Civic Learning and Engagement Saves Lives

February 22, 2018

By Anthony Iton MD, JD, MPH, Senior Vice President for Healthy Communities at The California Endowment

As Dr. Tony Itona medical doctor and executive at California’s biggest health foundation, I often get the question – what do we need to do to improve California’s health? My answer surprises many: empower people.

When I was the director and public health officer for Alameda County, I did a study that looked at the average number of years that people lived in different neighborhoods. We created a map of every neighborhood in Oakland that showed a more than 22-year life expectancy difference between those in the lower-income East and West Oakland flatlands and those in the more upscale Oakland hills. Most surprisingly, this difference was not caused by violence, drugs, or even HIV/AIDS. The difference is a lifetime of disadvantage and lowered opportunity which gets under the skin, causes chronic stress and changes people’s biology. When it comes to your health in this country, your zip code is more important than your genetic code. Living in a poor neighborhood in this country changes your biology and makes you more likely to die early.

In designing the Building Healthy Communities billion-dollar initiative to improve the health of low-income Californians, we looked at the science and it told us that three things matter most to a community’s health:
1) having a sense of power or control in your life
2) feeling valued and having a sense of belonging
3)  being in an environment rich in resources, with few risks.

Training young people to have their voices heard, giving them an opportunity to learn about how our government works and how they can organize and advocate for positive change in their schools and communities is an essential building block for their good health. Consequently, youth leadership is one of the cornerstones of our efforts. Civic engagement is like a muscle that needs exercise and offering young people opportunities to develop the skills and habits at a young age will improve their health and the health of their neighborhoods.

Through BHC, youth from some of our state’s lowest-income communities are learning deep civic engagement as they work to improve the climate in their schools using restorative justice. Restorative justice, also used in some courts, is an alternative to discipline that emphasizes supporting students rather than suspending or expelling them. Through their efforts, suspensions and expulsions dropped by almost half in the last five years in California while test scores have increased. Similarly, students are starting anti-bullying programs and other strategies that make young people feel safe and included. Youth in these 14 communities are changing the narrative to one in which low-income voices are heard and valued as part of the solution.

Chief Justice Cantil-Sakauye may not know it, but her Keeping Kids in School initiative and her Civic Learning Initiative—which recognizes schools for their efforts in civic education— is a public health strategy that is lengthening the lives of people throughout the state.