Finding the Bright Spots: What Policies Make Communities Healthy?

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Many factors influence the health and well-being of communities, including who can afford to live in them; local, state, and private-sector policies; and the availability of opportunities to live a healthy, engaged, and productive life. This project will seek to explain why some communities seem to have more opportunity and be healthier than others.

The team will use data from County Health Rankings and the Opportunity Atlas at the county level to examine variation in health outcomes and opportunity for counties that are persistently poor, defined as having more than 20 percent of the population living in poverty in the last four decennial censuses.

Researchers will then use these data merged with county-level demographic data to identify “bright spots”—counties that have health outcomes that are more positive than would be expected. Census tract–level data from the Opportunity Atlas and the United States Small-Area Life Expectancy Estimates Project will further illuminate whether and how health and opportunity vary within these bright spot counties.

To the extent that bright spot counties exist, the team will conduct several case studies to identify the policies and community attributes (e.g., job and educational opportunities, participation in civic life, etc.) that are associated with positive outcomes. In the absence of many bright spots, the team will consider whether some state and federal policies need to be adapted for these counties (e.g., whether work requirements under Medicaid are appropriate in areas where unemployment is high and job prospects are low).