Why Is It So Hard To Talk About Health Equality on Long Island?

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A presentation by Martine Hackett from the Nassau County Minority Health Conference held at Hofstra University on April 9, 2014 during National Public Health Week that explores health disparities in a suburban county.

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Why Is It So Hard To Talk About Health Equality on Long Island?

  1. 1. WHY IS IT SO HARD TO TALK ABOUT HEALTH INEQUALITY ON LONG ISLAND? Martine Hackett, Ph.D., MPH Hofstra University School of Health Sciences & Human Services Department of Health Professions Nassau County Minority Health Conference April 7, 2014
  2. 2. It’s hard to talk about health inequality because… People don’t know what health inequality is People don’t know what causes health inequality People don’t know what to do about it
  3. 3. There are significant differences in health outcomes by race/ethnicity in Nassau County.
  4. 4. Premature Deaths in Nassau County by race/ethnicity, 2009-2011 0% 10% 20% 30% 40% 50% 60% 70% White Black Hispanic 27% 56% 58% <75 years. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
  5. 5. Diabetes Mortality in Nassau County by race/ethnicity, 2009-2011 9.4 21.8 10.5 0 5 10 15 20 25 White Black Hispanic Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
  6. 6. Infant Mortality Rate Nassau County by race/ethnicity, 2009-2011 0 2 4 6 8 10 12 14 16 White Black Hispanic NYC Black Infant Mortality Rate, 8.6 13.4 Rate per 1000 live births. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm 2.7 3.8
  7. 7. Coronary Heart Disease Mortality Nassau County by race/ethnicity, 2009-2011 180.1 226.6 134.3 0 50 100 150 200 250 White Black Hispanic NYC Black coronary disease mortality rate, 218.1 Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011 http://www.health.ny.gov/statistics/community/minority/county/index.htm
  8. 8. These health differences are due to behaviors, and also where you live, your class status, and how society treats you.
  9. 9. Spatial segregation Source: Vital Signs, 2009
  10. 10. Spatial segregation Source: Vital Signs, 2009
  11. 11. The relationship between place & health • Residential segregation is the “fundamental cause of health disparities” (Williams & Collins, 2001) • Built environment • Housing hazards • Environmental hazards • Fewer options for healthy foods • Lower high school graduation rates • Safety • Vigilance/chronic stress
  12. 12. 11554 .9 Infant deaths per 1,000 births 11553 11.5 Infant deaths per 1,000 births Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011
  13. 13. 11554 Teen pregnancy rate=9.6 11553 Teen pregnancy rate=56.8 Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011
  14. 14. 11554 Childhood Asthma discharge rate=13.711553 Childhood Asthma discharge rate=53.2 Source: NYS DOH, Asthma Hospital Discharge rate per 10,000 population, Nassau County, Age 0-17, 2008-2010
  15. 15. “Those are places where there really isn’t a trash can, you throw it in places where people don’t really care. People throw garbage where they think it is abandoned. Maybe if there if there was someone there cleaning it would help.”
  16. 16. “They [the delis] all serve the same thing, they don’t serve anything fresh, like vegetables and fruit. There is really not any other stores in the area. They’ve got a premium.” ”
  17. 17. “People dump on these sites. The contamination gets into peoples homes and causes illnesses and genetic problems. I worry about this.”
  18. 18. “When you say you live in Roosevelt, some people think its like a ghetto neighborhood. Some times it really isn’t.”
  19. 19. Health equality requires a commitment to social justice to create healthier living environments for everyone
  20. 20. When social factors are equalized, health disparities dissipate (LaVeist, et al., 2011)
  21. 21. Identification and awareness of the differences among populations regarding health outcomes and health determinants are essential steps towards reducing disparities in communities at greatest risk. (World Health Organization, Social Determinants of Health Report, 2011)
  22. 22. Where do we go from here?
  23. 23. Making it Easier to Talk about Health Equality Commitment Partnerships Better Health for ALL of Nassau County

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