America’s mayors are tackling health equity, but they need Washington’s support

America’s mayors are tackling health equity, but they need Washington’s support

I strongly believe that your zip code should not determine your health outcomes. Growing up, my family did not have private health insurance — we relied on the public health care system, as did many other families in the Acres Homes neighborhood in Houston, Texas. My father died of cancer when I was 13, never having had any treatment other than painkillers. We didn’t even know he had leukemia until after he died. He went to the ER, got his prescription and went on.

As Mayor of Houston, these lessons from my childhood influence the way I view health care policy.

In my party, there is a disagreement about whether nationalized health care or a market-based approach to universal care is the answer. But we can’t put community access to health care on hold while we talk. Lives hang in the balance. Value-based care models from the Centers for Medicare and Medicaid Services focus on preventive care, help keep patients out of emergency care, and incentivize coordinated care and better outcomes — approaches I’ve seen work in Houston.

Houston’s Complete Communities initiative was established in 2017 during my first term to ensure that everyone has access to quality services and amenities, including health care. Complete Communities’ mission is to build and sustain uplifted neighborhoods, focusing on 10 historically under-resourced ones, including the area where I grew up. I am proud that this initiative is community-based and resident-led. Neighborhoods work together to create action plans to address economic, environmental and equity challenges that are then approved by the City Council and implemented by the Mayor’s Office of Integrated Communities.

I have worked alongside residents and local leaders to address our city’s biggest challenges. In Houston, we know that healthcare isn’t just about taking care of people when they’re sick – it’s about giving them the resources to live safer, healthier lives. Unique programs like CAPABLE (Community Aging in Place — Advancing Better Living for Elders) — a home-based program developed by the Johns Hopkins School of Nursing that combines nursing care, occupational therapy and artisan services — have helped seniors and Medicare recipients across the the city gains more independence and reduces the impact of health inequalities.

Of course, individual and community health and well-being are affected by social and economic stressors such as homelessness and food insecurity. We’ve provided more than 25,000 Houstonians with safe, permanent housing since 2012. In January, we announced $100 million in funding for programs to reduce homelessness and $65 million in funding related to COVID. This is proof that federal resources are making a real difference — and why Democrats in the Biden administration and in Congress need to recommit to innovative value-based health care models that help cities like Houston.

Our most vulnerable residents must have access to long-term, personalized primary care to address chronic medical conditions, mental health and physical disabilities. I’ve seen many Houstonians who have turned to emergency rooms and ambulances to get medical treatment—just like my father did—because they don’t know where else to turn. Once they have a relationship with a primary care provider, we need to ensure that the care they receive is comprehensive and affordable. If it’s not accessible, it’s not accessible.

America’s mayors are enthusiastic partners in the quest for healthier communities and greater justice. The U.S. Conference of Mayors and the Association of African American Mayors passed resolutions in support of the Center for Medicare and Medicaid Innovation (CMMI) Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model — the first program to require a plan health equity to reduce inequalities and collect patient demographic data linked to social determinants of health.

It is impossible to understand a person’s needs without understanding their circumstances, and this data will help us discern which resources are most vital. However, for the model to even have a chance to succeed, it needs broad federal support. I say to the legislators: No more debate. Now is the time to support a program that can improve health outcomes for all Americans.

Local leaders can and should be champions of public-private partnerships that build stronger, healthier cities. But we can’t do it alone, and we need the support of leaders in Washington to provide accessible health care for all.

Sylvester Turner has been the mayor of Houston, Texas since 2016.

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