Cooperative Ownership as a Health Justice Intervention: A Promising Strategy to Advance Health Equity Through the U.S. Childcare System.

In their article "The Civil Rights of Health," Harris and Pamukcu offer a framework connecting civil rights law to unjust health disparities with the aims of creating broader awareness of subordination as a root cause of health inequities and inviting policymakers to create new legal tools for dismantling it. They close with a call to action. Here, we take up their call and propose cooperative enterprises as a health justice intervention. To illustrate this conceptualization, we focus on childcare as a system with robust connections to social, economic, and health equity for children, workers, and families.

Health in Action: Evaluation of a Participatory Grant-Making Project in East Harlem.

Decision-making processes that include resident input have been shown to be effective in addressing community needs. However, few examples discuss the role of a local health department in leading a participatory decision-making process. In 2016, the New York City Department of Health and Mental Hygiene implemented a participatory grant-making process to allocate grant funds to community organizations in East Harlem. Findings from the evaluation suggest that a participatory grant-making process can be an effective way to include community member as decision makers. It can also build capacity among organizations and foster meaningful community engagement with a local health department.

New approaches for moving upstream: how state and local health departments can transform practice to reduce health inequalities.

Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream" behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators' role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.

Has New York City fallen into the local trap?

OBJECTIVES: Municipal policies aiming to improve equity in food access and health often rely on the assumption that neighborhoods with limited healthy food availability and high levels of diet-related illness should be the subject of targeted policy-driven change. This study explored this assumption in the context of recent food policy developments in New York City with the objective of empirically examining the geography of everyday food behavior in high- and low-income neighborhoods. STUDY DESIGN: This research used a multi method comparative design. Areas at the poles of income inequality in New York City were identified using census data and geographic information systems. Qualitative and geographic data were collected from individual eaters living and/or working in those areas. METHODS: A review of food policies in New York City from 2005 to 2012. Qualitative and geographic data were collected using space-time food diaries and mental mapping interviews. RESULTS: People living in the low-income study area had more localized food geographies than residents of the high-income study area. Individual-level qualitative data revealed that eaters with the least financial resources, those with physical disabilities, and those who were unemployed reported all or nearly all of their food events taking place within their neighborhoods. Eaters from the low-income area suggested that the barriers to healthy food that policy incentives should address were the high price of food and the consumer environment within stores, not the number of supermarkets in their area. Residents of the high-income area also expressed dissatisfaction with food prices and the in-store environment of their local supermarkets. These eaters leveraged their financial, technological, and transportation resources to overcome those barriers to fresh food. CONCLUSIONS: The policy review found that New York City's recent nutrition and food policies are to a great extent geographically targeted to low-income areas. As such, they miss opportunities for citywide interventions that would create food environment changes welcomed by residents of both high- and low-income areas. The recent nutrition and food policies also have the potential unintended negative consequence of promoting gentrification.

Mortgage foreclosure and health disparities: serial displacement as asset extraction in African American populations.

In this paper we offer a conceptualization of mortgage foreclosure as serial displacement by highlighting the current crisis in the context of historically repeated extraction of capital-economic, social, and human-from communities defined at different scales: geographically, socially, and that of embodied individuals. We argue that serial displacement is the loss of capital, physical resources, social integration and collective capacity, and psycho-social resources at each of these scales, with losses at one level affecting other levels. The repeated extraction of resources has negative implications for the health of individuals and groups, within generations as well as across generations, through the accumulation of loss over time. Our analysis of the foreclosure crisis as serial displacement for African American households in the United States begins with the "housing niche" model. We focus on the foreclosure crisis as an example of the interconnectedness of structured inequality in health and housing. Then we briefly review the history of policies related to racial inequality in homeownership in the twentieth and twenty-first centuries. We end with an analysis of the scales of displacement and the human, social, and capital asset extraction that accompany them.

A tale of two obesCities: the role of municipal governance in reducing childhood obesity in New York City and London.

As rates of childhood obesity and overweight rise around the world, researchers and policy makers seek new ways to reverse these trends. Given the concentration of the world's population, income inequalities, unhealthy diets, and patterns of physical activity in cities, urban areas bear a disproportionate burden of obesity. To address these issues, in 2008, researchers from the City University of New York and London Metropolitan University created the Municipal Responses to Childhood Obesity Collaborative. The Collaborative examined three questions: What role has city government played in responding to childhood obesity in each jurisdiction? How have municipal governance structures in each city influenced its capacity to respond effectively? How can policy and programmatic interventions to reduce childhood obesity also reduce the growing socioeconomic and racial/ethnic inequities in its prevalence? Based on a review of existing initiatives in London and New York City, the Collaborative recommended 11 broad strategies by which each city could reduce childhood obesity. These recommendations were selected because they can be enacted at the municipal level; will reduce socioeconomic and racial/ethnic inequalities in obesity; are either well supported by research or are already being implemented in one city, demonstrating their feasibility; build on existing city assets; and are both green and healthy.