INVESTING IN PEOPLE AND PLACE: Poverty and Childrens Health in - - PowerPoint PPT Presentation

Poverty and Children’s Health in Alameda County

Muntu Davis, MD, MPH Alameda County Public Health Department April 23, 2014 Alameda County Children's Policy Forum Series: Focusing on Economic Empowerment Opportunities for Children and Families Interagency Children's Policy Council

INVESTING IN PEOPLE AND PLACE:

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, June 2009:

“Despite increasing evidence of the long-term effects of early adversity on life-long health, little attention has been paid to…the reduction of significant stressors affecting everyday life for vulnerable young children and their parents.”

Shonkoff et al, 2009

Reducing health disparities means investing in healthy environments for children.

Cumulative exposures to stressful experiences (such as poverty) in early years of life are associated with prevalence of:

• coronary artery disease
• chronic pulmonary disease
• cancer
• alcoholism
• depression
• drug abuse
• mental health problems
• teen pregnancies
• cardiovascular risk factors, such as obesity, physical inactivity

and smoking.

Shonkoff et al, 2009

NEIGHBORHOOD POVERTY

Very high poverty neighborhoods High poverty neighborhoods Affluent neighborhoods

1 IN 3 NEWBORNS START LIFE IN POVERTY

PLACE MATTERS FOR HEALTH

North & West Oakland East Oakland Unincorporated Alameda County South Hayward

NEIGHBORHOOD POVERTY MATTERS FOR HEALTH

Source: Alameda County Vital Statistics files, 2008-2010

83 80 78 76 72 74 76 78 80 82 84 86 <10% 10-20% 20-30 30%+ Life Expectancy (in Years) Neighborhood Poverty Level

% of residents living in poverty

7 year difference in life expectancy

(Very High Poverty) (Affluent)

Source: Alameda County Vital Statistics files, 2006-2010

65 70 75 80 85 90 <10% 10-20% 20-30% 30%+ Life Expectancy at Birth (in years) Neighborhood Poverty Level

(% of residents living in poverty)

Asian Latino White Total Black

PLACE, RACISM, AND NEIGHBORHOOD POVERTY: HOW DO THEY INTERACT?

Race and Social Gradients in Health

(Very High Poverty) (Affluent)

Source: Alameda County Death files, 2010-2012; Alameda County Birth files, 2009-2011; American Community Survey, 2007-2011; California Dept of Education, 2012-2013

Compared to a White child in the Oakland Hills, an African American child born in East Oakland is…

2 times more likely to be born low birth weight 12 times less likely to have a mother with a college degree 21 times more likely to live in poverty 3 times less likely to read at grade level 6 times more likely to be unemployed 2.5 times more likely to die of stroke INFANT CHILD ADULT

Cumulative impact: 15 year difference in life expectancy

<10% Poverty (Affluent) 1 Cancer 26% 2 Diseases of Heart 23% 3 Stroke 6% 4 Chronic Lung Disease 5% 5 Alzheimer's Disease 4% Top 5 account for 63% of deaths 10-20% Poverty 1 Cancer 24% 2 Diseases of Heart 23% 3 Stroke 6% 4 Chronic Lung Disease 5% 5 Unintentional Injuries 4% Top 5 account for 62% of deaths 20-30% Poverty 1 Cancer 21% 2 Diseases of Heart 20% 3 Stroke 7% 4 Chronic Lung Disease 5% 5 Unintentional Injuries 5% Top 5 account for 58% of deaths 30%+ Poverty (Very High Poverty) 1 Cancer 22% 2 Diseases of Heart 22% 3 Stroke 7% 4 Homicide 5% 5 Unintentional Injuries 4% Top 5 account for 61% of deaths

Leading Causes of Death: by Neighborhood Poverty Level Source: Alameda County Vital Statistics 2008-2010

Leading Causes of Death: Young People (Ages 1-24 Years)

Source: Alameda County Vital Statistics 2008-2010

2 4 6 8 10 12 14 16 18

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Age-Specific Death Rate per 100,000

Cancer Diseases of Heart Unintentional Injuries Homicide Suicide

UNEQUAL NEIGHBORHOOD CONDITIONS MATTER FOR HEALTH

Income, employment, and wealth Education and quality schools Freedom from violence and incarceration Freedom from chronic stress and mental illness Quality, affordable housing Public transportation and safe streets Healthy vs. unhealthy land uses Clean air, soil, and water

Where You Live Affects Your Health

Poor Health Status

• Limited/Unsafe Parks
• Crime
• Fast Food Restaurants
• Liquor Stores
• Poor Performing Schools
• Pollution and Toxic Exposures
• Limited Public Transportation
• Absence of High Quality

Financial Institutions

• Predatory Lenders

Disinvested Communities

Source: Adapted from PolicyLink

Compared to people living in affluent neighborhoods of Alameda County, residents of very high poverty neighborhoods are: 2X MORE LIKELY TO LACK ACCESS TO EMPLOYMENT 7% 15%

unemployed in affluent neighborhoods unemployed in very high poverty neighborhoods

STRUGGLING WITH A 2-FOLD DIFFERENCE IN HOUSEHOLD INCOME LEVELS

Average annual household income in affluent neighborhoods =

$110,436

Average annual household income in very high poverty neighborhoods =

$46,598

9% 34%

• f adults in affluent

neighborhoods have less than a HS degree

• f adults in very high

poverty neighborhoods have less than a HS degree

ALMOST 4X MORE LIKELY TO HAVE LESS THAN A HIGH SCHOOL DEGREE

• f OUSD students in

affluent neighborhoods are chronically absent

OVER 2X MORE LIKELY TO BE ABSENT FOR 10%+ DAYS IN THE SCHOOL YEAR 8% 17% of OUSD students in

very high poverty neighborhoods are chronically absent

OVER 4X MORE LIKELY TO BE LIVING IN OVERCROWDED HOUSEHOLDS 3% 14%

• f households in

affluent neighborhoods are overcrowded

• f households in very high

poverty neighborhoods are overcrowded

ALMOST 2X AS LIKELY TO BE SEVERELY BURDENED BY RENTAL HOUSING COSTS 19% 36%

• f households in affluent

neighborhoods are spending ≥50% of their income on rental housing

• f households in very high

poverty neighborhoods are spending ≥50% of their income on rental housing

FACING NEARLY 8X HIGHER RATES OF HOMICIDE 4 30

homicides per 100,000 people living in affluent neighborhoods homicides per 100,000 people living in affluent neighborhoods

5X MORE LIKELY TO BE LOCKED UP AS A YOUTH FOR OVERWHELMINGLY NONVIOLENT OFFENSES 0.5%

1 in 200 youth (ages 10-17) in affluent neighborhoods is incarcerated

2.5%

1 in 40 youth in very high poverty neighborhoods is incarcerated

BURDENED BY A 4X HIGHER DENSITY OF INDUSTRIAL CHEMICAL AND FUEL RELEASE SITES THAT POLLUTE GROUNDWATER AND SOIL 83 332

Industrial chemical and fuel release sites per 100,000 residents in affluent neighborhoods Industrial chemical and fuel release sites per 100,000 residents in very high poverty neighborhoods

7X MORE LIKELY TO LIVE IN HOUSEHOLDS WITH ZERO VEHICLES AND DEPEND ON PUBLIC TRANSPORTION TO GET AROUND 2% 14%

• f households in affluent

neighborhoods have zero vehicles

• f households in very high

poverty neighborhoods have zero vehicles

Where You Live Affects Your Health

Communities of Opportunity

Poor Health Status

• Limited/Unsafe Parks
• Crime
• Fast Food Restaurants
• Liquor Stores
• Poor Performing Schools
• Pollution and Toxic Exposures
• Limited Public Transportation
• Absence of High Quality

Financial Institutions

• Predatory Lenders

Disinvested Communities

• Parks
• Safe/Walkable Streets
• Grocery Stores
• Good Schools
• Clean Air
• Public Transportation
• Good Jobs
• Strong Local Businesses
• Financial Institutions

Good Health Status

Source: Adapted from PolicyLink

INVESTING IN PEOPLE AND PLACES

INVESTING IN PEOPLE AND PLACES

Photos: Thomas Hawk, funkandjazz, Susan Decker (flickr), city- data.com, FYI youth, IPOP, www.home-lover.net, Food to Families

Everyone in Alameda County, no matter who you are, where you live, how much money you make, or the color of your skin, has access to the same opportunities to lead a healthy, fulfilling and productive life. HEALTH EQUITY

project

PROSPERITY City County Neighborhood Initiative

Healthy Food Education Residents Parks and Activities Planning Housing

WE’RE IN THIS TOGETHER

Childcare Preschool

Transportation

Policy Makers Jobs Safe Neighbor- hoods Clean Air Medical Care