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Fostering good health-related Quality of Life through community health literacy and action

September 19, 2014
by Ron Manderscheid
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Within the past month, I have described good health as a state of personal and social wellbeing. I also have discussed the health literacy about one’s life that one must possess to promote good personal health. However, please don’t assume that you can achieve good health solely through your own efforts!  At least equally important, good health is due to what transpires in one’s community, including one’s school or workplace and one’s family. It also is due to the quality of the physical environment within which one lives.

Every community includes multiple factors that either harm or promote one's personal good health. Primary examples of detrimental factors include poverty, discrimination, economic exploitation, social isolation, and stigmatization; examples of facilitative factors include social support, nurturing families, good health education and job opportunity structures. The combined effects of these factors will determine whether your community has a positive or negative effect upon your personal health.

As a key example, let’s examine the adverse effects of community poverty. If you live in an area where most people are poor, then you are much more likely to experience more hardship and more trauma than people who live in more affluent communities. Your hardships can range from not being able to access good quality food to living in housing that actually is dangerous because of the presence of asbestos, rodents, etc. Your traumas can range from the corrosive effects of social exclusion to victimization through violence.  How does all of this affect your personal health? Perhaps the most pointed effect is early mortality. Very consistently, those with the lowest educational levels, a key indicator of poverty, actually die five to seven years younger than those with the highest educational levels. To examine the effects of education on mortality for yourself, you can access an Education and Health Calculator here.  

Poverty also has a very negative effect upon one's mental and addictive health. For more than a half century, we have known that those who are poorest are 6 to 8 times more likely than those who are wealthiest to have a mental or substance use condition. What we have learned in the intervening years is that traumas of all types due to poverty—physical, sexual, emotional, social—are causal factors in these disorders. The importance of such findings cannot be overstated. They point the way toward the day when we actually will be able to prevent many mental and substance use conditions by decreasing exposure to trauma and by increasing personal resilience.

Now, we need to draw two important similarities.  Personal health literacy about one's community is analogous to personal health literacy about one's own health. Also, seeking to improve the positive effects that one's community has on personal health is very similar to one's efforts to promote good personal health in one’s own life.



Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid


Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

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