An hour before his next client is due, Edgardo “Chino” Ortiz is in the glass-walled break room of InnerCity Weightlifting (ICW) in Cambridge, Mass., poring over a study guide to become certified as a personal trainer. Fiercely focused on achieving that goal, he is rarely separated from his worksheets.

“Prescribe RICE,” he says, circling the acronym for “rest, ice, compression and elevation” on a sample quiz question about injury.

All across America, men and women with similar ambitions are prepping for careers in physical fitness. But few share the unique drive that fuels 33-year-old Chino’s determination. For him, getting certified as a fitness trainer is a life-changing turning point, built on his smarts, his talent, and his grit.

Chino recently completed a sentence of five years in a Massachusetts state prison for shooting a man in the leg over drugs. For most former inmates, finding a good job is notoriously difficult. But Chino’s future looks promising because of his connection to ICW. 

My sons are both in college, one at Howard University in Washington, D.C., and the other at Knox College in Galesburg, Illinois. Raising African American boys into adulthood was often stressful. Despite the many advantages and supports we had as a family while they were growing up, I worried about their safety, whether their schools would see and nurture their greatness despite the color of their skin, and whether they would be able to live up to their potential.

As a public health practitioner, I’ve also had the opportunity to observe the amazing efforts of so many caregivers and families with limited resources who heroically “make a way out of no way.” I’ve seen what it takes, for example, for a mom to just get her children to a doctor’s appointment when they each go to a different school because the schools in their neighborhood are not the best she wants for them. I’ve seen the enormous emotional, physical, and mental energy families with fewer economic resources spend simply on surviving day to day—and I know that statistically, the burden of poverty falls particularly heavily on children of color.

I’m now director of University of Wisconsin’s Population Health Institute, which has for nearly a decade compiled the annual County Health Rankings. The rankings have helped communities across the nation see how where we live makes a difference in how well and how long we live. This year we’ve added a layer of analysis that hits home for me, highlighting the meaningful health gaps that persist by race.

We wanted to cover both place and race because county-level rankings can mask the deep divides we have in the health of different groups within communities. Even in counties with the best rankings—and the highest overall level of opportunity for good health—not everyone in every part of the county has access to opportunities for safe housing, adequate physical activity or a good education.

For me, knowing we still have gaps to fill is a call to action, especially as we mark National Minority Health Month. So how do we overturn the current reality and give everyone a fair shot?

As a child, the United States Surgeon General Jerome Adams, MD, MPH, suffered from asthma so severe that he spent months at time in the hospital, even once being airlifted to a children’s hospital in Washington, D.C. During these stays he was struck by the fact that he’d never encountered a black physician. That finally changed when as an undergraduate he met a prominent African-American doctor who had overcome his own significant life obstacles. Seeing another African-American making important contributions to the field of medicine inspired the young Jerome Adams to decide, “I can do that too.”

With that resolve, he embarked on a path that led to becoming an anesthesiologist and culminated in his appointment as the nation’s 20^th surgeon general.  

Reflecting on his journey, Dr. Adams notes, “that’s why your efforts at the Robert Wood Johnson Foundation (RWJF) are so important. You’re providing mentorship and leadership opportunities to those who wouldn’t otherwise know how to navigate the world of public health.”

We know that where we live, work, learn, and play greatly impacts our health. Especially important among these, and too often overlooked, is the impact of where we live. Housing is tied to health in powerful and inextricable ways. Think about the steps you take each morning to care for yourself, or each evening when you go to sleep. What would happen if you didn’t know where you would sleep that night, or weren’t sure how long you had until you were forced to find new shelter? Would you still take the time to go through your routines, if there was nothing routine about them? Would you set up relationships with health providers if you might not live in the same community next month—or even next week?

I faced homelessness twice and they were the most stressful experiences in my life. Lack of access to stable housing can feel like an insurmountable barrier to achieving good health and well-being—even more so when one is dealing with a chronic illness or other health challenges.