Vision: The physical, psychological, and social health of our citizens should be the foremost priority of our community and its leaders. It is a key in the pursuit of happiness. Providing for a healthy workforce is critical for economic stability and growth. Health is directly linked to public safety. The healthier people are in body, mind, and in their relationships, the more likely a culture of harmony and civility exists, and the more likely that our natural surroundings will be preserved and enhanced. Only when the holistic health of all citizens of Evansville is preeminently prioritized will this community truly have an opportunity to pursue flourishing at the highest level.
Collective Goal: To make Evansville the healthiest, happiest city in the state of Indiana.
Slogan: Investing in People. Flourishing for the Future.
Statement of Collaboration: John F. Kennedy once famously said, “Ask not what your country can do for you. Ask what you can do for your country.” In order for Evansville to reach the collective goal, citizens and community leaders alike must partner together to pursue flourishing for all, starting with the most basic, yet most life-giving factors that make up our everyday life. While Evansville is composed of many people with diverse backgrounds and experiences, all depend on certain key lifestyle factors to provide a basis for life, liberty and the pursuit of happiness. Together, community initiatives and individual empowerment must form the basis of sustained change and growth.
What are examples of how health intersects with economics?
A 2016 analysis found that lost sleep in the US was associated with annual cost of 411 billion dollars in lost productivity and related costs.1
For employee-sponsored family health plans, premiums increased by 47% between 2011 and 2021, outgaining both wage and inflation growth.2
Using a constant-dollar analysis, out-of-pocket healthcare costs (not including premiums) in 1970 were $703 compared to $1,514 in 2023.3
The annual expenditure for GI diseases in the United States is $135.9 billion dollars. This exceeds costs for heart disease ($113.4 billion), trauma-related disorders ($102.7 billion) and mental disorders ($98.8 billion). Poor nutrition is a leading cause of GI disease.4
What are examples of how health intersects with public safety?
The United States has the highest incarceration rate of any developed country in the world. Those with substance abuse issues, mental health difficulties, and learning problems are disproportionately represented in US prisons and jails.
Medical and psychological conditions, such as diabetes, hypertension5, depression6, ADHD7 and chronic pain, and conditions involving emotional dysregulation, poor sleep, and other disorders are associated with increased driving impairment, and pedestrian and traffic accidents/fatalities.
Even when controlling for demographic factors and occupational hazards, smoking, overweight/obesity, and cocaine use are associated with increased rates of work accidents.8
What are the key health factors to address?
An abundance of research indicates that the following 7 lifestyle factors form the basis of individual health & well-being. While impacted by various familial, societal, cultural, and economic factors, each of these factors can be modified by an individual to some degree.
1) Sleep: Human beings are designed to sleep about 1/3 of their lives. Sleep is linked to countless areas of functioning across all key dimensions. Good sleep habits are linked to countless positive outcomes, and are essential in promoting healthy living.
Challenge(s): Evidence indicates that on a population basis, human beings are sleeping 20% less than they did a century ago. Adolescents are the most sleep deprived cohort in the United States, typically sleeping over an hour less per day than they should. Sleep is negatively associated with a myriad of negative outcomes, including increased anxiety, inattention, cardiac difficulties, and premature mortality.9
Read further how sleep is the cornerstone of this vision:
2) Diet/Nutrition: Nutrition has significant impact even before a child is born, and through the end of life. Studies have consistently linked diet to almost all major health outcomes, and evidence has clearly found a link to many psychological factors, including depression, anxiety, and hyperactivity. Nutrition is a key, malleable factor as it relates to reduced healthcare costs and longevity.
Challenge(s): A recent analysis found that 67% of the calories that children in the US consume are from ultra-processed foods10, which have little or no nutritional value. Obesity remains a leading cause of death and is associated with a myriad of negative medical and psychological outcomes. In 2020, Indiana joined a list of 12 states in which the adult obesity rate was more than 35%.11 In 2023, over 1 in 5 Hoosier children were living with obesity.
3) Activity Level: Closely linked with the prior two factors, activity level has been shown to have great impact on psychological, medical, and social factors. Studies have indicated that walking together incurs a number of benefits, including improved fitness, creativity, and conflict resolution.12 Evidence indicates that a regular exercise regiment is as effective in reducing mild to moderate depression as medication or therapy.13 Regular movement is linked to reduced risk of cardiac disease, diabetes, sleep difficulties, irritability, early mortality, and countless other outcomes.
Challenge(s): A quarter of the population is aerobically inactive. Less than 1 in 4 adults met the CDC activity guidelines (aerobic/strength-training) in 2020. Less than 30 percent of high schoolers get the prescribed amount of exercise per day. Only one in three children engage in physical activity every day. Reduced activity is linked to poor educational and occupational outcomes.14
4) Screen/Technology Time: The average 8-18 year-old child, when factoring in multi-tasking, spends nearly 11 hours per day linked to media and technology. Over 90% of middle school students utilize social media on a regular basis; over 85% of adolescents keep their phone on and next to their bed at night. The average American checks their phone around 200 times per day.
Challenge(s): Studies have consistently linked moderate to high digital usage to many negative health outcomes. Youth who keep their phones in their bedroom at night are at increased risk for poor sleep, daytime fatigue/irritability, illicit viewing, and countless other negative outcomes. Polls indicate that around 50% of youth admit being addicted to their phones.15 Social media use among teens, especially teen girls, has been linked to increase suicidality and body image concerns. Recent analyses found that moderate to high digital usage has been associated with ADHD symptoms in previously unaffected high school students.16
5) Communication/Relationships: Harsh, inconsistent, demeaning communication has direct links to mental illness, including psychotic disorders, depression, and anxiety.17 Evidence indicates that repeated verbal and psychological abuse can have more pervasive, longer lasting negative effects than physical abuse. Dr. John Gottman identifies four communication styles that are most associated with animosity, divisiveness, and unhealthy relationships: criticism, contempt, stonewalling, and defensiveness. On the positive side, relationships and regular communication with others is one of biggest protective factors against mental illness and loneliness. Recent studies have indicated that a person’s quality of relationships after 50 is a better predictor of their physical health than typical medical markers, such as cholesterol, exercise habits, and even IQ.18
Challenge(s): The advent of social media, decreased in-person engagement, and increased political polarization (among other factors) has led to increased threats to civil communication across both societal and familial fronts. As communication has increasingly become a commodity that is detached from the communicator-receiver relationship, evidence suggests that societal trust in others, and their communication, is eroding. In the 2025 Stress in America survey, a clear association was found between degree of stress related to societal division and loneliness while a significantly increased number of parents, students, and young adults cite advancing technology as a stressor in comparison to the 2024 survey.
6) Silence: For as long as humanity has lived, people have sought out silence in their daily lives. Whether in adventure or contemplation or prayer or rejuvenation or adoration, humans have always intuitively known that regular silence is a necessity of life. More recently, though, science has discovered that all human beings need silence more than we probably know. Research cites benefits beyond the obvious opportunities silence provides for rest, creativity, awareness, and discovery. Studies find that walking alone multiple times a week increases hippocampal growth, leading to improved memory.19 Those who allow even just two minutes of complete silence have positive changes in blood circulation and blood pressure associated with decreased tension. Older adults who meditate in complete silence each day demonstrate improved sleep patterns and decreased depression and fatigue. Not speaking for extended periods of times is associated with heightened sensitivity in other areas, such as thinking, feeling, and overall sensory perceptions.
Challenge(s): Research has indicated a widespread negative impact of noise pollution on various health factors, including hearing loss, cardiovascular disease, chronic irritability, stress, and sleep disruption. Over the last few decades, the price of external noise pollution has merged with the significant cost of noise pollution that occurs via personal devices. Youth especially indicate that they rarely or never go without their phone, and thus are repeatedly barraged with various notifications throughout the day and night. Thomas Merton once famously said “When society is made up of men who know no interior solitude it can no longer be held together by love: and consequently it is held together by a violent and abusive authority…when men are violently deprived of the solitude and freedom which are their due, then society in which they live becomes putrid, it festers with servility, resentment and hate.”
7) Outdoor, Natural Exposure: A 2018 review of studies20 found that increased greenspace exposure was associated with lower diastolic blood pressure, HDL cholesterol, salivary cortisol, decreased risk of preterm birth, type II diabetes, and all-cause mortality. Incidence of stroke, asthma, coronary heart disease, and dyslipidemia were reduced. Psychological benefits21 include improved attention, cognitive functioning (such as memory), happiness, and mood as well as decreased anxiety and stress. There has been a positive movement regarding the growth of trail networks and preservation and construction of green space.
Challenge(s): With increased obesity, screen/internet consumption, and overall sedentary behavior, as well as heightened use of delivery services, significant threats exist regarding incidental and intentional outdoor exposure. As suburban expansion continues, existing green space may be converted to residential and commercial areas. For those in the inner city and/or with transportation difficulties, access to green space may be limited.
What are examples of community initiatives to improve these health factors?
As it pertains to activity level, silence, natural exposure, and sleep, many cities across the country, including Evansville, have begun to prioritize certain initiatives that can improve opportunities for citizens in these 3 areas. This includes the following areas of focus:
- Decreasing light pollution
- Educational campaigns for sleep hygiene for new parents and schoolchildren
- Limiting loud street cleaning
- Increase access to trails and green space, and bikeability
- Tree planting for noise/light buffering
Regarding improved nutrition and increased access to natural, whole foods, cities have focused on the following factors:
- Restricting the sale and marketing of unhealthy foods, in and around schools.
- Require restaurants to provide detailed labels of menus
- Establish nutrition standards for all schools, government buildings, and city-sponsored events to ensure healthy options exist.
- Develop programs to incentivize buying of healthy foods.
- Increase edible landscaping
- Incentivize grocery stores and min-marts in urban areas to carry options for fruits and vegetables
One example of this is Seattle’s Fresh Bucks program, which enables eligible individuals to get financial assistance directly for the purpose of purchasing produce from local grocery stores and farmers markets. It reduces the cost of natural foods and helps local farmers. In its initial year of operation, it resulted in 7.36 million dollars of economic impact and served over 12,000 households. 90% of shoppers indicated that they bought more produce because of the program.22
The Indiana legislature passed Senate Bill 185 on July 1, 2024 prohibiting use of wireless communication devices like laptops, tablets, and cell phones during instructional time. A sizable body of research has indicated that student’s attention, learning, and retention is reduced when devices are present in the classroom. Each school district is responsible for developing a policy of implementation in enforcing the ban. EVSC and the Evansville Diocese, among other schools, have an opportunity to be a leader in SW Indiana in not only using the legislation to promote healthy tech use for students and teachers, but also in the home environment.
Educational and incentivized initiatives to promote delayed cell phone and social media usage as well keeping devices out of youth’s bedrooms can have widespread positive impact in improving psychological health, decreasing social isolation, and reducing the risk of illicit and predatorial behaviors as well as increasing activity level and exposure to green space.
What are accessible opportunities for citizens to contribute to improvement in these areas?
While a variety of personal, economic, societal, cultural, and structural factors can create obstacles for individuals in pursuing a healthy existence, all autonomous individuals have daily opportunities to improve their well-being. Given the current health climate, many individuals find themselves disempowered by public health standards (e.g., involving weekly exercise, food consumption, sleep guidelines) that are a “far cry” from the current state.
Established guidelines are important, but may unintentionally curb progress given many people’s perception of powerlessness in attaining these standards. The following are examples of ways that individuals can both contribute to improved public health while also developing meaningful habits focused on improved, sustainable well-being
- Substitute two artificial drinks per week for water
- Exchange one processed meal per week for a completely natural option
- Prioritize one 20-minute segment of intentional exercise per week
- Commit to visiting a park or greenspace at least twice per month
- Increase the thermostat by one degree in the summer, and decrease by one degree in winter
- Remove all devices from youth bedrooms
- Do not provide youth with a smartphone before driving age
- Designate two hours per week of non-screen time in the household
- Prioritize at least one daily, offline conversation with an emphasis on using I-statements
- Go to bed at least one night per week 7.5 hours before a planned wake time
Final Statement: Evansville has a rich history grounded in a tradition of hard-work, innovation, and community that has provided a foundation for generations of individuals and families. Yet within this tradition remains significant challenges on an individual and population level as it pertains to health, well-being, and the pursuit of flourishing. To truly make Evansville a premier destination to live and work, the physical, psychological, and social health of this community must be prioritized at the highest level. Evansville possesses the ideal size, infrastructure, and framework of resources to truly make it the happiest, healthiest city in Indiana. Together, an alliance of community government, organizations, and individuals can tap into a hidden greatness for a city that already stands proudly on the majestic bend of a timeless waterway.
References:
- https://www.rand.org/pubs/research_reports/RR1791.html
- https://www.kff.org/mental-health/2021-employer-health-benefits-survey/#1cd040ce-03af-4a6a-83cd-bb233aea938c
- https://www.healthsystemtracker.org/chart-collection/u-s-spending-healthcare-changed-time/#Per%20capita%20out-of-pocket%20expenditures,%201970-2023
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6689327/
- https://www.nhtsa.gov/sites/nhtsa.gov/files/documents/13394-mediconlitreview-073018-v3-tag.pdf
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6618203/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5889746/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4457123/
- https://www.scientificamerican.com/blog/talking-back/sleeps-role-in-obesity-schizophrenia-diabeteseverything/
- https://pubmed.ncbi.nlm.nih.gov/34374722/
- https://www.indystar.com/story/news/health/2020/09/18/indiana-sees-rate-obesity-risk-factor-covid-rise-35-plus/3487135001/
- https://pubmed.ncbi.nlm.nih.gov/28481583/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3674785/
- https://james-schroeder.com/the-exercise-potential-in-the-long-run/
- https://www.cnn.com/2016/05/03/health/teens-cell-phone-addiction-parents
- https://jamanetwork.com/journals/jama/fullarticle/2687861
- https://psychiatryonline.org/doi/10.1176/pn.45.13.psychnews_45_13_031
- https://www.relationshipsrewired.com/blog/the-harvard-study-that-found-relationships-are-the-key-to-a-good-life
- https://www.medicaldaily.com/5-health-benefits-being-silent-your-mind-and-body-396934
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6562165/
- https://www.apa.org/monitor/2020/04/nurtured-nature
- https://www.weforum.org/stories/2024/02/how-cities-can-have-impact-healthier-food-options/
3 thoughts on “A Vision for Evansville: Prioritizing Health & Well-Being in the River City”
Well said James!
This vision and goal are worth pursuing. How, though, to implement them? Where to begin?
As you may guess from my email, I say, start at the foundation of most of these issues: Adverse Childhood Experiences (ACEs) — help people heal from them and do everything we can to prevent them from happening anymore.
No doubt addressed ACES is a key variable to maximizing health & well-being for individuals and our community. As it pertains to healing and health in this and other areas, too, check out the sleep initiative that was linked in this vision for a critical place to start.