A Culture of Health for Everyone

Greater public investments translate to better health outcomes

A healthy population is vital to achieving economic prosperity in North Carolina. Good health allows for stronger communities, greater work productivity, and higher capacities for leaning. When individuals and families have the resources necessary for a well-balanced diet, safe and accessible recreational spaces, and affordable and quality health care, all North Carolinians experience an enhanced quality of life and have stronger capabilities to achieve their full potential. Healthier North Carolinians also means greater protection against chronic health conditions, fewer preventable visits to the emergency room, and lower overall health costs for everyone.

However, the opportunities and systems that support the health of North Carolinians have not been distributed equitably. Discriminatory systems and policies—such as unequal distribution of wealth, housing segregation, jobs that don’t pay wages that allow families to afford the basics, and the placement of harmful chemical plants in communities of color or in areas with concentrated poverty—have made strong, long term health largely out of reach for far too many North Carolinians.

These health inequities result in greater obstacles to achieving good health across racial and economic groups. In North Carolina, and nationwide, people of color and people living with low incomes typically have worse health than their white and/or wealthier counterparts. A history of public policies designed to sustain health inequities have essentially equated health with wealth. Existing systems quarantine the opportunity to achieve the highest level of health to those who can afford it. Poverty, in and of itself, can be considered a predictor for poor health. For example, not knowing if you will be able to afford housing, groceries, medicine, or transportation causes constant stress, which negatively impacts both mental and physical health. Additionally, households that are financially insecure typically have fewer healthy births, less access to medical care, and higher death rates

Nearly half of North Carolina’s children live in households with low incomes, placing significant barriers to their success and long term health. Any efforts to improve health for all North Carolinians must recognize the role wealth plays in health and work to build more equitable systems to address these differences in outcomes.

As the state continues to grow, North Carolina cannot afford to leave behind the health of entire communities. By means of the state budget, North Carolina has the tools to invest equitably in systems that ensure all North Carolinians can achieve the highest level of health and wellbeing. Addressing health equity through public investments means focusing spending efforts on communities that face the most significant barriers to achieving good health. The state can support a comprehensive set of investments that serve as the foundation for healthy communities.

It is well documented that adequate public investments in health play an important role in improving health and wellbeing. To date, “health spending” is often narrowly considered spending on health coverage or access, alone. However, the health of North Carolinians actually begins where we live, learn, work, and play. North Carolina’s health status is determined by the social policies that shape the world around us, through housing quality, proximity to parks and grocery stores, clean air and water, educational attainment, and a living wage, among others. Health truly transcends the boundaries that have been built to separate departments, agencies, and systems. Thus, factors beyond health coverage and access must be considered when talking about investments that advance health equity. Sufficient spending in education, housing, social services, infrastructure, environmental quality and other areas are essential to improving health and wellbeing in the Tarheel State.