Building Healthy Communities of Opportunity

Health is more than health care. It not only reflects personal choices about healthy habits, or access to primary care, but is significantly impacted by where one lives. Social factors like poverty, unemployment, housing, education, and the food system collectively exert an equally important, maybe even greater, impact on health. Although access to health care services and individual behavior play important roles in determining health, one’s immediate environment and access to opportunity structures are significantly more important. Kirwan’s research in this area has highlighted the importance of the spatial dynamics of health opportunity in understanding the social determinants of health and health outcomes.

Description of PICO work:

Kirwan partnered with PICO National Network and CCO in Kansas City, and MICAH in New Orleans, with the intention to build a common understanding of the conditions necessary for health in order to bring transformative change to the public health delivery system that is not only sustainable, but that promotes better health outcomes for all. Key to this understanding is an awareness of the causes and consequences of health inequities and their relationship to racial and ethnic disparities and hierarchies. The purpose of our study is to map where there are high concentrations of emergency room usage, the “hot spots,” in order to better understand the primary care needs of the community, the costs of using the ER system, and how to transform health care away from ER use and instead reinvest in these “hot spot” communities to build stronger, thriving and healthier families. Kirwan worked with stakeholders and organizers to develop mapping applications which assist in developing and communicating narratives on health care reform and health equity.


 – Bring Health Reform Home: Mapping Emergency Room Use to Understand Health Opportunity in Kansas City
 – Bring Health Reform Home: Mapping Emergency Room Use to Understand Health Opportunity in New Orleans