Long lives, well lived: What neighborhoods can do to increase life expectancy

Cincinnati’s first-ring suburbs face unique challenges. Changing demographics, economic stability, and issues regarding resources and security are common threads among these jurisdictions. 

The ways the 49 Hamilton County cities, villages, townships, and municipal corporations not only adjust but thrive is the focus of this series, First Suburbs—Beyond Borders. The series explores the diversity and ingenuity of these longstanding suburban communities, highlighting issues that demand collective thought and action to galvanize their revitalization. 

Back in 2007, Mary Corley, then a race walker and Pilates enthusiast, was asked to lead a fitness class for senior citizens in the central Hamilton County community of Wyoming. Mary, then 71, liked the idea of volunteering to lead a class that would be free of charge to Wyoming’s elderly.

“The community decided they needed to do more for their seniors,” she says.

The class started with three people. Sixteen years later, it now attracts 20 or 30. Mary, now 87, still leads the group twice a week through a routine of low-impact aerobics, light weights, and a mile-long walk.

“I love to be active,” she says.

Mary has lived in Wyoming most of her life, growing up there, graduating from Wyoming High School, and settling down and building a family with her husband, Don, in their Oliver Road home for six decades.

She also has plenty of 80-plus friends to walk with. Her hometown holds the distinction of having the longest average life expectancy of all 49 communities in Hamilton County – nearly 86 years (85.9 to be exact).

Wyoming’s achievement is something to be celebrated. But other communities aren’t as fortunate. Life expectancy is often compared from nation to nation or state to state, but there’s a wide disparity among neighboring communities just within Hamilton County.

A mere two miles from Wyoming in the village of Arlington Heights, the average life expectancy is only 63.4 years. That’s a stunning difference of 22 years, more than two decades of life lost, love missed, of children and grandchildren growing, of wealth building, sunsets, family reunions, connections with friends old and new.

The numbers are from community health assessments done by Hamilton County Public Health, which uses data from the U.S. Census Bureau, the Ohio Department of Health, and other local, state and federal sources. 

Why such health disparities?
Why do the residents of Wyoming have a good chance of living a long life, when within walking distance of Wyoming City Hall, their neighbors in Arlington Heights might expect to barely live past middle age? That’s a question with no easy answer.

“Within communities, there are many different disparities involved,” says Anne Arble, director of epidemiology at Hamilton County Public Health. “You can’t narrow it down to one or two.”

Public health specialists from her agency conduct assessments for communities that examine a variety of factors, including income, education, unemployment, housing, access to food, and then by examining death certificates, they calculate life expectancy.

Several of these factors are rolled up to create a measurement used in the world of public health called “concentrated disadvantage.” Poverty, unemployment, and the number of households headed by single mothers are among the key metrics a concentrated disadvantage score. “Concentrated disadvantage is often associated with worse overall health,” the agency says.

Long-term poverty and unemployment can create a vicious cycle that corrodes interest and engagement in the life and well-being of neighborhoods. “Communities that have higher levels of concentrated disadvantage often have less mutual trust and willingness among community members to intervene for the common good,” the agency says.

Using these neighboring communities that are poles apart in health and well-being illustrates the impact these factors can have. In Arlington Heights, 15% of the residents live in poverty, and the median household income is $40,649. (Arlington Heights’ assessment was published in 2019, using data from 2016).

Down the road in Wyoming, only 1% of the residents live in poverty, while the median household income is $133,500.

Good jobs usually come with employer-sponsored health insurance, which directly affects access to care. “People with economic disadvantage are much less likely to be insured, and much less likely to use health care services,” says Mike Samet, public information officer the county health agency. 

Education is a key factor, as preschool and early childhood education have been shown to lead to healthier children, and a college degree has been shown to lead to higher incomes.  “Poverty and education are certainly two huge factors,” Samet says.

The difference in education can be stark from community to community. Using the two extreme examples again, only 3% of Arlington Heights residents have earned a bachelor’s degree, while in Wyoming, nearly three-quarters of the population -- 72% -- have graduated from college.

The scourge of drug abuse affects communities across the country, some harder than others. In Wyoming, the death rate from drug overdoses is 21 per 100,000 people. In Arlington Heights, it’s three times worse, at 65 per 100,000.

Racial segregation can aggravate all these factors. Predominantly black communities can have high degrees of segregation, which historically has contributed to lower quality schools, lower rates of home ownership and, therefore, less wealth, fewer job opportunities, and diminished access to health care.

What can be done?
So what can communities, all of which have limited resources, do to improve the health of their residents in the face of such complicated factors? They can begin by tapping into the county health agency’s expertise for an overall assessment.  The point of the health assessment is to point out ways that we can help reduce disparities,” Arble says.

In 2009, the health department began a program called We Thrive designed to engage elected officials, community leaders, business people and others in programs that can improve health, prevent injuries, reduce substance abuse, and in general make communities safer, healthier places to live. So far, 24 communities and eight school districts have joined the We Thrive initiative.

The health assessments not only point out health-related shortcomings, but suggest actions local officials and residents can take to begin to improve community health. “Every community has their own assets and opportunities to improve or to build upon,” Arble says.

For example, Arlington Heights’s assessment concludes with a list of recommendations for action, including partnering with Cincinnati Children’s Hospital Medical Center and the neighboring Reading police and fire departments to collaborate on ways to prevent child injuries and deaths.

The department can also suggest ways to improve what is increasingly seen among public health professionals as a key, but under-appreciated element of well-being – community connectedness.

People with strong social bonds are much more likely to survive serious illnesses such as heart disease, stroke and dementia than those who have fewer social connections, research from the Centers for Disease Control and Prevention shows.

Connections with others also promote physical activity, reduces the risk of violence and suicidal behavior, and improve sleep, the CDC says.

The Covid-19 pandemic pointed out the need for cities and towns to collaborate and improve connections among neighbors to respond to challenges.  “We saw a need for social connection and for resilience in our communities through the Covid response,” says Cristie Iwasko, a county population health specialist. 

While the factors underlying shortened life expectancies – chronic disease, lack of education, poverty, substance abuse – may seem overwhelming, health experts say local leaders can take steps that might seem small, but can have an outsized impact on promoting healthy behaviors, fostering community resilience, and creating connections among neighbors.

The village of Lincoln Heights, for example, used a $3,500 grant to organize a community event celebrating Juneteenth and another that brought a Shakespeare in the Park production to the village. “With a small amount of money, you’d be surprised what you can do to bring residents together,” says Mayor Ruby Kinsey-Mumphrey.

In the wake of the pandemic, the city of Montgomery created a project to increase awareness of mental health issues and reduce the stigma felt by those suffering from depression and other mental illnesses, says Mayor Craig Margolis. The city has sponsored a four-part series on understanding and responding to dementia, and in October, it is sponsoring an appearance by Kevin Hines, a mental health activist who, at the age of 19, survived a suicidal jump off the Golden Gate Bridge.

In the village of Golf Manor, a community health assessment revealed that the bus stops in the village lacked shelters, says Mayor Stefan Densmore. New shelters have helped to encourage taking the bus, providing mobility and access to people who lack their own transportation.

The health agency says it can act as something of a convener, sharing information and encouraging action. “It’s about getting people at the table,” Iwasko says. “Local businesses, churches, elected officials, recreation centers, residents, libraries -- bringing all these folks together to have a conversation and identify things we can do and then support each other.”

In Wyoming, the seniors in Mary Corley’s exercise class share each other’s joys and sorrows.  “One gal just lost her husband and everybody rallied around her,” she says. They did the same when Mary lost her husband two years ago. “The friendships have been just amazing,” she says.

For her part, Mary doesn’t smoke, swore off alcohol a few years ago, and moves carefully to avoid falls. She manages her arthritis with an intangible yet essential trait of longevity: grit. “I try not to pay any attention to it,” she says.

The secret of her long life boils down to a simple philosophy. “I just keep moving.”

The First Suburbs—Beyond Borders series is made possible with support from a coalition of stakeholders including Mercy Healtha Catholic health care ministry serving Ohio and Kentuckythe Murray & Agnes Seasongood Good Government Foundation - The Seasongood Foundation is devoted to the cause of good local government; LISC Greater Cincinnati LISC Greater Cincinnati supports resident-led, community-based development organizations transform communities and neighborhoods; Hamilton County Planning Partnership; plus First Suburbs Consortium of Southwest Ohio, an association of elected and appointed officials representing older suburban communities in Hamilton County, Ohio.


    



        
 
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Read more articles by David Holthaus.

David Holthaus is an award-winning journalist and a Cincinnati native. When not writing or editing, he's likely to be bicycling, hiking, reading, or watching classic movies.