America’s mayors are tackling health equity, but they need Washington’s support

I’m a firm believer that your zip code shouldn’t determine your health outcomes. Growing up, my family did not have private health insurance—we relied on the public health care system, like many other families in the Acres Homes neighborhood of Houston, Texas. My father died of cancer when I was 13, never getting any treatment other than pain meds. We didn’t even know he had leukemia until he died. He went to the emergency room, got his prescription and went on.

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

There is a debate in my party about whether nationalized health care or a market approach to universal care is the solution. But we cannot stop community access to health care while we debate. Lives hang in the balance. Value-based care models from the Center for Medicare and Medicaid Services focus on preventive care, help keep patients out of the emergency room, and drive coordinated care and better outcomes—approaches I’ve seen work in Houston.

Houston’s Complete Communities initiative was created in 2017 during my first term to ensure that everyone has access to quality services and amenities, including health care. Complete Communities’ mission is to build and sustain uplifted neighborhoods, focusing on 10 that are historically under-resourced, including the area where I grew up. I am proud that this initiative is community-based and resident-led. Neighborhoods work together to create action plans to address economic, environmental and equity challenges, which are then approved by our City Council and implemented by the Mayor’s Office of Comprehensive Communities.

I worked alongside residents and local leaders to address our city’s biggest challenges. In Houston, we know that health care isn’t just about taking care of people when they’re sick—it’s about giving them the resources to live safer, healthier lives. Unique programs such as CAPABLE (Community Aging in Place — Advancing Better Living for Elders)—a home-based program developed by the Johns Hopkins School of Nursing that combines nursing care, occupational therapy, and homemaker services—have helped seniors and Medicare recipients in around the world the city is gaining greater independence and reducing the impact of health disparities.

Of course, individual and community health and well-being are affected by social and economic stressors such as homelessness and food insecurity. We have provided more than 25,000 Houstonians with safe, permanent housing since 2012. In January, we announced $100 million in funding for programs to reduce homelessness and $65 million in funding related to COVID. It’s proof that federal resources are making a real difference — and why Democrats in the Biden administration and Congress must recommit to innovative, value-based health care models that help cities like Houston.

Our most vulnerable residents must have access to long-term, personalized primary care to address chronic illness, mental health and physical disabilities. I’ve seen many Houstonians go to emergency rooms and ambulances to get medical help – just like my father did – because they don’t know where else to turn. Once they are connected to a primary care provider, we must ensure that the care they receive is comprehensive and accessible. If it’s not available, it’s not available.

America’s mayors are enthusiastic partners in the quest for healthier communities and greater equity. The U.S. Conference of Mayors and the Association of African American Mayors 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, which calls for a health equity plan to reduce disparities and to collect patient demographics related to the social determinants of health.

It is impossible to understand an individual’s needs without understanding their circumstances, and this data will help us understand which resources are most vital. However, for the model to even have a chance to succeed, it needs broad federal support. I say to the legislators: No more debates. Now is the time to support a program that can improve health outcomes for all Americans.

Local leaders can and should be advocates for 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 ensure affordable health care for all.

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

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