Twenty Years of Life Suzanne Bohan Book Review

In Xx Years of Life, award-winning health journalist Suzanne Bohan shows that information technology's not a lack of medical intendance or poor lifestyle choices behind much of the ill health and shortened lives in impoverished communities, but a dearth of political power. She illustrates why the most effective solution for improving health actually hinges on preventing disease in the showtime place. To help create equitable places that support longer lives, poor communities can become politically organized to demand the same health-supporting resources and policies that wealthier areas take for granted, including well-maintained parks, prophylactic streets, quality schools, and grocery stores.

Drawing from years of on-the-ground reporting, Bohan brings the impact of this new activism to life. With dozens of profiles of mettlesome and adamant customs residents and leaders tackling a broad assortment of topics, she details success stories with lessons for communities across the nation. As 1 public health proficient wrote, "This book is filled with superheroes! Daring people who refused to watch their neighborhoods be plagued by avoidable and unjust inequities." Read our conversation with Bohan beneath, and share your questions in the comments.

Seven years into the x-year entrada covered in the book, California has seen the passage of more than than 500 new policies in 14 communities, and some statewide. How are the impacts of these policies measured? In other words, have these communities seen actual alter?

The changes you'd ultimately desire to see in these distressed communities include lower rates of diabetes, heart illness, obesity, cancer, hypertension, depression, and other common chronic diseases, along with increased life expectancies. However, every bit you can imagine, that takes time, as the youngest generation enters adolescence and transitions to machismo. These diseases are hard to contrary, and prevention through better living atmospheric condition yields the nearly powerful results. The leaders of this California campaign don't look to meet communitywide reductions in disease and early mortality for peradventure another decade, although mayhap a few years earlier.

They liken it to the campaign to reduce lung cancer rates by reducing tobacco apply, through laws limiting smoking in workplaces and public venues, tax on tobacco products, public education campaigns so on. No 1 expected an immediate turn down in lung cancer rates, but in the years subsequently these campaigns began, they did start dropping.

To keep an eye on changes in illness rates and longevity in these 14 communities, the campaign leaders are working with the University of California, Los Angeles, which conducts the "California Wellness interview Survey" (the largest state wellness survey in the nation), to include a few questions to monitor customs-wide changes in the coming years. And there are already changes underway in these communities that are visible to many of those living there, creating a sense of positive momentum.

Is at that place a particular story in the book that stands out to y'all?

In that location are many, so it's hard to choose. I met with many heroic individuals adamant to challenge caitiff systems. This campaign really bolstered my faith in the prospects of some degree of increased denizen appointment in the country—and every increment helps. I was also securely impressed past the forcefulness of the people living in these distressed communities, who persevere through challenges others in more comfortable neighborhoods scarcely, if ever, run into.

That said, the story of Pogo Park, led by Toody Maher, is extraordinary. She was utterly committed to turning a small urban center park in a notoriously dangerous neighborhood—a park few used because of illegal drug activity, loose dogs that terrorized kids, and vandalism and litter— into an oasis of peace, beauty, and enjoyment. Confronting all odds she succeeded, and her revolutionary vision of harnessing the skills and commitment of residents living around the park to make it happen—because they're deeply invested in its success, and compensated for their work—transformed that neighborhood. Information technology's truly a national model.

The last affiliate in the volume describes hit and consistent differences betwixt how Democrats and Republicans chronicle to issues of health disparities. How tin community groups utilize this information to effectively anteroom their representatives—federal, state, or local—for meaningful policy change?

Very few are enlightened of this one-of-a-kind report I reported on regarding the different perspectives Democrats and Republicans hold on the reasons for wide gaps in health and longevity between US communities. To my knowledge these ideas have been tested in merely limited means in the policy loonshit, and so one reason I covered this report is to better inform this dimension of the fence going forward.

As described in the affiliate, all the same, one of the report authors brash those leading campaigns to reduce health disparities to utilize the aforementioned message with both bourgeois and progressive audiences, rather than 2 separate messages. He advised highly-seasoned to Americans' fundamental sense of fairness, and how most people understand that "where you alive, learn, piece of work, and play" will have an influence on your health. He suggested using stories and "colloquial, kitchen-table" language, and to avoid stuffy academic terms like "social determinants of health" (which people peculiarly disliked) or fifty-fifty "wellness disparities." And to include a message of personal responsibility for health, but woven in with the notion that people should take the same opportunity to brand healthy choices.

Furthermore, the message of citizens organizing to advocate for their own communities' interests generally resonates beyond the political spectrum, as that'south the essence of democracy. It'southward the aforementioned kind of collective action behind the revered American tradition of "barn raising."

The communities you profile in the volume take received millions of dollars in funding since the Edifice Healthy Communities campaign launched in 2010. What is the importance of this type of intensive, long-term investment?

It makes all the difference, as the outcomes of these investments typically last decades and do good generations. In City Heights, a low-income San Diego neighborhood, teen advocacy under this campaign created two new skate parks in an area which previously had none, funded with a few million dollars in grants. Remarkably, in Fresno, community organizing under the entrada ushered in a $75 million community revitalization plan, which is expected to transform a distressed neighborhood with a high disease burden and uplift living conditions far into the future.

Sustained advancement past community activists, parents, and students has funneled many millions of dollars into the state's schools to fund practices to promote peaceful, productive school climates and parental date, along with accountability to ensure these practices are actually implemented. These critical changes help students learn and graduate, and ultimately head into successful careers and healthier lives. And these health-supporting policies are expected to become entrenched in schoolhouse systems going forrard, again benefiting time to come generations.

What lessons tin other communities learn from the success stories in the book? Can residents expect to affect real change in their neighborhoods without substantial fiscal back up? Why or why not?

They can, and at that place are examples such as the Dudley Street Neighborhood Initiative, which began more three decades ago and has made extraordinary changes in its Massachusetts customs. Notwithstanding "substantial fiscal support" is relative: according to the most recent almanac report on its website, Dudley Street brought in about $4 1000000 in 2015, so it was inappreciably insubstantial. Just that compares to $1 billion over 10 years for the California campaign—an unprecedented commitment by a foundation to this blazon of work. And then some funding is critical for a sustained endeavor, and one of the messages of this volume for the world of philanthropy is that this model is showing major success in "funding alter, not charity." An outside funder brings numerous benefits as well, such equally providing a "neutral convener" to aid numerous community groups in developing a unifying vision for action, and of course the resources to run a sustained campaign, with staffing, role space, and funds for supplies, media campaigns, research, etc.

Still, there are innumerable examples of campaigns with no upkeep—typically shorter-term but not e'er—that have led to lasting alter. So if citizens recognize a pressing outcome facing their community, they can accept some of the examples in this book (or ane specifically on community organizing) on how to run a campaign—which includes thorough, accurate enquiry, reaching out to those in a bona fide position to influence, holding tightly-run public meetings to build credibility and support, etc.—to create alter with few or no expenditures. And people unremarkably draw attaining a new sense of power and optimism by participating in these efforts, forth with better customs or school conditions and a greater sense of connexion to neighbors.

Did you lot detect anything in the course of researching and writing this book that surprised you?

Many things, really. One strategy that struck me as surprisingly powerful and yet simple is the advice to keep customs organizing events to a precise time frame—such every bit one hour and to offset and terminate precisely on fourth dimension. That's specially truthful for "actions," in which a demand is made of those in power. Most people await customs volunteers to run things a little more casually, and are surprised to see that kind of bailiwick on brandish. It respects the time of those attention, and people are more likely to stay involved if they're confident meetings will end at a predictable fourth dimension. That strategy is especially powerful in youth groups. While of grade the quality of content matters enormously, those minor but critical steps leave a lasting impression, and those in positions of power are often taken aback by this command of the meeting. Equally community organizers frequently say, "Power respects ability."

And edifice power is in fact what these endeavors must reach, as that's ultimately what causes those in positions of influence to shift their position—be it releasing resources, enacting a new policy or police, etc.

What exercise you hope readers take away from Xx Years of Life ?

That within these distressed communities effectually the nation—the ones oftentimes labeled as "bad neighborhoods"—at that place's a deep reservoir of talent, goodness and latent ability. That'due south commonly disregarded, and those living in these neighborhoods ofttimes comport the extra brunt of unwarranted, offensive stereotypes.

And that rather than concentrating on charitable programs to help these communities, a smart investment is in building upwards their political power, so residents can advance their visions for a healthier community and drive sustainable modify by cultivating long-term local empowerment. And that in fact the entire nation benefits, every bit when these horrific disparities betwixt communities in something every bit cardinal lifespan and affliction burdens begin to compress, it's likely to lead to a more peaceful, less stressful society for all.

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Source: https://islandpress.org/books/twenty-years-life

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