Better Health at Home for Everyone

Advances in screening and treatments for a broad range of chronic diseases have led to improvements in health, yet many lack access to such care – leading researchers, health care providers and public health agencies on a long, collective mission to find out why.

They found the economic and social factors that influence an individual’s health and well-being were at the heart of the issue. These factors, commonly referred to as the “social determinants of health,” can include an individual’s access to a quality education, a good income, having a support system, and living in a safe neighborhood.

In August, researchers from Drexel’s Dornsife School of Public Health partnered with the City of Philadelphia to observe social determinants of health in “Close to Home: The Health of Philadelphia’s Neighborhoods.” The report illuminated the significant contrast in health outcomes for residents in the City’s 46 neighborhoods in hopes of improving actions by policymakers, health care providers and citizens to reduce disparities and improve the health of everyone in Philadelphia. The report particularly zeroed in on social and economic factors, and health outcomes, such as those for chronic kidney disease and mental health.

While they were publishing that report, some of their Urban Health Collaborative colleagues, in collaboration with the Health Federation of Philadelphia and the Family Practice Counseling Network (FPCN), were publishing two studies that delved into how neighborhood characteristics may yield insights into healthcare outcomes in Philadelphia.

James W. Buehler, MD, a clinical professor in the Dornsife School of Public Health, led a study of 1,708 African American adult patients who were recommended colorectal cancer screening and received care from any of three federally qualified health centers run by the FPCN. The researchers controlled for age, gender, and insurance coverage, and found that those residing in the most racially segregated areas were 10 percent less likely to be screened for colorectal cancer. The findings were published in August in the journal Preventing Chronic Disease.

Buehler also served as senior author on a study led by Félice Lê-Scherban, PhD, MPH, an assistant professor in Dornsife, that published in the journal Preventive Medicine Reports. The study found of 1,061 African Americans diagnosed with hypertension and 2,633 African Americans suffering from diabetes in Philadelphia. All were patients of federally qualified health centers run by the FPCN. After examining nine neighborhood-level factors, including poverty, education, racial segregation, and neighborhood development, the team found that poor diabetes and hypertension control were more common among those living in highly segregated neighborhoods. These studies did not explain why racial segregation is associated with less favorable health care outcomes, although racial segregation has long been recognized as the result of discrimination in housing policies and is likely a marker for a mix of neighborhood stressors that can adversely affect health.

Additionally, living in a more walkable neighborhood was associated with better control of hypertension and diabetes. The findings highlight the potential for community attributes to be considered in designing effective health care strategies among underserved populations.

These and other studies from the Urban Health Collaborative illuminate the complex interplay of personal and community attributes that influence health and health disparities, an increasingly important area for researchers in public health and public policy who aim to improve population health.

Media interested in talking to Buehler should contact Greg Richter at 215-895-2614 or

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