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Working Differently to Achieve Better Results

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By Kathryn Lawler, executive director, Atlanta Regional Collaborative for Health Improvement (ARCHI)

For several years, Atlanta has made headlines as the city with the greatest income inequality in the United States. Compared to other large metropolitan areas in the U.S., Atlanta has ranked the lowest or among the lowest for the last five years. Atlanta has the largest gap between the highest income and the lowest income residents, greater even than cities like San Francisco or New York. It also means that a child born into poverty in Atlanta has only a 4 percent chance of ever moving out of poverty.

The data are clear. Poverty in Atlanta is not the result of personal failings, individual choices or even bad luck. There are systemic issues holding too many back. The Atlanta Journal-Constitution dutifully reports this statistic each year, meetings have been organized following these announcements and even the scientists who do this annual analysis have flown in to discuss this alarming information. Yet, Atlanta has not implemented a plan to ensure that one day there will be different results.

This past year, the partners of the Atlanta Regional Collaborative for Health Improvement (ARCHI) committed to a yearlong study of the specific history of Atlanta that has created the inequities many experience today. ARCHI is guided by a 28-year strategy to improve health in Fulton and DeKalb counties, which includes real economic opportunity for all as a central component.

Over the course of multiple workshops, 1,000 individuals explored many critical topics, such as the political and power dynamics that built the city, the history of transportation and infrastructure investment that has favored some and disadvantaged others, and housing discrimination, including redlining and its lasting impact on health and economic opportunity. They also looked at the experience of immigrants, refugees and other newcomers, and the science around trauma, including poverty, racism and abuse that create significant lifelong health challenges.

In addition, a smaller community-of-practice workgroup met following each session to further process what has been learned for themselves, for their organizations, neighborhoods and for ARCHI’s future work. While there is still much more to learn together and there are no “silver bullets” in the next steps, it is clear we must dismantle and leave behind the old systems, patterns of investment and access to services that benefit only some and prevent too many from moving forward.

The more than 90 partners of ARCHI have been honored by U.S. News and World Report and the Aetna Foundation as one of four bright examples in the country where community organizations are doing things differently and demanding different results.

The 2018 Community Health Leadership Award is a tribute to the hard work of the individuals and organizations aligning their work and resources to ARCHI’s 28-year strategy. It recognizes the leadership of ARCHI’s Steering Committee that has steadfastly guided ARCHI and consistently maintained ambitious goals for the region’s future.

It is because of those ambitious goals that ARCHI partners can clearly imagine a time when Atlanta is not near the bottom of the inequality rankings, but is a place where everyone thrives.

Kathryn Lawler is ARCHI‘s executive director. She helped ARCHI develop its 28-year strategy, which focuses on immediate health conditions and the larger issues that can result in poor health. The Georgia Health Policy Center at Georgia State University was a founding member of ARCHI.

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