Public Health

The right to smoke versus the right to breathe

August 15th, 2011 by Joe Kriesberg

The first advocacy campaign of my life did not involve housing, community development, civil rights, the environment or even Vietnam. Instead, it was a years-long effort to get my mother to quit smoking! Every day, for years, I would interrogate her after school about how many cigarettes she had smoked that day. I was relentless, using every tool I had – facts, nagging, shame, and most of all guilt (“you are going to die!”)  Eventually, my mom finally acquiesced and quit smoking when I was about 11 years old. I’d like to think I had a role in helping her live a full and active life until she passed away last year at the age of 82.

At the time, the early 1970s, smoking was still widespread and accepted just about everywhere. Over the past 35 years, however, smoking has been banned from virtually every indoor and even many outdoor venues. Despite my roots as an anti-smoking crusader, I sometimes wonder if perhaps we have gone too far – smokers should have rights too. 

All of this came to mind recently when I met with leaders from Health Resources in Action and the Boston Alliance for Community Health who are working to encourage CDCs and others to implement no smoking policies in their rental housing.  Shouldn’t people be allowed to smoke in their own homes, for goodness sake, even if they happen to need subsidized housing? Should low income people have to give up their rights?

Upon reflection, however, I think the reasons to go smoke free outweigh any hesitations that I or others may have. Smoke free housing is healthier, safer, cheaper and preferred by the majority of tenants. In the words of Ava Chan at the Allston Brighton CDC, “it's about the right to breathe rather than the right to smoke.”  And smoke free housing appears to be the wave of the future as it quickly emerges as a “best practice” for providing safe and healthy housing to our communities. A wide range of housing groups are adopting such policies, including the Boston Housing Authority, the national nonprofit group, Preservation of Affordable Housing, and several of our members.

Implementing smoke free housing is not easy. It requires education, organizing, and ultimately some tough love. Elderly tenants who have smoked in their homes for years may be a particular challenge. Thankfully, affordable housing owners who want to go smoke free don’t have to do it alone. Health Resources in Action is providing funding and technical assistance to five CDCs (Allston Brighton CDC, Asian CDC, Dorchester Bay EDC, Grove Hall NDC, and Jamaica Plain NDC) to help them adopt such policies and they can help others. The Mass. Department of Public Health and the Center for Disease Control (the other CDC) both have resources to help CDCs and others implement smoke free housing policies.

CDCs have always been committed to creating healthy communities. I hope more of our members move in this direction because smoke free housing is a tangible and significant way to improve the lives of our tenants. And I’m sure there are many boys and girls living in these apartments who will very much appreciate an ally in their own campaigns to get their parents to stop smoking! And those parents, like my mother, will be glad they did.

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A Smarter Way to Reduce Health Care Spending

April 25th, 2011 by Joe Kriesberg

The first meeting I ever attended on behalf of MACDC – way back in 1993 – was at the Bowdoin Street Community Health Center. The purpose of the meeting was to strategize ways to reduce childhood lead poisoning by building a coalition of community development, housing, environmental and public health advocates to fight for changes in policy and practice that would better protect our children. Over the ensuing years, we successfully won major legislative change, new funding for lead abatement, and a robust effort of abatement, education, prevention and treatment that has nearly eliminated lead poisoning from the Commonwealth (although the risk is still serious in much of our older housing stock.)

The success of that collaborative effort came to mind the other day when I was attending the Health Communities Conference co-sponsored by the Federal Reserve Bank of Boston, the Mel King Institute’s Innovation Forum and several other partners. The conference explored the benefits of linking community development to community health efforts as a way to reduce chronic disease and improve wellness. The importance of this effort was underscored by Paul Grogan, President of the Boston Foundation, in his keynote remarks where he highlighted the fact that health care spending is now completely crowding out public investment in virtually every other area – education, recreation, housing, community development, food supports, and public transit. Yet by investing in these other areas we could actually reduce the need for costly medical care and improve the quality of people’s lives. Indeed, providing a homeless family with stable, safe housing might do more to reduce hypertension, asthma, and other chronic illnesses than all the medicine that money can buy.

The Conference included a number of interesting speakers from both the community development and the community health sectors. We heard about cutting edge research that documents that close correlation between socio-economic status and neighborhood quality with health outcomes. We also learned about innovative programs at the ground level that are beginning to make an impact. Materials from the conference are expected to be available soon on the Federal Reserve Bank’s conference web site.

MACDC intends to work with our partners in the public health field to build on the excitement from the conference to explore opportunities for innovation in public policy and community practice. With health care at the top of the priority list in both the State House and Congress, there will be many opportunities to gain traction. Perhaps someday, doctors will have the ability to fight the causes of disease by prescribing rental assistance subsidies, job training and T-passes instead of being limited to simply treating the symptoms of disease with costly medical procedures and pharmaceuticals

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Five Hidden Opportunities in the 2010 Election Results

February 12th, 2011 by Joe Kriesberg

The 2010 midterm elections have certainly made many community developers anxious for our communities and our field—and with good reason. The Republican Party’s agenda of draconian spending cuts has the potential to devastate struggling communities and families across the country. We must resist their agenda as strongly as we can.

That said, there may be a few hidden opportunities in the current climate for community developers to seize. At the risk of being Pollyannaish, here are five opportunities that call out for action:

Climate Change: With national climate legislation dead, environmental advocates and funders are looking to create a “Plan B” for stopping climate change. This plan is likely to include advocating for state and local policy changes, as well as changes in local practice. They will also need to broaden their coalition and base of support. This creates a tremendous opportunity to frame community development as a key part of a serious, comprehensive climate change agenda. We know that creating livable, well-designed urban neighborhoods will reduce carbon and other greenhouse gas emissions significantly.

Community developers should not only work to explicitly “green” their agenda by weatherizing their rental properties and developing transit-oriented projects, but should also make the case that community development itself is a climate change strategy. Here in Massachusetts, the largest environmental funder in the state, the Barr Foundation, and the Ford Foundation, have adopted this thinking and are supporting sustainable neighborhood development in a regional context through the Smart Growth Alliance’s Great Neighborhoods program. We can build on this across the country.

Health Care: The debate over our national health care system is far from over, and once again community development could be a nonpartisan solution that becomes widely embraced. There is growing evidence that healthy homes and healthy communities can substantially reduce health disparities and improve health outcomes for everyone. With the health care sector embracing new ideas and innovation, there is the potential for community developers to find new funding sources and new political allies. As one colleague has pointed out to me several times, if community developers could access just a small percentage of the nation’s investment in health care, we would increase community development funding many times over!

Local Solutions: While community developers and Tea Party activists probably do not agree on much, we may be able to find some limited common ground. Community developers support strong federal investments in communities and we support a robust safety net. But we can also be critical of federal programs for their rigid and bureaucratic rules that do not work well at the local level. Perhaps we can find new allies that will support building the capacity of local, nonprofit (and importantly, nongovernmental) organizations that can develop and implement practical solutions that are tailored to the local context. Perhaps CDCs can gain bipartisan support as organizations that reflect a long-honored American tradition of local people working together to solve problems and improve their own communities.

Rental Housing: The collapse of the homeownership industry and mortgage lending has created a new appreciation of the important role that rental housing plays in our country. For too long, tenants and rental housing have been denigrated. Today, policy makers understand that we need a strong and diverse supply of rental housing to meet the needs of our communities and our economy. This long overdue shift in public opinion could pave the way for policy changes that help protect tenants and help us to build and preserve high quality and affordable apartments.

Homeownership: While it may seem contradictory, I also believe that the current political climate provides an excellent opportunity to have a long overdue and important conversation about the role of homeownership in low- and moderate-income communities. While the growing conventional wisdom that low- or moderate-income families cannot and should not own homes is a major threat, it is also an opportunity to tell the story of how these families can and have been successful homeowners.

We need to embark on a major policy and educational campaign to highlight the success of homeownership education, specialized mortgage products and shared equity homeownership models. Such a campaign is essential because we know the new Congress will be enacting major new legislation to transform Fannie Mae and Freddie Mac and the entire mortgage lending industry and we know that the Obama administration is looking to update CRA regulations and roll out the new Consumer Financial Protection Bureau. All of these policy debates and shifts create an opportunity to transform the mortgage industry in a way that better serves our communities.

These opportunities do not come without risks and challenges, and I could have easily written a much longer article about the threats and challenges emerging from the election. But it is vital that community development leaders retain our tenacious optimism as we move forward. It has served us well for over three decades during good times and bad, and we need it now more than ever!

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