Health Inequities in Spokane County Income Health Inequities in Spokane County Income Board of...
-
Upload
duane-boone -
Category
Documents
-
view
222 -
download
1
Transcript of Health Inequities in Spokane County Income Health Inequities in Spokane County Income Board of...
Health Inequities inHealth Inequities in Spokane County Spokane County
Income Income
Board of HealthMarch 22, 2012
The goal of this assessment is to increase and provide a perspective on different health and social inequities in Spokane County and provide information that can be used for potential changes that affect health outcomes.– Build awareness– Identify further areas for exploration– Identify community partners– Intended for health professionals, legislators (policy
makers), administrators, community members, and anyone interested in addressing health concerns in Spokane County
Purpose of Health Inequity Report
Data Sources
Washington State Population SurveyBehavioral Risk Factor Surveillance Survey (BRFSS)Birth CertificatesDeath CertificatesCommunity Health Assessment Tool (CHAT)Office of Financial Management, Washington StateWashington State HIV Surveillance ReportStrategic Research Associates, Omnibus Survey
Definitions
Health DisparityDifferences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.
Health InequityConcerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable; thus being inherently unjust and unfair.
Definitions
Social Determinants of Health
Through research, factors (i.e., determinants) in our social and economic environment that have been found to negatively (or positively) affect health.
Social Gradient An individual's or population group's position in society and different access to and security of resources such as education, employment and housing, as well as different levels of participation in civic society and control over life.
The Ladder Position
Using ladder as a metaphor to explain health inequities
Societies are structured like ladders
The rungs of the ladder represent the resources that determine whether people can live a good life or a life plagued by difficulties
A Framework for Health Inequity
Upstream Downstream
•Race•Class•Gender•Immigration status•National Origin•Sexual orientation•Disability
Discriminatory Beliefs (ISMS) •Corporation
s & other businesses•Government agencies
•Schools
InstitutionalPower •Neighborhoo
d conditions
SocialPhysical
•Residential segregation
•Workplace conditions
•Education
Social Inequities
•Smoking•Nutrition•Physical activity•Violence•Chronic Stress
•Infectious disease•Chronic disease•Injury (intentional /
unintentional)
•Infant mortality•Life expectancy
Social Factors
Health Status
Hea
lthca
re
Acce
ss
Medical Model
Risk Factors & Behaviors Disease & Injury Mortality
Socio-Ecological
Components to Health Inequities
Why Income/Poverty Level?
What We HeardFocus group participants were asked about their perceptions of stereotypes that others may have of people from their socioeconomic level: “I think the biggest stereotype is that we don’t try. I think that’s a problem. People are at this bracket for whatever reason, but I certainly don’t think it’s for lack of trying.”
Focus Group Participant (income <35k)
Scott Finyalson
Poverty• Poverty was defined as 200% FPL using the Federal Registrar’s 2008
Percent of Poverty Guidelines• For a family of 4 (2 adults and 2 children) at 200% FPL, the gross annual
household income equates to $42,0000• Household income was calculated based on total income in that
household and determined as a percent of FPL• The number of members in a household and the total income in the
household was used to determine a households poverty level• When a poverty level was determined for a household, all individuals in
that household were given the same poverty level
Increasing Income Inequality in Spokane County
Data Source: Washington State Population Survey
Looking at Growth of Income at Each Level of Wealth in Spokane County and Washington
State from 2000 to 2008
Change in Income from 2000 to 2008
5th Percentile
10th Percentile
25th Percentile
50th Percentile
75th Percentile
90th Percentile
95th Percentile
Spokane County ↓1.2K No change ↑4.3K ↑4.7K ↑8K ↑14K ↑11.5K
Washington State ↑1.1K ↑1.8K ↑5.3K ↑10.4K ↑15K ↑19.2K ↑21K
Data Source: Washington State Population Survey
Change in Median Household Income (2008 Inflation-Adjusted Dollars) from 2000 to 2008
Overall PovertyOverall Poverty by Categories, 2000 to 2008
Data Source: Washington State Population Survey
Poverty significantly increases for children whose mother is a single parent.
General Health Status by IncomeGeneral Health Status by Household Income among Adults 25 Years of Age or Older, 2000 to 2008
Data Source: Washington State Population Survey
Household Income as Percent of Federal Poverty Level
Parents’ Income and a Child’s Chance for Health
Household Income as Percent of Federal Poverty Level
Child’s Health Status by Household Income, 2000 to 2008
Data Source: Washington State Population Survey
Effects of Chronic Illness on Physical Activity by Income
Household Income as Percent of Federal Poverty Level
Physical Activity Limitations Due to Chronic Illness among Adults 25 Years of Age or Older by Household Income, 2000 to 2008
Data Source: Washington State Population Survey
Physical Inactivity Among Adults by Income
Physical Inactivity by Household Income among Adults 25 Years of Age or Older, 2005 to 2009
Household Income as Percent of Federal Poverty Level
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Smoking by Income Level Smoking by Poverty Level, 2005 to 2009
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Household Income as Percent of Federal Poverty Level
Lower income adults are more likely to smoke than adults in higher income groups.
Diabetes by Income
Household Income as Percent of Federal Poverty Level
Diabetes by Poverty Level among Adults 25 Years of Age or Older, 2005 to 2009
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Obesity by Income
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Household Income as Percent of Federal Poverty Level
Obesity by Poverty Level among Adults 25 Years of Age or Older, 2005 to 2009
Poor Mental Health by Income
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
Household Income as Percent of Federal Poverty Level
Poor Mental Health by Household Income among Adults 25 Years of Age or Older, 2005 to 2009
A Framework for Health Inequity
Upstream Downstream
•Race•Class•Gender•Immigration status•National Origin•Sexual orientation•Disability
Discriminatory Beliefs (ISMS) •Corporation
s & other businesses•Government agencies
•Schools
InstitutionalPower •Neighborhoo
d conditions
SocialPhysical
•Residential segregation
•Workplace conditions
•Education
Social Inequities
•Smoking•Nutrition•Physical activity•Violence•Chronic Stress
•Infectious disease•Chronic disease•Injury (intentional /
unintentional)
•Infant mortality•Life expectancy
Social Factors
Health Status
Hea
lthca
re
Acce
ss
Medical Model
Risk Factors & Behaviors Disease & Injury Mortality
Socio-Ecological
All we see of someone at any moment is a snapshot of their life, there in riches or poverty, in joy or despair. Snapshots don't show the circumstances and the million decisions that led to that moment.
Richard Bach
Adrian E. Dominguez, M.S.Epidemiologist
Spokane Regional Health DistrictDisease Prevention and Response
Community Health Assessment, Planning , and [email protected]
509.324.1670