of gentrification has started to reintegrate different socio-economic status families together but the process is slow and lacks the necessary drive. What I find most concerning is that each part of Gateway’s struggle feeds into itself in a negative loop. For example, the lack of resources causes a lack of food accessibility. This is further exacerbated by the fact that there are limited grocery store options. This then causes disease which causes disabilities which causes a further lack of resources. This feedback loop is destructive and takes outside resources and outside help to allow Gateway residents to escape from the loop. Of course, the residents themselves have some agency but their power is so limited that, even if fully focused, the chances of upward mobility are less than 30%. This lack of agency is a detriment to the human condition and prevents human flourishing. When people feel helpless about their outcomes and unable to control their condition, it leads to a crumbling of the individual and eventually the neighborhood. Therefore, it takes substantial effort to overcome this feedback loop. It is not as simple as placing a park or adding a grocery store. Rather, it takes a multi-faceted, multi-pronged approach that attempts to address as many of the social determinants of health as possible to give the community the best chance of getting back on its feet.
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