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The cross-generational ties to poverty are also ties to poorer health. Here are a few examples: Babies born to mothers who did not finish high school are nearly twice as likely to die before their first birthdays as babies born to college graduates. Children in poor families are about seven times as likely to be in poor or fair health as children in the highest income families. Children whose parents did not finish high school are more than six times as likely to be in poor or fair health as children of parents who earned a college degree.
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Because of the need to address these “social factors” in the most strategic way, four years ago we convened the Commission to Build a Healthier America to explore those factors outside the health care system that affect health. We charged the commissioners to craft actionable recommendations for change. The commission, led by economists Alice Rivlin and Mark McClellan and comprising leading experts from a broad range of sectors, came back with 10 recommendations that focused largely on communities rather than health or disease prevention. As they reminded us, the economic and social vitality of the neighborhood or community contributes to residents’ health and longevity. From ensuring that children have access to early childhood education, to creating public-private partnerships to open and sustain full-service grocery stores, to developing cross-sector healthy community demonstration projects, to making sure that housing and infrastructure projects consider the health impacts of their work, the commission made clear points about how we should shape our foundation’s work.