The People of Washington, DC’s Anacostia are Building a Culture of Health

The last time I was in Anacostia, Ward 8 of Washington, DC, was almost exactly 2 years ago (!) when I walked with Kait Roe (@Fuse_Kait) and Pierre Vigilance, MD (@PierreVigilance) (see: My #walkwithadoc and patient, exploring the determinants of health in Washington, DC Ward 8 | Ted Eytan, MD). Well actually, I was *near* Anacostia when I walked the future 11th Street bridge (@DCBridgePark) (Photo Friday: Walk With a Doc over a future, beautiful park over water, in Washington, DC, USA | Ted Eytan, MD).

On the ride back to much-less-obese Ward 2 in 2012, I remember asking Pierre about the determinants of the social determinants of health in Ward 8. If people didn’t want to die any earlier in Ward 8 than in Ward 2, how did they want to live? There was so much in the media about dog parks, bike lanes, and food deserts at the time, what was the answer?

It’s now 2 years later, and this time, I didn’t go to Anacostia to go see Anacostia, I was invited, along with my friend Lane (@tlanehudson), to meet Khadijah Tribble (@tribbleme), who is a person who lives in Anacostia. We chatted in the brand newish NURISH Anacostia (@NurishAnacostia) cafe, one of only 3 sit down restaurants in the Ward, one of which has a sign on the door that says, “Please have your shirts on.”

Khadijah used to be over 300 pounds. She’s now at 208 and she let us know that she’s working to create a culture of health in Anacostia, because when she looked for one, it wasn’t there.

“Culture of Health” were her exact words – she said she picked the phrase up from the Robert Wood Johnson Foundation’s newest initiative. Hey I know some people that know a little something about that @RWJF :).

The Maps

Thanks to the still awesome Community Commons platform (@CommunityCommon) I ran some maps of Washington, DC with data on food access, poverty, and high school education. Poverty plus high school education gives you a vulnerability index.

It doesn’t matter which map you look at, you can tell which parts of the city are most in need. The Northwest part of Washington, DC is the least obese, has the greatest income gradient, lowest poverty rate, highest educational attainment, highest access to healthy food. The Southeast part of the city, across the river, where Ward 8 is, the opposite:

The county level obesity data is not useful, as you can tell, and actually tends toward being harmful, because it implies that Washington, DC is in the top quartile of obesity status and that there isn’t a problem. I’ve explored this in a previous blog post – you have to look at sub-county level data (Do national numbers inaccurately represent Washington, DC’s obesity condition? what electronic and personal health records can do to help | Ted Eytan, MD). There is a problem. There are impressive disparities in this city.

I ran a comparison of San Francisco, CA on the food access data, which shows that even the less vulnerable parts of Washington, DC are more challenged in food access than in San Francisco.

The Walk

Khadijah took us on a walk down Martin Luther King, Jr. Ave SE, past “The other U Street” (Southeast, we inhabit U Street NW, which a generation ago was strikingly deprived itself). We passed the largest chair ever made (“The Big Chair”), rededicated as a sign of hope for this community in 2006. The convenience store that I visited in 2012 didn’t seem to be open this time.

I took photos. See if these images are the signs of a healthy community:

I was so lucky that I got to meet The Advoc8te (@TheAdvoc8te), fellow blog writer of the I’ve-been-following Congress Heights on the Rise Blog. She’s in the photo with myself and Khadijah. It was a cool moment for me 🙂 . I also got to meet Dr. Lisa Fitzpatrick (@askdrfitz), who’s currently enrolled at the Harvard Kennedy School mid-summer program.

The Culture (of Health)

Lisa and Khadijah are part of (founded?) The Community Wellness Collective (@comemovenlearn) which is based at the Anacostia Arts Center (@AnacostiaArts), where NURISH is also housed. So where I left Ward 8 2 years ago with a lot of questions, this time I left with a lot of ideas, that are not from me. Those are the best kinds of ideas.

As Khadijah explained, there isn’t yet a sense of “comfort” for women in the community who want to exercise. A lot of messaging (and the assumptions that go along with them) are not appropriate for this audience. Here’s a great example of that: How Low-Income Commuters View Cycling – CityLab. People don’t know how to use health services well, and they don’t know how to shop healthy within their immediate environment, based on what’s available. These add up to challenges that need to be solved at many different levels, because as the data shows, there are large disparities.

The Community Wellness Collective is working toward this, with exercise classes and food instruction. I hope to attend some of these, because all I know is that I don’t know about what’s needed.

Our Cities are Changing

The new Ward 8 7-11 looks a whole lot like this Ward 2 7-11 from 2012, and that’s a healthy thing View on Flickr.com

I just noticed this post on CHOTR: Congress Heights on the Rise: Anacostia welcomes it’s 1st national retailer to the neighborhood!, which is about the first 7-11 opening up in Ward 8. And guess what. The photographs of the Ward 8 7-11 show a similarity to the photographs I took of the Ward 2 7-11 in 2012, right down to the fresh fruits and vegetables..

She writes:

As we were exiting I noticed that several discount stores on Good Hope Rd had undertaken a little upgrade of their own. The shop directly across from 7-11 was sporting some freshly cleaned windows (possibly a first in the 6 years I’ve been in the neighborhood) and a newly organized window display. It seems consumers aren’t the only ones taking notice of the new kid on the block. 😉 Here is to hoping the upgrades continue.

I came to Anacostia for the same reason my generation came to health care – we are not satisfied with the status quo, we love the places that we live in, and we’re here to change everything. Yes, here is to hoping the upgrades continue, because, to quote community leader Ruby Corado (@CasaRubyDC):

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Ted Eytan, MD