Just this morning, I read that Tennessee is in the bottom five of fifty states when it comes to the health of its citizens. In only took a minute, if that, to mentally start listing reasons why, immediately followed by the question, “what are other 90% of our states doing better?”
The health of our citizens directly impacts the health of our state . The health of our citizens is impacted by many factors; it’s not just eating right or exercising or even being lucky or unlucky enough to have “good” or “bad” genes. It’s not just taking soda vending machines out of the schools or removing those bad fats from restaurant foods, or banning smoking. It’s a broader issue, that encompasses not just the obvious: health care systems, nutrition, exercise. It’s a broader issue rooted in economics, education, regional culture, public policy, and a multi-layered infrastructure in dozens of cities and towns that supports — or does not support — good health and well-being.
Universal health care would be an obvious place to start; every American, from our children to our elders, deserves adequate health care and accessibility to affordable medications. Massachusetts passed the first health-care-for-all program a few years ago. I did sit up and take notice of Wal-Mart’s recent list of $4 prescription drugs; that even had me mentally running down my own list of medications. I thought to myself, at $4, a lot of people may not have to choose which medicine they can afford or what they have to skip, or whether they have to choose between food or medicine or heat. And why can’t other pharmacies do the same? It’s a start.
Major insurers now offer discounts to companies that offer employeeshealth club access at discounted rates, or (if they are large enough) have an in-house gym for employee use. As an increasing number of companies feel the pinch of health benefits, the shift to an emphasis on wellness is reaping benefits reflected on their bottom line. It’s a start.
Raise the minimum wage (it’s coming, slowly), and correlate it to a reality-based “living wage” that can actually support a family. Take the pressure off people who must work two or three jobs to survive, to pay rent, feed their kids, buy school supplies. Such pressures wear people down, create stress, errode the time needed to create and sustain a healthy family relationship, and can ultimately break up the family structure. Children often become what they see, what they learn from the people around them. Place value on family, and our youngest citizens, our children, reap the benefit. That’s another good place to start.
Stop shipping American jobs abroad to the lowest bidders, and put Americans back to work in jobs with that “living wage” and benefits. Give tax breaks to companies that invest in America and create jobs in this country at decent wages. Plug the leaks in economic policy that created a flood of outsourcing and the shift of our manufacturing and technology to foreign countries. Bring those jobs home and let those paychecks line the pockets of our workers, not the profit margins of America’s billionaire companies. Having a good job and a decent paycheck is great for one’s self-esteem, one’s sense of security and well-being. And that has a trickle-down effect on every level of the family structure, including setting an example of responsibility and productivity. Working families are the core, the key indicators of a community’s health.
Factor education into the economic equation and make college affordable, not something that has to be financed with tens of thousands of dollars in student loans, the mortaging of the family home or signing over the right to one’s first-born child. Put a dollar value on academic achievement in the form of additional incentive (college) grants based on grades or related to fields of study such as math, science or the art of teaching. Let our college students study and not have to juggle as many jobs as their parents to fund their learning. Raise the bar and let them catch up with students in other countries (we do lag behind in many areas). Dreams and ambitions are good; fuel them. It’s healthy.
Create a trade school system (prevalent in the Northeast) that starts technical training in a variety of fields in the first year of high school and teaches math and language arts as applied skills linked to specific job training. For those young people who want an alternative to the traditional course of study, those not suited for or interested in the basic college prep oriented studies, vocational schools provide training and hands-on experience, immediate usable skills. They graduate rather than drop out, and usually move directly into the workforce. Magnet schools have similar results. And with a 63% graduation rate in Tennessee, anything that improves on the 37% who don’t graduate is a good thing. Having a marketable skill, and a job, instills pride. It’s healthy.
Put physical education (good old gym class) back on the list of required school subjects, not just as part of health class in freshman year of high school, but every year, with nutrition education included. The obesity level of our children is climbing rapidly; learning what to eat, how to work off the calories and stay fit, even how to cook healthy, is critical. Make sports (little league, volleyball, soccer, swimming and such ) more accessible and affordable. Keep our kids active. It’s good for them.
Parents: Turn off the TV and the Playstation game of the day. It is sad to think that for so many, children included, exercise is what happens when one walks from the car to the door of the mall, department or grocery store, or from school bus to locker to classroom, or from the front door to the TV or refrigerator.
With all the talk of Clarksville’s redevelopment, our leaders need to take a good multi-level look at urban planning, not just downtown but citywide. Create an infrastructure that encourages movement and connectivity: cluster new housing within a framework of greenspace or berms, with sidewalks and paths, and strive for an interactive downtown mix of housing, business, the arts and sports. Fill small empty spaces with mini-parks and welcoming benches. Infuse small spaces with small businesses or business incubators. A mayor I once knew said “I’d rather see grass and a bench than a vacant corner, a small co-op shop than an empty storefront.” Extend bus service to late evenings and Sundays. Build bike trails, skateboard parks, playscapes and sidewalks connecting neighbors, neighborhoods, the riverfront and activities. Mobility. Movement. Access. Interaction.
The health ratings of America’s states are a symtom, a warning and a challenge that brings us back to economics and public policy. The onus is on us, as the creators, the developers, the investors, the role models, the instigators, the “movers and shakers” to set an example, to conceptualize and create policies and products (and our city is a product) that motivate, inspire and implement healthy change and healthy attitudes that will filter through the community over time.
Reclamation, redevelopment of a city takes years. Changing the factors affecting the health of its people also takes years. None of it is easy. People are ultimately responsible for themselves, for their own behavior, for the choices they make about health and lifestyle. But those choices can be impacted, altered, affected by what they have, what they see and what they know. Information. Education. Jobs. Housing. Nutrition. Health. Community. Spirituality. It’s an interactive web.
Just look at the best American cities, the ones that make those ‘desirable places to live’ lists. They are not just pretty places. Over time, they’ve created a healthy mix of place, space, physical activity, culture, education, economics, social services, and infrastructure.
As a state, Tennessee needs to take a hard look at how it cares for and educates its people. As a city undergoing phenomenal growth, Clarksville needs to factor health and fitness, and the things that affect wellness and community, into the picture of the progressive urban center they are developing.