As the senior vice president of Building Healthy Communities for The California Endowment, Tony Iton has built health initiatives that have reduced school suspensions, led to the reclassification of minor felonies, and insured 300,000 undocumented children. Overall, he has spent $1 billion — and not a single dollar has gone to what might traditionally be defined as “healthcare.”
“Our $3.7 trillion healthcare system is essentially managing the consequences of underinvestment in the social contract…. We’ve argued that this doesn’t just happen in health. You see the same manifestations in the education system — school absences, truancy, failure, and dropout,” Iton says. That’s why his work has focused on building up communities.
Speaking at the Education Redesign Lab’s recent By All Means convening, which emphasizes the work of children’s cabinets to bolster the assets of communities across the country, Iton addressed the ways in which the health industry should be understood, so that communities can come together to combat the root causes of inequality. His talk was cosponsored by the Harvard T.H. Chan School of Public Health.
HEALTH IS NOT:
- Behavioral: We like to think that if people would just behave or make different choices, they’d be healthier. But what’s missing from this narrative is the fact that people can’t always afford or don’t always have access to better choices.
- Transactional: We like to think health is about services and the more you see doctors, the healthier you are. But a doctor has no control over larger, systemic problems that influence health outcomes.
- Genetic: We like to think if we’ve have good genes, we’ll live longer. However, this does not include external factors like trauma that research has linked to changes in genes.
- Political with a small ‘p’: “It is a struggle and at the end of that struggle there is an allocation of certain health-protective resources … things as simple as a park or a grocery store in your neighborhood,” Iton said.
- Community and individual agency: “If you want to improve health, you have to build power — social political and economic power matter,” Iton said.