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Debbie Swanson: Public-health challenges remain in Grand Forks

Debbie Swanson

GRAND FORKS — This National Public Health Week, ask yourself: What is good health? What makes us healthy?

These seem like simple enough questions on the surface. But when you take a moment to really ponder them, you see that their answers are really a web of factors that shape our opportunities to make healthy choices and live free from preventable disease and injury.

For example, geography is a key barrier to good health for the millions of Americans who live in primary care shortage areas. For others, eating a healthy diet is hampered by a lack of local stores that sell affordable veggies, fruits and whole grains.

And for millions of workers who don't have access to paid sick leave, the choice between losing needed income and staying home to care for a sick child is a common and heartbreaking dilemma.

Thankfully, these barriers can be overcome. Health systems are building innovative telemedicine programs, communities are coming out to support farmers markets, and voters and policymakers are backing paid sick leave laws.

All of these health-promoting opportunities require both collective and individual action. For instance, we must support the expansion of community gardens and farmer's markets to new neighborhoods. Grand Forks is a model of success by accepting food assistance payments, which means families and children who face the greatest barriers to nutritious eating and the highest risks for diet-related disease now have a chance to make healthy choices.

The addition of the Forks Mobile Food and Education Trolley this year will provide fresh fruits and vegetables in more neighborhoods.

Encouraging physical activity also should be part of our community health improvement plan. In the recent County Health Rankings, a measurement of each county's health indicators, Grand Forks residents reported low levels of physical activity.

The Greenway and bike path system are great examples of the built environment providing opportunities for all residents to be able to exercise without cost, but we need to do more. The next step is creating a culture of health at our workplaces, worship spaces and community events.

The Partners for a Healthy Community Program provides a toolkit to take action. Check it out at

Creating these kinds of opportunities is what this year's National Public Health Week is all about. For more than two decades, the American Public Health Association has organized this nationwide celebration the first week of April to recognize public health workers and educate communities about the role of public health in making our lives healthier, safer and better.

With a theme of "Healthiest Nation 2030," we're calling on everyone to join forces with public health workers to create the healthiest nation in one generation. While research shows that health insurance is a critical component toward this goal, we also know that it's just one piece of a much bigger picture.

A growing body of research also tells us that social and environmental determinants — such as education, income, housing and childhood trauma — help shape not only people's risk of disease and poor health throughout their lifetimes, but also the risk of disease and poor health into the next generation.

In Grand Forks County, one factor with the potential to harm health is the large percentage of children living in poverty. Lifting families out of poverty and supporting children to achieve their full health potential should be our collective goal.

We hope Herald readers will join us for activities during National Public Health Week and engage in conversations about the factors influencing the health of our community. Together, we can achieve the healthiest nation in 2030.

Swanson is director of the Grand Forks Public Health Department and a member of the American Public Health Association Action Board.