Health Disparities in Contra Costa County July 2009

What are health disparities? Health disparities refer to differences in health outcomes (death, illness, injury and birth-related outcomes) Most often these differences are examined as differences by race/ethnicity because that data is most readily available. But there as measures get better there is increasing recognition of the role that socioeconomic status (measured by education, income, wealth etc) plays in determining a population’s health

What are the causes of health disparities? There are many ideas about what leads to health disparities. It depends on how health disparities are defined. The most consistent causes: Differences in resources (education, income, wealth, support) Differential treatment based on language, culture or race/ethnicity

Low resources Discrimination Living in unhealthy physical, social and economic environments -Chronic Stress -Unhealthy behavior (smoking, excessive drinking, eating unhealthy food) -Exposure to pollutants and carcinogens -Lack of access to needed goods and services Increased Rate of Illness, Injury and Death >>> One View of Health Disparities

Distribution of Population by Race/Ethnicity Contra Costa, Percent

Contra Costa Overview Contra CostaCalifornia Population1,019,64036,553,215 Percent White Percent Black Percent Hispanic Percent Asian Median HH Income76,43559,948 Percent >HS grad Another language at home

Distribution of Births by Race/Ethnicity Contra Costa, 2007 Percent

What do we know about health disparities by race/ethnicity in Contra Costa? African-Americans and those living in cities with high rates of poverty, in general do less well compared to other race/ethnic groups or those living in cities with lower rates of poverty. Those cities and areas of Contra Costa with higher levels of poverty and the resulting lower levels of physical, social, economic and institutional resources, tend to have higher rates of mortality from many diseases. The Hospital Council report provides information about differences in health outcomes by race/ethnicity and by city

Per 100,000 Cancer Death Rate by Race/Ethnicity Contra Costa,

Overweight 5 th Graders Contra Costa, Percent

Per 1,000 teen girls Births to Teens (Age 15-19) Contra Costa,

Per 100,000 Homicide by Race/Ethnicity Contra Costa,

What should be done about health disparities? Work to reduce or reduce the effect of the main causes of health disparities: Differences in resources (education, income, wealth, support) Differential treatment based on language, culture or race/ethnicity Specifically health care institutions should: Provide high-level culturally, linguistically appropriate care to all of its clients Work with community partners and partners from other sectors (recreation, education, transportation, housing, etc) to improve the physical, social and economic environment in which those with low-income live

What is CCHS doing about health disparities? Reducing Health Disparities Initiative (RHDI) Language Access  Video and phone translation Cultural Humility Training Service Excellence/RHD policy African-American Health Initiative (AAHI) Connected Activities Life Course Built Environment Environmental Justice Healthcare Safety Net (Basic Health Care)

African American Health Initiative Action Steps Recruit and Retain African American staff Provide Cultural Humility Training Identify Key Indicators for Specific Actions Establish Partnerships with Community Expand the Health Conductors Project

Connected Activities Life Course Life Course Initiative focuses on adding life and generational perspective to health promotion activities Building Economic Security Today (BEST) project focuses on providing information and tools for asset development to FMCH clients Built Environment This project is working with city planners in Richmond and Concord to change the physical environment in a way that improves health behavior and outcomes (Example: Health Element in Richmond General Plan)

Connected Activities Environmental Justice Has developed a framework for working on environmental issues in communities (Example: Dirty Diesel) Health Safety Net Provides basic health care to those who have little or no resources to pay for care (Example: Basic Health Care)