Come Together Now: Building Healthy Communities for Women

285 ComeTogetherPractical resources and personal support networks help women live healthy lives in their communities.

By Diana Price

The headlines pop up regularly in media outlets: “Top Healthy Cities,” “Healthiest Places in the US,” “Healthiest Cities for Women.” Published annually, these lists are enticing, complete with beautiful photos of inviting neighborhoods and inspiring skylines. But what do these compilations really tell us about what it takes for women to live healthy lives in these communities?

Generally, these listings are created by crunching data: crime rates, number of walking and bike paths, rates of heart disease and other health conditions, average life expectancy, and many other criteria are sorted and prioritized to compose a picture of inhabitants’ health. The results are interesting in that they provide an overview of the health of various populations, and they offer a launching pad for discussions about what factors contribute to creating a healthy community.

While it would be nice to think that if we were all able to live in these healthful hubs we would be guaranteed a healthy life, the reality is that a woman’s ability to live a healthy life in her community depends on not only what resources exist in a place but also if and how she has access to and interacts with those resources.

We wanted to dig a little deeper and offer up insight from leading experts in public health and women’s health to understand what key factors need to be in place for women to maintain physical, mental, and emotional well-being in their communities and what barriers women face in accessing those resources. So, here is what experts tell us are the key components of healthy living for women, no matter where they live—whether big city, small town, or rural county.

1. Regular Physical Activity

Nancy C. Lee, MD, deputy assistant secretary for health and women’s health and the director of the Office on Women’s Health, says that “regular physical activity is one of the most important things women—or anyone—of all ages can do to improve their health. Regular physical activity that is performed on most days of the week reduces the risk of developing or dying from some of the leading causes of illness in the United States, such as heart disease. And regular, moderate exercise can also promote a women’s emotional well-being and reduce feelings of depression and anxiety.”

For women who live in communities with ample green space, safe sidewalks, and health and fitness classes, working exercise into their lives can be accomplished by committing to something as basic as a daily walk, checking out class offerings at a local gym, or asking friends or family to commit to working out together.

But while regular exercise may seem like an obvious component of maintaining health, it can be a challenge for women living in communities where personal safety is a concern. If you feel that your neighborhood is not safe—whether because of high crime rates or unsafe sidewalks or lack of green space—you are not likely to head out on a walk.

Marilyn Sawyer Sommers, PhD, RN, FAAN, Lillian S. Brunner Professor of Medical-Surgical Nursing and director of the Center for Global Women’s Health at the University of Pennsylvania School of Nursing, says, “We have major disparities in low-resourced and high-resourced urban areas in the US.” High-resourced areas provide green spaces, bike lanes, safe areas for walking, easy access to nutritional foods in stores, and home security, Dr. Sommers says, whereas low-resourced areas lack these benefits. Without safety and space to walk, getting regular exercise can be very difficult.

In addition to the environmental challenges that exist in low-resourced communities, many women lack support from family and friends in their efforts to exercise, which can have a negative impact on their motivation. These combined barriers can be significant obstacles to healthy living and contribute to the large number of women who are not exercising regularly. In fact, according to Dr. Lee, “less than half of women get the physical activity they need.”

2. Safety

A woman’s sense of security—physical and emotional—is a major factor in her ability to live a healthy life in her community. Dr. Lee says that the role of safety cannot be overstated: “Safety is the most important factor that influences a woman’s ability to live a healthy life. If she feels safe, she will leave her home to run or walk outside. If she feels safe, she will take her children to play at local parks and playgrounds. If she feels safe, she will go to the nearby gym or swimming pool for exercise. If she feels safe, she will walk or bike to work, the grocery store, or a friend’s house.”

In addition to resources and infrastructure that help women feel safe as they exercise and move around in public, a safe community for women is one that supports women’s emotional well-being and domestic safety. Dr. Sommers says that women’s shelters are a key component, as is a police force adequate to enforce safe streets, providing women a physical place of refuge and the support of law enforcement. When these resources are not in place, women’s health suffers.

3. Community Support

Beyond a physical environment that promotes safety and mobility within her community, a woman’s health is also reliant on the support she receives in her effort to live a healthy life. A healthy community for women is one that provides both the infrastructure for her to easily make healthy choices and the support of her family and friends as she strives to live a healthy life.

Dr. Sommers says that some practical community support might include “low-cost day care that allows women to work and public transportation to provide easy access to healthcare facilities.”

Dr. Lee notes that other policies that support good health include “smoke-free public spaces; fluoridated, lead-free water; and easy access to parks, tennis courts, recreational centers, playgrounds, and gyms.” If women do not have these resources, achieving and maintaining good health can be a challenge.

In addition to these resources, the support women receive from their friends and family is critical in encouraging healthy choices and reinforcing the benefits of a healthy lifestyle. Beth Battaglino, RN, CEO and president of HealthyWomen.org, says that women provide one another with essential support. By encouraging one another and forming groups to get out and exercise together, women can improve their physical well-being and create valuable support networks in their communities. Battaglino says that “support enables women to continue in their fitness regimen, empowers them, and helps them cope with everyday stressors to stay balanced.” Knowing that you have the strength of a group of women behind you also adds to your sense of security, she adds: “A community that is supportive and tight-knit creates a sense of belonging, which I believe helps women feel connected and plays an enormous role in our health and wellness.”

For women who do not have a group of friends or family to reach out to for support, Dr. Lee suggests “checking out local community groups, places of worship, or organizations such as the YWCA or YMCA, which may offer opportunities for group support and can help women optimize their health.”

4. Access to Nutritious Food

Eating nutritious food is one of the cornerstones of health. “A healthy community includes farmers’ markets and grocery stores with healthy, affordable, and culturally appropriate food,” Dr. Lee says.

For women living in some communities, however, finding healthy food can be a challenge. When communities lack well-stocked grocery stores or other healthful food outlets, like growers’ markets, women rely on less nutritious, highly processed foods—and their health suffers. Women who live in these “food deserts,” which are predominantly low-resourced neighborhoods, often lack access to transportation to travel to other areas where they could purchase healthier foods. “When women do not have access to nutritious foods and other resources, the overall negative impact on health is considerable,” Dr. Sommers says.

5. Good Health Resources

Another key element of a healthy community is access to preventive healthcare and to credible information about health and wellness. Dr. Lee says that “every woman should visit her doctor to receive regular checkups and preventive screenings. Checkups provide an opportunity to talk with her doctor about health concerns and screening tests, such as mammograms, blood pressure tests, and Pap tests. These healthcare visits are vital to the early detection of heart disease, diabetes, cancer, mental health illnesses, sexually transmitted infections, and other conditions.”

Battaglino notes that women should be aware that preventive care does not always necessitate a trip to a clinic or hospital: “Health screenings are often held at local churches, grocery stores, and through drugstore ‘minute clinics’ that offer reduced fees for vaccinations, blood pressure screening, and other preventive care that could be lifesaving.”

6. Live a Healthy Life in Your Community

No matter where you live, you can make significant choices every day to improve your health and that of your community. Dr. Lee says that while some factors are out of our control, there are steps each of us can take to maintain health and promote healthy living in our communities:

  • Eating healthy foods
  • Being active
  • Being tobacco-free
  • Getting enough sleep
  • Wearing a seatbelt
  • Using a bike helmet
  • Going to your doctor
  • Supporting others who choose to live healthier in your community and beyond

Women’s Health Resources and Initiatives

Office on Women’s Health (OWH) Helpline

The OWH Helpline connects women with information and resources to answer their health questions. Women can speak with trained English- and Spanish-speaking information and referral specialists by calling (800) 994-9662, Monday through Friday from 9 a.m. to 6 p.m. eastern time (closed on federal holidays). The OWH Helpline also has breastfeeding peer counselors available to answer common questions about breastfeeding. Women with access to a computer or smartphone can access online resources, such as womenshealth.gov and girlshealth.gov, that provide many health fact sheets and other content. These online resources can help women optimize their health.

National Women’s Health Week

Every year OWH coordinates National Women’s Health Week, a weeklong observance aimed at empowering women to make their health a priority. OWH wants women to get active, eat a healthy diet, visit a doctor, pay attention to their mental health, and avoid unhealthy behaviors such as smoking. Visit womenshealth.gov for more information.

 Healthy Community Profile: Fort Worth, Texas

Mayor Betsy Price keeps her city moving on the road to good health.

As a dedicated cyclist for more than 30 years, Betsy Price, mayor of Fort Worth, knows the personal benefit of regular exercise: “For me fitness isn’t just about health—it’s also a fun, social activity. Cycling is really fun, and I get to enjoy the outdoors,” she says.

As mayor, Price has made a commitment to bring her enthusiasm for fitness and healthy living to the community of Fort Worth. Together with local employers, schools, hospitals, government officials, faith communities, nonprofits, and retailers, Price launched the FitWorth initiative in 2012 with the goal of building local momentum to curb the obesity epidemic and encourage healthy living. “Our health, as individuals and a community, is the foundation of our ability to pursue a livelihood and contribute to society,” Price says. “Poor health is a huge obstacle to overcome, whether it is the result of illness, genetics, or poor personal choices. From my perspective the city government’s role is to facilitate an environment where the private sector and private citizens are encouraged to join together to create a healthy, happy community.”

The various programs of FitWorth—including exercise initiatives through local businesses, school programs, and online tools—encourage employers, families, and the community as a whole to promote wellness activities and healthy eating. Price says the response has been positive, as the community has worked together to effect change.

When a local middle-school teacher, Blanca Salinas, started a school triathlon club, Price says local triathlete organizations and businesses outfitted the team with bicycles, helmets, running shoes, and all the requisite gear. “The kids completed their first sprint triathlon this May and then competed in our first annual Mayor’s Triathlon right here in downtown Fort Worth in July,” Price says. “Watching those kids experience the joy and power that comes from training and challenging themselves is just absolutely amazing. And the community support makes me so proud.” Blanca Salinas’s contribution is a prime example of the impact that women, specifically, can have on inspiring healthy living within their communities. “Women like Blanca Salinas change the lives of kids,” Price says.

For more information about FitWorth, visit fwtexas.org.

Does Your State Get a Passing Grade?

The Women’s Health Report Card assesses women’s health in each state.

Michelle Berlin, MD, MPH, co-director of the
Oregon Health & Science University Center for Women’s Health, says that living in a “healthy” community—or one that meets a set of criteria for healthy living—does not guarantee a woman’s well-being. “It’s not like osmosis. Moving from one place to another is not going to make you healthier,” she says. The formula is a bit more complicated: “It’s about interaction” with the resources that are available.

While we know that data is not a guarantee of health for women living in various communities, it can nevertheless provide valuable information about different populations and help prompt improvement in the resources available to women. This is one of the goals of Making the Grade on Women’s Health: A National and State-by-State Report Card (hrc.nwlc.org), an annual assessment of women’s health distributed by the National Women’s Law Center. Dr. Berlin helped develop the Report Card in the late 1990s and says that the indicators it assesses—including access to healthcare services, addressing wellness and prevention, key conditions, and living in a healthy community—provide a valuable picture of the state of women’s health across the country.

Women interested in seeing how their state stacks up in providing women with resources necessary to optimal health should visit the site and see to what extent laws support health resources and initiatives. Learn more at hrc.nwlc.org.