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

INVESTING IN PEOPLE AND PLACE: 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

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 1 IN 3 NEWBORNS START LIFE IN POVERTY Very high poverty neighborhoods High poverty neighborhoods Affluent neighborhoods

PLACE MATTERS FOR HEALTH North & West Oakland East Oakland Unincorporated Alameda County South Hayward

NEIGHBORHOOD POVERTY MATTERS FOR HEALTH 86 7 year difference in life expectancy 84 83 Life Expectancy (in Years) 82 80 80 78 78 76 76 74 72 <10% 10-20% 20-30 30%+ (Affluent) (Very High Poverty) Neighborhood Poverty Level % of residents living in poverty Source: Alameda County Vital Statistics files, 2008-2010

PLACE, RACISM, AND NEIGHBORHOOD POVERTY: HOW DO THEY INTERACT? Race and Social Gradients in Health 90 Latino Asian 85 Life Expectancy at Birth (in years) 80 Total 75 White 70 Black 65 <10% 10-20% 20-30% 30%+ (Affluent) (Very High Neighborhood Poverty Level Poverty) (% of residents living in poverty) Source: Alameda County Vital Statistics files, 2006-2010

Compared to a White child in the Oakland Hills, an African American child born in East Oakland is… 2 times more likely to 21 times more likely to 6 times more likely be born low birth live in poverty to be unemployed weight 12 times less likely to 3 times less likely to 2.5 times more likely have a mother with a read at grade level to die of stroke college degree INFANT CHILD ADULT Cumulative impact: 15 year difference in life expectancy Source: Alameda County Death files, 2010-2012; Alameda County Birth files, 2009-2011; American Community Survey, 2007-2011; California Dept of Education, 2012-2013

Leading Causes of Death: by Neighborhood Poverty Level Source: Alameda County Vital Statistics 2008-2010 <10% Poverty 10-20% Poverty (Affluent) 1 Cancer 26% 1 Cancer 24% 2 Diseases of Heart 23% 2 Diseases of Heart 23% 3 Stroke 6% 3 Stroke 6% 4 Chronic Lung Disease 5% 4 Chronic Lung Disease 5% 5 Alzheimer's Disease 4% 5 Unintentional Injuries 4% Top 5 account for 63% of deaths Top 5 account for 62% of deaths 30%+ Poverty 20-30% Poverty (Very High Poverty) 1 Cancer 21% 1 Cancer 22% 2 Diseases of Heart 20% 2 Diseases of Heart 22% 3 Stroke 7% 3 Stroke 7% 4 Homicide 5% 4 Chronic Lung Disease 5% 5 Unintentional Injuries 4% 5 Unintentional Injuries 5% Top 5 account for 61% of deaths Top 5 account for 58% of deaths

Leading Causes of Death: Young People (Ages 1-24 Years) Source: Alameda County Vital Statistics 2008-2010 Age-Specific Death Rate per 18 16 14 12 100,000 10 8 6 4 2 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Cancer Diseases of Heart Unintentional Injuries Homicide Suicide

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

Where You Live Affects Your Health Disinvested Communities • 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 Poor Health • Predatory Lenders Status 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 STRUGGLING WITH A LACK ACCESS TO 2-FOLD DIFFERENCE IN EMPLOYMENT HOUSEHOLD INCOME LEVELS Average annual unemployed in Average annual household income household income 7% affluent in very high poverty in affluent neighborhoods neighborhoods = neighborhoods = $46,598 $110,436 unemployed in very 15% high poverty neighborhoods

OVER 2X MORE LIKELY TO BE ALMOST 4X MORE LIKELY ABSENT FOR 10%+ DAYS TO HAVE LESS THAN A IN THE SCHOOL YEAR HIGH SCHOOL DEGREE of adults in affluent of OUSD students in 8% 9% neighborhoods have affluent neighborhoods less than a HS degree are chronically absent of adults in very high 17% of OUSD students in 34% poverty neighborhoods very high poverty have less than a HS degree neighborhoods are chronically absent

OVER 4X MORE LIKELY ALMOST 2X AS LIKELY TO BE TO BE LIVING IN SEVERELY BURDENED BY OVERCROWDED RENTAL HOUSING COSTS HOUSEHOLDS of households in of households in affluent 3% affluent neighborhoods 19% neighborhoods are are overcrowded spending ≥ 50% of their income on rental housing of households in very high of households in very high 14% poverty neighborhoods poverty neighborhoods are are overcrowded 36% spending ≥ 50% of their income on rental housing

5X MORE LIKELY TO BE FACING NEARLY 8X LOCKED UP AS A YOUTH FOR HIGHER RATES OF OVERWHELMINGLY HOMICIDE NONVIOLENT OFFENSES homicides per 100,000 people 4 living in affluent neighborhoods homicides per 1 in 200 youth (ages 10-17) 100,000 people 0.5% in affluent neighborhoods is 30 living in affluent incarcerated neighborhoods 1 in 40 youth in very high 2.5% poverty neighborhoods is incarcerated

BURDENED BY A 4X HIGHER 7X MORE LIKELY TO LIVE IN DENSITY OF INDUSTRIAL HOUSEHOLDS WITH ZERO CHEMICAL AND FUEL RELEASE VEHICLES AND DEPEND ON SITES THAT POLLUTE PUBLIC TRANSPORTION TO GROUNDWATER AND SOIL GET AROUND Industrial chemical and of households in affluent fuel release sites 83 2% neighborhoods have zero per 100,000 residents in vehicles affluent neighborhoods Industrial chemical and fuel release sites of households in very high 332 per 100,000 residents in very 14% poverty neighborhoods high poverty neighborhoods have zero vehicles

Where You Live Affects Your Health Disinvested Communities Communities of Opportunity • Limited/Unsafe Parks • Parks Good Health • Crime • Safe/Walkable Streets Status • Fast Food Restaurants • Grocery Stores • Liquor Stores • Good Schools • Poor Performing Schools • Clean Air • Pollution and Toxic Exposures • Public Transportation • Limited Public Transportation • Good Jobs • Absence of High Quality • Strong Local Businesses Financial Institutions • Financial Institutions Poor Health • Predatory Lenders 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

HEALTH EQUITY 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.

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