If the latest ‘Healthiest Cities’ study to roll into my inbox hadn’t come from WalletHub, I would not even have clicked on it.
Let alone write about it.
And while this list, at first glance, suffers from the same predictability of so many other “healthy cities” lists, it does offer a few interesting nuggets.
First things first: The top 10 “Healthy Cities” include the usual West Coast suspects. San Francisco? Yet. San Diego? Of course. Seattle? Yaaaaaassss.
But Washington, D.C.? I’m not even trying to be funny when I say that’s one of the last places I think of as “healthy.”
When I was writing about HIV/AIDS, I knew D.C. had one of the most serious problems with the disease of any urban area. Many people in Washington are marginalized and do not have proper access to care.
But a quick Google search showed me that things have changed in Washington D.C. as it pertains to HIV/AIDS since I last regularly wrote about the topic. The Washington Post reported in June that “efforts undertaken by the city — including distributing more than 6 million male and female condoms in 2016 and removing more than 800,000 needles from the street — are helping to make progress, Health Department Director LaQuandra Nesbitt said.”
How much progress? Just seven HIV infections were tallied in 2016, down from 149 in 2007.
So, I’m intrigued: Just how did WalletHub arrive at this list of “healthy” cities?
A case study: DC and HIV
“Location matters when it comes to health,” the financial literacy website explained. “Some places promote wellness by expanding access to nutritious food and recreational facilities. Others strive to keep healthcare costs affordable for everyone or keep parks clean and well-maintained.
In the case of Washington D.C. and HIV, the public health menace was injection drug use. Public health officials there found themselves in a pickle caused by Capitol Hill, of all places.
“From 1998 to 2007, Congress blocked the District from allocating local tax dollars for needle-exchange efforts, the Post reported.
This exacerbated D.C.’s HIV/AIDS problem. More on how D.C. turned things around in a second.
How WalletHub arrived at its conclusions
“In order to identify the overall healthiest cities in the U.S., WalletHub compared 174 cities — including the 150 most populated U.S. cities, plus at least two of the most populated cities in each state — across four key dimensions: healthcare, food, fitness and green space,” the financial literacy website explained.
Under the healthcare heading, metrics include a community’s overall mental health, which were based on the number of adults reporting 14 or more unhealthy days in a month.
Other metrics included access to care, quality of the local hospital systems, healthcare costs, and even specific metrics such as the percentage of adults receiving cholesterol screenings and the number of women ages 50-74 receiving mammogram screenings.
For my local followers, the Quad-Cities is not ranked. Chicago ranked 17th, but by no means can we compare our healthcare system to their’s. Cedar Rapids, Iowa ranked 77th, but again, Cedar Rapids has much closer access to the world-class University Hospitals in Iowa City than we do in the Quad-Cities, about 60 miles away.
Walk, take the bus, eat your fruits and veggies
So how can you choose a healthy community?
One panelist in this WalletHub report says to do what I do: Walk, and use public transportation, to stay healthy.
Of course, that means you need to live someplace where you can safely do those things.
“Studies show that people who use public transportation tend to walk more and have a lower body mass index (measure of weight) than those who do not,” says Lorrene Ritchie, director and cooperative extension specialist in the Nutrition Policy Institute at the University of California’s Division of Agriculture and Natural Resources. “So, look for places to live where you can take public transit to work and other places.
“Taking public transit is an example of a built-in way to make you be more active — without you having to buy a gym membership, find time to work out, or go out of your way. Can you walk from home to the market, or do you need to drive everywhere? How walkable is the neighborhood? Are there parks and other green spaces nearby? Would you bike to work if you could? If so, are there bike paths? Sidewalks? Connected streets?
“If you have children, can you live close enough to a school to have them walk or bike? Is it safe? Does the school have a joint use agreement with the city so that the school grounds are open to the public during non-school hours? For children, are there places in the neighborhood to be safely outside and play?”
The other thing to remember is that canned or frozen fruits and vegetables ARE better than no fruits or vegetables at all, if you are on a budget and cannot afford fresh.
“There is nothing wrong with frozen vegetables and canned fruits and vegetables (as long as low in sodium and without added sugar), Ritchie advises. “They are typically cheaper and less prone to spoiling — so less waste. Frozen may not have the texture that fresh produce does, but often, the flavor is pretty close. And if you put them in mixed dishes, you can hardly tell the difference.”
Choose a community with a good health IQ
So, why are all those healthy cities on the left coast?
Well, because that’s where smart people go these days to get rich (tech boom). So, there are a lot of smart people there, and consequently, a lot of people who care about staying healthy (and rich).
“Research has consistently shown a positive correlation between health status and years of education,” said John Sardelis, associate chair of health administration and professor at St. Joseph’s College, New York.
Sardelis’ statement underscores the importance of effective public health messaging, which can be a challenge in places where educational attainment and access to care are not high.
And that historically has been the case with HIV/AIDS in Washington. In recent years, however, public health officials have overcome these obstacles.
In addition to getting all those needles off the street and distributing millions and millions of condoms, the city also became the first in the country to roll out a public health campaign promoting PrEP, the HIV prevention pill. In addition, the city has created an innovative “UequalsU” campaign about HIV.
The point? Take your HIV medication every day and you cannot pass along the virus. That makes you “undetectable” and destigmatizes the disease by placing people with HIV on the same level as everyone else in the bedroom.
That’s still a huge deal, and stigma is never good for public health.
Local authorities should encourage health systems to address the social determinants of health (education, nutrition, housing, etc.), since so much of health is determined by these factors. Our medical system is wonderful, but we need to address the root causes that emanate from social factors.
And that’s what Washington, D.C. has done. No wonder it landed fifth on the “Most Healthy Cities” list.
Until next time.