The Marriage of Health and Wealth: A Union to Last a Lifetime
"If you want to lower my blood pressure, help me pay my electricity bill." These words that frame Jason Purnell's essay in What It's Worth capture it perfectly: the connection between health and wealth is inextricable. At Prosperity Now's 2016 Assets Learning Conference, we held a lively concurrent session and an invitation-only discussion with 50 leaders from the health care, public health, community development and asset-building sectors to gain a deeper understanding of this intersection. Judging by both attendance and the enthusiasm of the conversation, we've tapped into something important—and we're excited to share three promising avenues for us to explore as a field.
Prolonged financial stress can cause "toxic stress," which affects the immune, cardiovascular and nervous systems, and can lead to conditions like high blood pressure and heart disease. Financial stress also forces some households to forgo doctor visits or skip prescriptions. For children, the stakes are even higher—their brains develop differently when they grow up carrying the stressors of poverty.
The "social determinants of health"—which the World Health Organization defines as "the conditions in which people are born, grow, live, work and age"—are "shaped by the distribution of money, power and resources." While the social determinants of health may be shaped by systems, they impact us as individuals. We must address financial health as a foundational issue to the social determinants of physical health. Based on what we heard at the ALC, we see three opportunities emerging for our field.
Opportunity 1: Expand Service Delivery
How can we build fruitful partnerships with health care providers to jointly deliver services? Just like asset-builders, many in the health care field provide financially vulnerable people with established, trusted community services. For example, Federally Qualified Community Health Centers serve 24 million low-income people annually. Broadly speaking, their mandate is to serve the community's health needs, and they accomplish this in part by being true community hubs: their staff and boards are composed predominately of community members, and they provide wraparound services and host community events. More about how we might integrate financial capability services into CHCs can be found in our recent policy brief.
Opportunity 2: Broaden Our Coalitions
The U.S. Department of Health and Human Services recently released a new definition of public health. "Public Health 3.0" is the idea that a community public health officer sits at the intersection of each of the systems impacting social determinants of health: business, economic development, housing or criminal justice, to name a few. As such, health policy should be embedded into each sector to ensure equal access to health, not just health care. Public Health 3.0 is a call to expand coalitions, which presents an opportunity for the many asset-building coalitions around the country. Expanding and joining coalitions can help us work together to answer many of these critical questions and forge a path forward.
Opportunity 3: Build Better Systems Together
When people are healthy, our economy benefits. In his What It's Worth essay, Jason Purnell explains that the most powerful interventions to make people and society healthier involve changing the ways our systems are configured. The Affordable Care Act is a great example of this configuration shift in that it focuses on remunerating health care outcomes, rather than individual services. For instance, if a patient is seen for the same illness multiple times in a month, the health care provider may only be reimbursed once for that expense, thus incentivizing a holistic, preventive approach to health care. These seemingly small intervention can have big effects, as it orients our thinking toward measuring progress in terms of progress toward our ultimate goal: healthier people and healthier communities.
Participants in our ALC sessions dove into these topics by thinking about the other systems-based changes we can leverage to make people healthier. Among the many opportunities raised, they pointed to advocating for systemic change to build a more equitable society and reduce financial stress by bridging the racial wealth divide and turning the tax code right-side up. Although these are no small undertakings, they would go far to improve not only people's financial health, but also their physical well-being.
The potential for collaboration between the physical and financial well-being sectors is vast. We're ready to dive deeper.