Improving Health in Poor Communities by Providing Children With Hope

The country is facing a calamity, and the complexity of it frightens people and deters them from trying to figure out how to address health disparities and level the playing field for all Americans, Geoffrey Canada, president of the Harlem Children’s Zone, said during the keynote at The National Center of Complex Health and Social Needs’ Putting Care at the Center conference, held December 7-9, in Philadelphia, Pennsylvania.

Canada’s belief that health played a critical role in education started 40 years ago.

“Why? Because I knew as a very young child that kids growing up in the South Bronx, my friends, had no chance of making it,” Canada said. “They just had no chance.”

He likened the South Bronx in the 1970s to Aleppo—crumbling buildings and rubble in the streets. Of all the kids he grew up with, only 2 are still alive and one of them has stage 4 cancer and the other is waiting on a kidney transplant.

“We talk health disparities, we’re talking about devastation that most people have no idea what it is to grow up in these places and live these kinds of lives and try to figure out how to get out so that you can have some shot at the American dream,” Canada said.

At the age of 4, living in the South Bronx, Canada felt anxiety, uncertainty, and despair—who was going to rescue him? People in his neighborhood didn’t know whether or not they would have enough money to have heat or hot water. They lived with vermin. Living like this is why so many people in the neighborhood turned to drinking and smoking. The had less stress and anxiety—they find peace in something that will destroy them, Canada said.

Try telling someone living in poverty, in a violent neighborhood that smoking will give them cancer and kill them. They will say, “I will be so happy if I could live 30 years and die of cancer,” Canada said. “‘I’m worried about making it a year, 2 years.’ It’s hard to get people to focus on that when their lives are so out of control.”

He saw this issue as a child, and that is why as an adult he created the Harlem’s Children Zone, which works to disrupt generational poverty and give kids support to get educated, go to college, and become self-sustaining adults.

Rebuilding the community was the first step, and they went block by block to clean up the streets and make them safe for the kids to walk. The second part was setting a pipeline for the kids to succeed. The organization starts at birth, discussing with the families the science of brain development from ages 0 to 3.

There are real health barriers that will prevent the kids in his community being successful, which he describes as going to college. The first is asthma, which is a widespread problem in communities of color.

“The number 1 reason by kids were missing school is asthma,” he said.

So the organization started an asthma program with the local hospitals and reduced hospitalization rates, emergency room visits, and hospital stays. They did small things that make a big difference: get medicines to children and ensure they used them, clean carpets in their homes, and deal with mold in the building.

The next issue was one that surprised him: obesity and overweight. “It was staggering the obesity levels in poor communities,” Canada said. “It is a real problem.”

Today, maybe half a block has overweight children. He compared it to when he grew up and there were only 2 overweight kids he knew. He places the blame on adults, who have seen it and allowed it to happen.

The third health barrier, and the most important one, is related to the violence in the neighborhood. The kids in his community had ongoing traumatic stress in their lives with death always in the back of their mind.

“How is it these kids are going to function?” Canada asked. “What happens to that immune system when it is totally overtaxed all the time with this anxiety, with the depression, with the fear constant and everyday going from bad to worse. And those kids are supposed to compete with other kids growing up without that kind of constant stress?”

The Harlem Children’s Zone provides kids in the community with hope. With hope, they pay attention to their health. Kids who believe they can get out and go to college and have a future don’t have babies as teenagers, don’t get involved in drugs, and don’t get arrested, he explained.

“These kids believe there is a way out,” Canada said. “They believe they can make something out of their lives.”