A Vital Condition for Well-Being: Basic Needs for Health and Safety

Back to Spring 2020: Volume 109, Number 1

By Tyler Norris

Security is a prerequisite for human survival, and essential to our well-being. When basic needs, such as access to food and shelter are threated, our ability to lead healthy lives is undercut.

But basic needs go beyond having roofs over our heads and full stomachs. We need to be well emotionally and physically, be safe from violence in our homes and communities, and be protected from trauma.

Often, access to these basic needs are blocked by systemic barriers — from the high cost of care to disinvestment in vulnerable communities to a culture of racism, poverty, and violence that’s been passed down from generation to generation. These obstacles disproportionately harm low-income residents of every race and ethnicity and have created lasting legacies that continue to impact health and well-being today. For example:

  • Food insecurity. Forty-two million people lack steady access to enough food — and 13 million of them are children.
  • Childhood trauma. Nearly half of all children in the U.S. have experienced at least one adverse childhood experience. 

Lacking access to even one “basic need” can result in vast health disparities that can spur a long cycle of disadvantage and instability for families and children. We need to make it easy for people to stay healthy, feel safe in their neighborhoods, and protect themselves from physical and emotional harm.

Here are some ways to address the issue:

Eliminate hunger and food insecurity

The ability to access full-service grocery stores and affordable healthy foods is a prerequisite to health. Heavy disinvestment in zip-codes with low-income residents and/or residents of color aggravates these factors, leaving communities without access to essentials like grocery stores, including the jobs they create. When junk food costs less than fresh fruits and vegetables, there needs to be a more concerted effort to eliminate “food deserts” and ensure healthy food is within reach for all.

Food assistance programs like the National School Lunch Program and Supplemental Nutrition Assistance Program (SNAP) have been shown to reduce food insecurity, but they still fall short due to limited funding, and current threats to cut off even more families from the food they need to be healthy. More investment in these programs can ensure greater access to healthy foods for low-income populations.

While these programs are important safety nets, additional policy and systems change is vital.

We can look to cities and towns to show us how to break through. Minneapolis, for example, was the first city to require every corner store to carry essential groceries — such as eggs, grains and milk — and at least five kinds of fresh produce. In Baltimore, the city health department created the Virtual Supermarket Program so that residents can order groceries online and pick up at local libraries, schools and housing developments at no added cost. These programs are effectively increasing access to healthy foods for residents in areas with limited options.

Break the cycle of intergenerational poverty 

The effects of growing up in poverty are numerous and cumulative. Children growing up in poverty experience less stability in their homes and education, and are more likely to witness violence, substance misuse and trauma. Because children who witness or experience violence are more likely to perpetrate it as adults, the impact of abuse, violence, and trauma is often passed down from generation to generation.

This complex cycle of harm requires systemic policy change. We need to provide more funding to low-income neighborhoods — so they can implement programs that will foster a culture of engagement and economic development.

In Stockton, California, for example, residents and leaders are working together to incorporate trauma-informed care into existing structures and develop reconciliation programs with local law enforcement that will help residents heal from decades of trauma and violence. Community-building efforts like these are key to creating safer, healthier places to live. 

Ensure access to high quality healthcare for all 

In order to promote well-being rather than playing defense and treating illness and suffering after the fact, we need to foster a proactive culture of well-being, and support and enforce policies like the Affordable Care Act, the Mental Health Parity and Addiction Act, and The Prevention and Public Health Fund, that ensure health insurance, care and the vital conditions for intergenerational well-being become the norm for all—not just the wealthy.

Right now, Congress could expand treatment facility access by directing the Centers for Medicare and Medicaid Services to issue an order that all state Medicaid programs must cover FDA-approved Medication Assisted Treatment (MAT) drugs without prior authorization. On the private insurance side, Congress could enact new protections for MAT by requiring health plans to cover FDA-approved medication for substance use disorders if medically necessary.

Ultimately, greater investment into communities is a key part of improving well-being and ensuring everyone has the basic needs for health and safety. By taking the initial steps above, we can get closer to reversing centuries of bad — sometimes intentionally so — public policy and move toward a culture of healthier outcomes, stability, and well-being for every person in America.

Tyler Norris is CEO of Well Being Trust. From 1990-1995, he led Civic Assistance at the National Civic League.

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