School, Jobs, and Health

I work as a family doctor at a community health center in the Bronx.  I’m always wondering, what can I do during a 15-minute visit to have the most impact on my patient’s health?  The answer is often that smoking cessation counseling, or screening for depression, or some other preventive health maneuver, will have the biggest return on investment.
As a community member, I look outside the walls of my clinic and wonder what I can do that will most impact the health of the community.  The answer seems to be better school and work opportunities.  There may be disagreement on the best way to improve the school system or the best way to create jobs that pay a living wage.  But the evidence is clear: education and employment are driving disparities in health.
The Robert Wood Johnson Foundation has been creating a new space for this discussion through their Vulnerable Populations series of webinars.  They also supported the creation of a County Health Calculator at Virginia Commonwealth University.  The startling data  show that if the Bronx was raised up to the same education level as Manhattan, this would prevent 1 in 4 deaths each year.  If  we saw the same improvement in income levels, this would prevent 1 in 12 deaths each year.
Budget debates happen at the state and federal level every year.  As doctors, we need to be thinking about how these budget decisions affect jobs and education for the patients and communities in our care.