US mayors are tackling health equality, but they need Washington’s support


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

As mayor of Houston, these lessons from my childhood influence how I view health care policy.

In my party there is a dispute about whether nationalized care or a market-oriented approach to universal care is the solution. But we cannot suspend community access to health care while we debate. Lives are at stake. Value-based care models from the Center for Medicare and Medicaid Services focus on preventive care, helping keep patients out of the emergency room, and driving coordinated care and better outcomes — approaches I’ve seen work in Houston.

Houston’s Complete Communities Initiative was founded in 2017 during my first term to ensure everyone has access to quality services and amenities, including healthcare. Complete Communities’ mission is to build and maintain lofty neighborhoods, focusing on 10 historically under-resourced, including the area I grew up in. I am proud that this initiative is community-oriented and resident-driven. Neighborhoods work together to create action plans to address economic, environmental, and justice issues, which are then approved by our city council and implemented by the Whole Communities Mayor’s Office.

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I’ve worked with residents and local leaders to address our city’s biggest challenges. In Houston, we know that healthcare means not only taking care of people when they are sick, but also giving them the tools to live safer, healthier lives. Unique programs such as CAPABLE (Community Aging in Place – Advancing Better Living for Elders) — a home program developed by the Johns Hopkins School of Nursing that combines nursing care, occupational therapy, and handyman services — have helped seniors and Medicare recipients around the city gain more independence. and reduce the impact of health inequalities.

Of course, the health and well-being of individuals and communities are affected by social and economic stressors, such as homelessness and food insecurity. We have provided safe, permanent housing to more than 25,000 Houston residents since 2012. In January, we announced $100 million in funding for homelessness reduction programs and $65 million in COVID-related funding. This is proof that federal resources really make a difference — and why Democrats in the Biden administration and Congress need to re-engage in innovative, value-based healthcare models that help cities like Houston.

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Our most vulnerable residents need access to long-term, personalized primary care to address chronic medical conditions, mental health and physical disabilities. I’ve seen many Houston residents turn to emergency rooms and ambulances to get medical care—just like my dad did—because they don’t know where else to go. 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 affordable, it’s not accessible.

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

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It is impossible to understand an individual’s needs without understanding their circumstances, and this data will help us discern which resources are most essential. But for the model to even have a chance to succeed, it needs broad federal support. I tell the legislators: no more debating. 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 bring accessible health care to everyone.

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


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