A:Most of the world’s population live (often just exist) in urban areas. Cities are places in which many immigrants seek employment and opportunities to improve their often difficult lives. There may be opportunities for work, but inner cities are also often the hub of drug dealers; crime syndicates; and corrupt and greedy landlords who often lease substandard and sometimes unsafe and unhealthful rooms/apartments to those who are unsuspecting, vulnerable, and desperate. Additionally, with the economic turbulence of the past 10 years, infrastructure, as well as health and education facilities, have been victims of shrinking budgets, resources, and expert personnel.
Inner cities are case studies of how social and economic circumstances determine health outcomes, disease patterns, and longevity. To make a difference in these circumstances, we have to understand these social determinants:
The social gradient: the lower levels of the social ladder in each society experience more disease and shorter life expectancy.
Stressful circumstances damage health and may lead to premature death.
Strong and supportive relationships in early life impact development and health outcomes over a lifetime.
Discrimination and social exclusion cost lives because quality of life is impacted.
Workplace stress or lack of work can increase the risk of disease.
Supportive networks and strong relationships improve health in every aspect of life; these are often lacking in the crucible of inner-city life.
The use of alcohol, tobacco, and other drugs is influenced by the wider social setting; the inner city spawns such addictions.
The availability and security of healthful food impact the burden of disease, and, when inadequate, can be detrimental to health.
Adequate and safe low-pollution modes of transport, such as walking and cycling, improve health outcomes.
In 2005 the World Health Organization put forward goals to close the social gap by improving people’s daily living conditions, addressing inequitable distribution of resources, and measuring outcomes. What can local churches do?
For the past decade the objective of the General Conference Health Ministries Department has been for every church to become a center of health and hope. What does that look like?
Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department.