Dr. Anthony Iton can predict your lifespan with startling accuracy. He’s a John’s Hopkins-trained doctor, but he won’t need to examine you. He won’t need your medical history either.

Iton just needs to know your address.

“It shouldn’t work, but more often than not, it does,” he said. “Premature death is not randomly distributed. It is predictable.”

By zip code.

Drive fewer than 10 miles from Interstate 540 to east of North Carolina Central University and find a 12-year loss in life expectancy, according to Virginia Commonwealth University’s Center on Science and Health.

With this stark inequity in place, people suffer from a lack of opportunity. A baby’s future is determined more by accident of birth than by potential and merit.

The doctor was the keynote speaker for a crowd of over 500 leaders at Triangle Community Foundation’s What Matters 2016: A Region of Opportunity on April 27 at the Raleigh Convention Center.

Iton directs Building Healthy Communities for the California Endowment. He has 10 years and $1 billion to spend to improve health outcomes in 14 poverty-wracked California areas.

Of that $1 billion, he won’t spend a single dollar on health care.

The United States already ranks number one globally in health dollars per capita by a vast margin, yet the lavish spending produces a mediocre life expectancy. US average lifespan ranks 34th according to the World Health Organization.

The story that health care spending determines health is narrative that has to be fact-checked and re-written. The facts show that 80 percent of what influences health is tied to poverty and policy.

That’s why the zip code prediction works. Its accuracy was achieved over decades of discriminatory racial and economic policies, such as redlining in the mortgage industry.

The extreme poverty around John’s Hopkins in Baltimore shocked Iton, who transplanted for medical school from Canada. He was shocked again to learn his American friends accepted it as a matter of course.

Iton saw “children living in a minefield of risk” and wondered how it impacted their health. His American counterparts shrugged off the devastated landscape as normal because “it’s the inner city.”

A different perspective, a different narrative, changes how we tackle problems.

Once we understand the root causes of unhealthy communities, we know where to apply dollars and effort.

Iton’s $1 billion is being spent to pour a foundation of opportunity and equity to transform 14 California communities. The work is being done at every level, from recasting the narrative to advocating for equitable social policies to collaborating with banks like Wells Fargo to build supermarkets in food deserts.

Iton was met by the crowd with a standing ovation at the conclusion of his address, by the same audience that tacked hundreds of equitable hopes and dreams to a thought-board outside the room that the Foundation will share throughout the year Wednesdays on Twitter.

At the Foundation, which manages more than $200 million in donor funds, leaders invested time last year honing the organization’s mission to effect positive change.

“What does access to opportunity look like?” asked Lori O’Keefe, the Foundation’s president and CEO. “Food; nutrition for children; opportunity for employment; affordable housing; quality of life for everyone.”

O’Keefe offered to the audience a different way of thinking about our differences, and our backgrounds. Rather than focusing on what we are against, she encouraged attendees to focus on what we are for, noting that “it’s not about sides, it’s about people.”

She repeated her plea as the luncheon concluded, reminding everyone that “it is important to learn with an open mind about who we are helping – all people, with dreams and goals, who should have access to opportunity.”

Learning Together: Opening Sessions on Equity

Think about inequity as a game of Pictionary. But in this game, one team gets an easel and easy-to-read clues. The other team gets its clues in a foreign language and has to draw on smaller paper. Guess who’s going to win?

The people served by various Triangle nonprofits face that kind of inequality in their daily lives, and finding ways to improve opportunity was a key part of the Foundation’s What Matters community luncheon on April 27.

This year, in the midst of the national conversation on inequity, the Foundation sought to delve into the meaning of opportunity and how to build a Triangle region where everyone thrives. The opening sessions helped participants see how current systems create roadblocks for people from marginalized groups.

“It’s necessary to start asking the question of ‘how do we get on the path to dismantle the weight of systems and social pressures,” said Laura Martin, programs director for Step-Up Ministries in Durham. She said she appreciated the discussion for nonprofits, entitled “Equity: The Path to Opportunity and Success for our Region” and facilitated by OpenSource Leadership Strategies. A similar session was available for donors and fundholders at the Foundation.

They began with a game called Power Pictionary, which was used to illustrate the disparities in nonprofit work.

One group was afforded an easy path to success, while the other team struggled from the outset. After the game, the facilitators said these differences were not a fluke, that nonprofits play Power Pictionary every day.

Next, OpenSource associate Sterling Freeman, dove into structural inequities and the things that prop them up: Stories, Rules, and Resources.

“There are things that we’re internalizing all the time that create a narrative of our country and our community that socialize us and condition us in certain ways,” Freeman said.

Those narratives, or stories, can label or stereotype certain groups and privilege others, he said and they contribute to systemic inequality.

Rules and practices — even when not codified — can privilege some groups and marginalize others, he said.

Resources, Freeman said, are often inaccessible to a marginalized group, thus promoting inequity. For example, he said feeling safe is a resource not everyone has. People who don’t feel safe day-to-day can’t make good decisions or improve their lives.

After the discussion, equity was defined as “a proactive strategic approach that accounts for structural differences in opportunities, burdens and needs in order to fulfill the promise of true equality for all.”

This definition was applied to a case study of Student Action with Farmworkers, a Durham nonprofit designed to bring farmworkers together to learn about each other’s lives.

Bryan Gilmer, marketing and development director for Urban Ministries of Durham, said OpenSource Leadership has always been thought provoking.

“It was very interesting to consider these concepts in the context of the work that we do every day,” he said. “Recognizing inequity is important to understand why people may be in the situations or circumstances that they’re in and that we as a society have a long way to go to provide a truly fair playing field for everybody.”