And in all states, black mothers gave birth to a disproportionately high percentage of underweight babies. The report details that the percentage of black children being born at low birth weights is higher than the typical worse-performing county in every state.
“Our health is influenced much more by what happens, and the experiences and the opportunities we have where we live than what happens in the doctor’s office,” said Abbey Cofsky, the foundation’s managing director of programs. “So if you’re thinking about what it takes to improve health, yes, what happens in the doctor’s office and having access to high quality care is very important, but it is only a piece of the puzzle.”
The other pieces, Cofsky emphasized, are defined by broader social and economic factors, including behavioral patterns, opportunities for high quality education, jobs with fair wages and social and community support.
Unfortunately, these opportunities are not equally available to economically disadvantaged or minority populations.
In communities segregated along racial or ethnic lines, black residents are more subject to the negative impact of segregation. In those segregated communities, there are higher rates of child poverty and lower rates of high school graduation than those in less segregated counties. That matters, Cofsky said, because of the impact that poverty and education have on long-term health and well-being.
“We need to start having tougher conversations about why we do economic development in certain parts of the city, why do we not create affordable housing when we are given tax incentives for skyscrapers,” Kansas City’s Martin said. “These things that have dramatically changed ZIP code life expectancy happen because we attracted the healthiest, most affluent people to these areas.”
County health data can be sobering. But they can also galvanize local leaders to make real change.
In 2001, Kansas City received a wake-up call.
County health data revealed extreme disparities in health outcomes among the four counties that make-up the city — specifically, life expectancy for black residents was about 6.5 years shorter than that for whites.
The data helped spur the city into action. The city successfully raised taxes to help fund new health incentives, like Kansas City’s revised Community Health Improvement Plan, which became the cornerstone of their efforts.
“Ours was devoted to health behaviors and diseases for a long time, because we were asking the community what diseases they had. You get what you ask for,” Martin said. “Instead we started listening to people talk about their communities. Then we had this great idea: Health is more than just health care.”