What happens in the community has a greater impact than what happens in the doctor’s office
As I’ve listened to the debate about Proposition 15, the Schools and Communities First ballot initiative, I’ve been surprised that so little of the conversation has focused on the impact the proposition could have on Californians’ health. Our state is experiencing a devastating pandemic that’s taken more than 16,000 lives and stretched local healthcare and public health systems to the breaking point. And — because of the pandemic’s economic fallout — we’re bracing for what could be the largest budget cuts in state history.
While the state and many jurisdictions have so far put off sharp budget cuts in the hopes that federal relief might soon be on its way, policymakers warn these cuts are coming — for schools, parks, housing and other public services.
These kinds of resources and services play a vital role in supporting health, safety, and wellbeing. They are exactly what Proposition 15 funding would reinforce by channeling a large amount of money into schools and local services that can improve community conditions. And they’re exactly what will suffer when the budget cutting begins.
Health outcomes, including how long people live and their quality of life, are powerfully influenced by community conditions like the availability of parks and open space, high-quality schools, healthy food, affordable housing, and clean air and water. In fact, what happens in the community environment has a greater impact on health than what happens in the doctor’s office.
For example, asthma cases go up when the air is polluted, and developmental disabilities in children increase when their tap water is contaminated with lead. Living in substandard housing increases the risk of respiratory and cardiovascular diseases. Whether people have access to high-quality schools and live in neighborhoods that are safe from violence also have a major influence on whether they will be able to avoid preventable disease and injuries. In the case of COVID-19, people’s likelihood of becoming infected greatly depends on the kind of job they do, the transportation they rely on, and their housing situation.
Communities in California where these health-promoting resources are in short supply, which are by and large low-income communities and communities of color, will face the greatest damage from cuts to schools and local services. These communities are already disproportionately harmed by preventable chronic diseases like type-II diabetes, heart disease, high-blood pressure — and now COVID-19.
According to the California Department of Public Health, Latinos make up 39% of the California population but 61% of the COVID-19 cases and 49% of the COVID-19 deaths. Although California’s infant mortality rate is better than the national average, Black infant mortality is more than twice the rate of other groups. When it comes to type-II diabetes, people who earn less than $15,000 per year are impacted at a far higher rate than people who earn more. These health disparities will only get worse if state and local governments, in response to the economic crisis that’s been created by the pandemic, cut programs that support affordable housing, keep parks and libraries open, and pay the salaries of public health workers.
The timing for Proposition 15 to be on the ballot couldn’t be better. By requiring that corporations pay their fair share of taxes on commercial property, the proposition will generate an estimated $8 to 12 billion in funds per year. Forty percent of those funds will go directly to schools and the other 60 percent will go toward county-level services like nutrition assistance, rent relief, and public health contact-tracing programs, among others.
My community of El Sereno in Los Angeles County needs this funding to redesign our schools so that children can return to in-person learning in an environment that’s safe from the spread of COVID-19.
I urge you to think about the health needs of your own community when you vote on Proposition 15.
Elva Yañez is the director of health equity at Prevention Institute and a resident of the El Sereno community in Los Angeles.