Health disparities in America persist, influenced to a significant degree by where people live and by their racial/ethnic group, a study by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute finds.
Based on county-level data tracking more than thirty factors that influence health outcomes, including education, employment, income, family and social support, neighborhood safety, and access to quality health care, the 2018 County Health Rankings Key Findings Report (HTML or 16 pages, PDF) found that residential segregation and discriminatory practices and policies such as unfair bank lending practices and property tax-based school funding formulas have cut off communities of color from investments that typically result in better health outcomes.
Among other things, the report found that after a decade of improvement, the percentage of low birthweight babies increased between 2014 and 2016, and that differences in low birthweight rates were wider between racial/ethnic groups than between counties. In every state, rates of low birthweight among babies born to African-American mothers were significantly higher than those of other racial/ethnic groups, and higher than the median in the state's worst-ranked counties. The study also found that African Americans living in more segregated counties had higher rates of infant mortality and child poverty and lower rates of high school graduation than African Americans living in less segregated counties, while white residents fared better on all three indicators, with little difference between more or less segregated counties.
"Better-educated individuals live longer, healthier lives than those with less education, and their children are more likely to thrive," the report's authors write. Indeed, more than one in five youth in the counties with the worst health rankings do not graduate from high school in four years, and the unemployment rate in those counties was 7.5 percent, more than twice the rate in the top-ranked counties. At the same time, one in four African-American, Native American, and Latino youth fails to graduate from high school in four years, while African Americans and Native Americans face unemployment rates of 10.5 percent and 9.9 percent.
According to the report, rates of child poverty — which limits opportunities and increases the likelihood of poor health outcomes — have declined in recent years, but they remain above pre-recession levels, especially in rural counties and in counties with a greater percentage of people of color. And across all types of counties, child poverty rates are worse among African-American and Latino children.
"As an organization committed to improving health and well-being, we can't tolerate the reality that some Americans don't have the same opportunity to be healthy because of where they live, how much money they make, or the color of their skin," said RWJF president and CEO Richard Besser. "As a nation, we will be healthier and stronger together when we remove barriers to opportunity for everyone in America."
"The time is now to address long-standing challenges like child poverty and residential segregation," said Julie Willems Van Dijk, director of County Health Rankings & Roadmaps. "This year's rankings are a call to action to see how these persistent health gaps play out locally, take an honest look at their root causes, and work together to give everyone a fair shot at a healthier life."