New reports find "place matters" in understanding impact of racial health disparities

New reports find "place matters" in understanding impact of racial health disparities

April 02, 2014

People of color living in Rochester neighborhoods with the highest concentration of poverty  are more inclined to suffer negative health outcomes than people residing anywhere else in  Monroe County.  That is among the findings of newly released studies examining the local impact of health care disparities.

 Finger Lakes Health Systems Agency (FLHSA) convened two coalitions—the African American Health Coalition and the Latino Health Coalition—to inform separate reports evaluating the health status of members of the African American and Latino communities. Both coalitions asked FLHSA’s data staff to place greater emphasis on ascertaining the role of “place” in driving racial health disparities. 

 According to those reports, African Americans and Latinos living in Rochester’s poorest neighborhoods experience a disproportionate premature mortality rate compared to Caucasians living throughout the balance of Monroe County. For African Americans residing in these areas, that rate is nearly three times higher.

 The African American Health Coalition report focused on a bundle of ZIP codes it believes warrant special attention – specifically 14605, 14606, 14608, 14609, 14611, 14613, 14619, and 14621. These areas combined represent about 63 percent of all African Americans living in the Finger Lakes region and include culturally significant neighborhoods such as the 19th Ward and Marketview Heights.

 The Latino Health Coalition report focused on three ZIP codes it believes warrant special attention – specifically 14605, 14613, and 14621. Individuals who reside in these areas represent 28 percent of all Latinos living in the region. Coalition members felt these areas were significant since they encompass several close knit neighborhoods, or “los barrios,” that offer a pervasive Latino culture and historical significance for Latino immigrants.

Tied to the notion that “place matters,” authors of the reports focus on how disparities impact “years of potential life lost.” The findings indicate that life expectancy is influenced by residency, with people from the poorest neighborhoods living shorter lives on average than other residents of Monroe County.  These deaths are most often caused by heart disease, cancer, homicide, mental health issues, accidents, chronic pulmonary obstructive disorder, and HIV.

The reports are the third edition to a series focusing on disparities that was launched by the Finger Lakes Health Systems Agency in 2003. The current initiative documents how socio-economic factors and the environment greatly influence the health care experience.

In Monroe County, disparities are most profound in “The Crescent” neighborhoods, located in the city of Rochester. These neighborhoods struggle with a high concentration of poverty, and people of all races living in The Crescent experience health care disparities.

“What’s Goin’ On”—the report targeting issues in the African American community—notes that living in the Focus Area presents a unique set of environmental conditions.  These factors likely have an influence on both the health behaviors and the health outcomes of African American residents. In evaluating the factors that influence health disparities in the focus  areas, the African American Coalition points to the existence of environmental hazards, impaired access to primary care and other health services, high rates of crime and violence, high concentrations of liquor and tobacco outlets, and a relative shortage of grocery stores that sell affordable  health food options.

“Being born into poverty can significantly limit opportunities and social mobility, forcing individuals to live in unhealthy physical environments,” said Wade Norwood, director of Community Engagement at FLHSA. “Being confined to a living situation like this makes it much more challenging to live well and be well.”

Latinos in Rochester’s poorest neighborhoods face many of the same challenges. “Nuestra Salud”—the Latino Health Coalition report—states that Latinos in Monroe County self-report worse overall health and higher levels of physical limitations compared to Caucasians. Latinos also experience the highest rate of mental health issues among all racial and ethnic groups examined. High rates of poverty and unemployment, low levels of educational attainment, and a high proportion of single-parent households are identified as key factors.

FLHSA intends to have the findings serve as a mechanism to engage community influencers in a discussion about health care disparities. The objective is to arm these individuals with the tools

needed to communicate effectively at a grassroots level and inspire community leaders and health advocates to take a proactive role in eliminating health disparities.

 “This may enhance health in abstract ways, such as lower levels of stress and greater feelings of belonging, or in tangible ways, which could include free or low cost child care, assistance with activities of daily living, or access to community health centers, Noted Norwood.”

“As a community, health disparities affect all of us, “said Byron Kennedy, MD, director of Monroe County Public Health Department.  “Public health affects health care costs, our workforce, our education system, and much more. We have several programs in place that address health disparities in our community, but much more needs to be done.”