why is it so hard to talk about health equality on long island?
DESCRIPTION
A presentation by Martine Hackett from the Nassau County Minority Health Conference held at Hofstra University on April 9, 2014 during National Public Health Week that explores health disparities in a suburban county.TRANSCRIPT
WHY IS IT SO HARD TO TALK ABOUT HEALTH INEQUALITY ON LONG ISLAND?
Martine Hackett, Ph.D., MPHHofstra University
School of Health Sciences & Human Services
Department of Health Professions
Nassau County Minority Health Conference
April 7, 2014
It’s hard to talk about health inequality because…
People don’t know what health inequality is
People don’t know what causes health inequality
People don’t know what to do about it
There are significant differences in health outcomes by race/ethnicity in Nassau County.
Premature Deaths in Nassau County by race/ethnicity, 2009-2011
White Black Hispanic0%
10%
20%
30%
40%
50%
60%
70%
27%
56%58%
<75 years. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
Diabetes Mortality in Nassau County by race/ethnicity, 2009-2011
White Black Hispanic0
5
10
15
20
25
9.4
21.8
10.5
Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
Infant Mortality Rate Nassau County by race/ethnicity, 2009-2011
White Black Hispanic0
2
4
6
8
10
12
14
16
NYC Black Infant Mor-tality Rate, 8.6
13.4
Rate per 1000 live births. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
2.73.8
Coronary Heart Disease Mortality Nassau County by race/ethnicity, 2009-2011
White Black Hispanic0
50
100
150
200
250
180.1
226.6
134.3
NYC Black coronary disease mortality
rate, 218.1
Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
These health differences are due to behaviors, and also where you live, your class status, and how society treats you.
Spatial segregation
Source: Vital Signs, 2009
Spatial segregation
Source: Vital Signs, 2009
The relationship between place & health• Residential segregation is the
“fundamental cause of health disparities” (Williams & Collins, 2001)
• Built environment• Housing hazards• Environmental hazards• Fewer options for healthy foods• Lower high school graduation
rates• Safety • Vigilance/chronic stress
11554.9 Infant
deaths per 1,000 births
1155311.5 Infant deaths per 1,000 births
Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011
11554 Teen
pregnancy rate=9.6
11553Teen
pregnancy rate=56.8
Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011
11554 Childhood Asthma
discharge rate=13.711553
Childhood Asthma
discharge rate=53.2
Source: NYS DOH, Asthma Hospital Discharge rate per 10,000 population, Nassau County, Age 0-17, 2008-2010
“Those are places where there really isn’t a trash can, you throw it in places where people don’t really care. People throw garbage where they think it is abandoned. Maybe if there if there was someone there cleaning it would help.”
“They [the delis] all serve the same thing, they don’t serve anything fresh, like vegetables and fruit. There is really not any
other stores in the area. They’ve got a premium.” ”
“People dump on these sites. The contamination gets into peoples homes and causes illnesses and genetic problems.
I worry about this.”
“When you say you live in Roosevelt, some people think its like a ghetto neighborhood. Some times it really isn’t.”
Health equality requires a commitment to social justice to create healthier living
environments for everyone
When social factors are equalized, health disparities dissipate (LaVeist, et al., 2011)
Identification and awareness of the differences among populations regarding health outcomes and health determinants are essential steps towards reducing disparities in communities at greatest risk. (World Health Organization, Social Determinants of Health Report, 2011)
Where do we go from here?
Making it Easier to Talk about Health Equality
Commitment
Partnerships
Better Health for
ALL of Nassau County