Suburban Health Inequity


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Suburban Health Inequity

  1. 1. Suburban Health Inequity: SocialDeterminants, Health Outcomes and Missing Pieces Martine Hackett Hofstra University
  2. 2.  What is the contribution of suburban space in Nassau County to health inequities? What are the challenges to creating health equity in Nassau County?
  3. 3. Source: Vital Signs, 2009
  4. 4. Source: Vital Signs, 2009
  5. 5.  Massey and Denton (1993): …"the key structural factor for the perpetuation of Black poverty in the U.S." and the "missing link" in efforts to understand urban poverty.
  6. 6. Condition DisparityTeen Pregnancy Rate • 4X higher in Roosevelt than Nassau County average • 3X higher in Westbury, Uniondale, HempsteadChlamydia Incidence • 5X higher in Roosevelt than Nassau County average • 4X higher in HempsteadDiabetes Hospitalization 3x higher in blacks vs. whitesCancer Mortality Highest among black malesAssault Hospitalizations 5x higher in Roosevelt than Nassau County averagePoisoning hospitalizations 2.5X higher in Roosevelt than Nassau County averagePeople living with HIV/AIDS Significantly higher in Roosevelt and Hempsteadincident ratesSource: Nassau County Department of Health, 2010
  7. 7.  Segregation determines SES by affecting quality of education and employment opportunities. Segregation can create negative neighborhood and housing conditions. Conditions linked to segregation can constrain the practice of health behaviors and encourage unhealthy ones. Segregation can adversely affect access to medical care and to high-quality care.
  8. 8.  Built environment Housing hazards Environmental hazards Lack of social supports, community Cumulative disadvantage builds in segregated neighborhoods
  9. 9. Too suburban to be Too many inner-city a problem like problems to becompared to inner- considered city suburban
  10. 10.  Poverty Race/Ethnicity Aging population Aging infrastructure High housing costs, shortage of rentals
  11. 11.  Familiar thinking about the suburbs influences current decisions—denying current reality and changes to maintain traditional ways of life Taxes already high for services that are expected High level of governmental fragmentation
  12. 12.  Suburban social services and safety net inadequate  Decentralization in times of economic crisis means priorities shift away from those in need Fewer public and private resources for suburban health equity Advocacy efforts to connect segregation, economic opportunities and health outcomes in Nassau County
  13. 13. • Failure to address Long Island’s current challenges—and the social disparities associated with them— threatens future growth and vitality in the region• Health disparities hurt those directly affected by them, but they also harm the social and economic well-being of the greater community.• Public health is at the core of sustainability