sick forjustice
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Sick forJustice
Alyson Shupe, Ph.D.Chief, Health Statistics Section
Alyson.shupe@state.co.us
Mauricio Palacio, M.S.Director, Office of Health EquityMauricio.palacio@state.co.us
Latino Health Disparities Conference w October 2013
Health Equity
• Health equity is achieving the highest level of health for all people. Health equity entails focused societal efforts to address avoidable inequalities by equalizing the conditions for health for all groups, especially for those who have experienced socioeconomic disadvantage or historical injustices.
• Health equity concerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable – and thus inherently unjust and unfair.
Determinants of Health
Source: Healthy People 2010
Policies and Interventions
Access to Quality Health Care
Physical Social Environment Individual Environment
Behavior
Biology
Total White Latino Black Asian American Indian
0
10
20
30
40
50
60
70
80
90
73.981.1
60.164.6
81.7
52.2
Perc
ent
Colorado high school graduation rates, 2011
Source: Colorado Department of Education
Total White Latino Black Asian0
2
4
6
8
10
12
14
16
8.7 8.4
13.2 12.8
6.3Perc
ent
Source: U.S. Bureau of Labor Statistics
Colorado unemployment rates, 2010
TotalWhite
Latino
Black
Asian
Pac. Is
.
America
n Indian
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$55,430 $57,511
$38,299$33,354
$64,622
$56,288
$42,024
Colorado median household income, 2009
Source: U.S. Bureau of the Census, 2009 American Community Survey 1-Year Estimates
Total White Latino Black Asian American Indian
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
17.414.3
30.8
39.0
9.0
32.9
12.1 10.8
21.6 20.3
11.1
23.6
Colorado poverty rates by age, 2010
Children (<18) Adults (18+)
Perc
ent
Source: Small Area Income and Poverty Estimates (SAIPE) , US Census Bureau
White Black Latino0
5
10
15
20
25
30
10.8
18.1
24.7
Perc
ent
Fair or poor health by race/ethnicity, Colorado Adults, 2011
Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
White Black Latino0
10
20
30
40
50
60
37.3
25.4 22.4
Household tested for radon, by race and ethnicity, Colorado Adults, 2009
Perc
ent
Source: Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
Example Study Area for 2013 OHD ReportDemographics of those living within a selected high volume transportation corridor.
Air quality within a 500’ zone adjacent to roadways is suspected of increasing certain health risks.
20082009
20102011
201217.3
17.5 2018.9
18.725.5
22.426.5
26.526.9
0
5
10
15
20
25
30White Hispanic Live Births
Obesity prevalence by race and ethnicity 2008-2012, Colorado adults
Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
Per
cent
20082009
20102011
2012 5.2 4.8 4.6 5.5 6.1 7.7 9.3 8.110.3
11.50
2
4
6
8
10
12
14White Hispanic Live Births
Diabetes prevalence by race and ethnicity 2008-2012, Colorado adults
Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
Per
cent
2005/2006
2007/2008
2009/2010
2011/2012
10.411.1
11.512.8
22.517.8
19.618.6
0
5
10
15
20
25White Hispanic
Obesity rates of Colorado children ages 2-14 by race and ethnicity, 2005-2012
Source: Colorado Child Health Survey, Colorado Department of Public Health and Environment
Per
cent
20082009
20102011
2012 1616.1
15.417.6
16.8 2119.8
17.620.2
19.60
5
10
15
20
25White Hispanic Live Births
Smoking prevalence by race and ethnicity 2008-2012, Colorado adults
Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
Per
cent
20082009
20102011
201289.8
88.588.7 87
88.360.6
62.4 6462.8
57.50
102030405060708090
100White Hispanic Live Births
Insurance coverage by race and ethnicity 2008-2012, Colorado adults
Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment
Per
cent
Years of potential life lostLeading causes of YPLL-65 by race/ethnicity: Colorado residents, 2010-2012
Race/ethnicityLeading causes of years of potential life lost before age 65 (YPLL-65)
First Second Third Fourth Fifth
All races/ethnicities
Unintentional injuries Cancer Suicide Heart disease Perinatal period
conditions
White, Non-Hispanic
Unintentional injuries Cancer Suicide Heart disease Perinatal period
conditions
White, Hispanic Unintentional injuries
Perinatal period conditions Cancer Suicide Heart disease
Black/African American
Unintentional injuries
Perinatal period conditions
Homicide/legal intervention Cancer Heart disease
Asian/Pacific Islander Cancer Suicide Unintentional
injuries Birth defects Heart disease
American Indian/Native
AlaskanUnintentional
injuries SuicideChronic liver disease and
cirrhosisCancer Heart disease
Source: Vital Statistics Unit, Colorado Department of Public Heath and Environment
20072008
20092010
201135.2
31.8 3430.2
29.741.4 47
47.544.4
49.20
10
20
30
40
50
60White Hispanic Live Births
Unintended pregnancy rates by race and ethnicity 2007-2011
Source: Colorado Pregnancy Risk Assessment and Monitoring System, Colorado Department of Public Health and Environment
Per
cent
20072008
20092010
20112012
7.9
8
8.1
8.2
8.3
8.4
8.5
8.6
8.7
8.8White Hispanic Low birth weight births
Low birth weight births by race and ethnicity 2007-2012
Source: Vital Statistics Unit, Colorado Department of Public Health and Environment
Per
cent
20072008
20092010
20112012
0123456789
10White Hispanic Low birth weight births
Infant mortality rates by race and ethnicity 2007-2012
Source: Vital Statistics Unit, Colorado Department of Public Health and Environment
Per
cent
Colorado fertility rates for teens 15-17 years old, 1990–2011
19901991
19921993
19941995
19961997
19981999
20002001
20022003
20042005
20062007
20082009
20102011
0
10
20
30
40
50
60
70
80
90
Total Fertility Rate White Non-Hispanic Fertility RateWhite Hispanic Fertility Rate Black Fertility RateAsian/Pac. Is. Fertility Rate American Indian Fertility Rate
Birt
hs p
er 1
,000
wom
en a
ge 1
5-17
Source: Vital Statistics Unit, Colorado Department of Public Heath and Environment
20072008
20092010
201112.6 7.3
11.9 9.6 7.6 6 1.7 4.2 1.4 2.10
2
4
6
8
10
12
14White Hispanic
Smoking during the last 3 months of pregnancy by race and ethnicity 2007-2011
Source: Colorado Pregnancy Risk Assessment and Monitoring System, Colorado Department of Public Health and Environment
Per
cent
20072008
20092010
201115.9
12.914.4
14.612.9 2.5 2.9 1.7 2.5 2.9
0
2
4
6
8
10
12
14
16
18White Hispanic Drinking during pregnancy
Drinking during the last 3 months of pregnancy by race and ethnicity 2007-2011
Source: Colorado Pregnancy Risk Assessment and Monitoring System, Colorado Department of Public Health and Environment
Per
cent
Latino Population Growth• 2000 – 2010:
– Latino population in CO increased 41% (735,601 to 1 million)
– States’ population increased 17% (4.3 million to 5 million)• Latinos represent 21% of Colorado’s population• Latinos are the second largest population group in
Colorado• Nearly 31% of all Coloradans under 18 are Latino• Latino population growth presents many opportunities
for increasing Latino representation in business, employment, education and politics (Paul Lopez, Denver City Councilmember).
Source: NALEO Educational Fund, News Release, February 24, 2011.
Healthy Latino Communities• Healthy communities are critical to our residents’
wellbeing and a thriving Colorado economy.• For years we have mainly attributed our health to
the day-to-day choices we make.• While individuals are responsible for making
healthy choices, the conditions where we live, learn, work and play limit our choices and opportunities to be healthy.
• We now know there are hidden health factors that impact our lives, including our education, socio-economic status and job opportunities.
So, what do we do about it?• The first step is promoting awareness
and understanding of these hidden health factors.
• Next, we must work in partnership with communities to bring everyone up to an optimal level of health.
• Finally, we must all take action to improve health equity and eliminate health disparities.
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