By Shahana Hirji

When Dr. Tony Iton became the Vice President for Healthy Communities at the California Endowment, he was given a unique opportunity: $1 billion to improve the health status of residents in 14 low-income communities across California in a measurable fashion over 10 years. The kicker? Using a social determinants of health strategy, he could not spend a single dollar on healthcare!

Dr. Iton visited the Baltimore City Health Department on Monday, April 20th to discuss the importance of incorporating community organizing into public health work. Formally titled the “10-Year, Multimillion-Dollar Statewide Commitment to Advance Policies and Forge Partnerships to Build Healthy Communities and a Healthy California”, Dr. Iton has taken a three-pronged approach to tackle this challenge: addressing health from a life course perspective; taking a policy and systems change approach; and addressing issues of power, privilege, and equity as the root causes of poor health.

Central to Dr. Iton’s vision is creating trauma-informed practices to reduce risk and enhance resiliency in the communities in which he works. Dr. Iton discussed how differences in life expectancies between neighborhoods are not necessarily due to policies, but are often a result of the ways in which people are differentially situated to access resources in a community.  He stressed the importance of designing interventions to identify existing assets and build social, political, and economic power among a critical mass in historically under-resourced communities.

Dr. Iton enlisted the people most impacted by inequity to set the agenda and solve inequities. He hired organizers to challenge status quo power dynamics and train youth to become advocates for their communities. Dr. Iton sees intervening in the life course and organizing with youth as the best ways to restore hope and agency in communities, transforming anger and resentment from historical traumas into empowerment and a sense of purpose.

Organizing is also taking place at the Baltimore City Health Department.  For example, theB’more for Healthy Babies coalition has established the Teen Pregnancy Prevention Initiative, which created the Youth Advisory Council comprised of teens and young adults aged 14-20. This group developed a campaign that utilizes teens to share information with their peers and connect them to sexual and reproductive health services, collaborate with healthcare providers to offer a full range of effective birth control methods, and partner with schools to enhance health education received by Baltimore City youth.

Mayor Stephanie Rawlings-Blake and Baltimore Health Commissioner Dr. Leana Wen have partnered with other community stakeholders to discuss overdose issues in community forums for the Mayor’s Heroin Treatment and Prevention Taskforce.

After his discussion with BCHD staff, Dr. Iton joined Dr. Wen to speak at the Johns Hopkins Urban Health Institute’s Fourth Annual Symposium on the Social Determinants of Health, titled “Healing Together: Community-Level Trauma – Its Causes, Consequences, and Solutions.”