America’s mayors are tackling health equity, but they need Washington’s support

I firmly believe that your zip code should not determine your health outcomes. Growing up, my family didn’t have private health insurance — we relied on the public healthcare system, as many other families in the Acres Homes neighborhood in Houston, Texas, did. My father died of cancer when I was 13, never having any treatment besides painkillers. We didn’t even know he had leukemia until after he passed. He went to the emergency room, picked up his prescription, and carried on.

As the Mayor of Houston, these lessons from my childhood impact how I view healthcare policy.

In my party, there’s a dispute about whether nationalized healthcare or a market-based approach to universal care is the solution. But we can’t put community access to healthcare on hold while we debate. Lives are hanging in the balance. Value-based care models from the Center for Medicare and Medicaid Services focus on preventative care, help keep patients out of emergency care, and incentivize coordinated care and better outcomes — approaches that I’ve seen work in Houston.

Houston’s Complete Communities initiative was established in 2017 during my first term to ensure everyone has access to quality services and amenities, including healthcare. The mission of Complete Communities is to build and maintain uplifted neighborhoods, focusing on 10 that are historically under-resourced, including the area where I grew up. I’m proud that this initiative is community-based and resident-driven. Neighborhoods work together to create action plans to address economic, environmental and equity challenges that are then approved by our City Council and implemented by the Mayor’s Office of Complete Communities. 

I’ve worked alongside residents and local leaders to address our city’s greatest challenges. In Houston, we know that healthcare doesn’t just mean taking care of people when they’re sick — it means giving them resources to live safer, healthier lives. Unique programs like CAPABLE (Community Aging in Place — Advancing Better Living for Elders) — a home-based program developed by the Johns Hopkins School of Nursing that combines nursing care, occupational therapy, and handyman services — have helped seniors and Medicare recipients across the city gain greater independence and reduce the impact of health disparities.

Of course, individual and community health and wellness are affected by social and economic stressors, such as homelessness and food insecurity. We’ve provided more than 25,000 Houstonians with safe, permanent housing since 2012. In January, we announced $100 million in funding for programs to reduce homelessness and $65 million in COVID-related funding. This is proof that federal resources make a real difference — and why Democrats in the Biden administration and Congress must recommit to innovative, value-based healthcare models that help cities like Houston. 

Our most vulnerable residents need to be able to access long-term, personalized primary care to address chronic medical conditions, mental health and physical disabilities. I’ve seen many Houstonians who have turned to emergency rooms and ambulances to receive medical care — just like my father did — because they don’t know where else to turn. Once they have a relationship with a primary care provider, we need to ensure that the care they receive is comprehensive and affordable. If it’s not affordable, it’s not accessible.

America’s mayors are enthusiastic partners in the quest for healthier communities and greater equity. The U.S. Conference of Mayors and the African American Mayor’s Association both passed resolutions in support of the Center for Medicare and Medicaid Innovation (CMMI) Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model — the first program to require a health equity plan to reduce disparities and to collect patient demographic data tied to social determinants of health.

It’s impossible to understand an individual’s needs without understanding their circumstances, and this data will help us discern what resources are most vital. However, for the model to even have the chance to succeed, it needs widespread federal support. I am telling lawmakers: No more debating. The time is now to support a program that can improve health outcomes for all Americans.

Local leaders can and should be champions of public-private partnerships that build stronger, healthier cities. But we can’t do it alone, and we need the support of leaders in Washington to provide accessible healthcare to all.

Sylvester Turner has been the mayor of Houston, Texas, since 2016.