PHILADELPHIA — A DECADE and a half ago, a landmark study explored how racial and ethnic minorities face disparities in health care quality, even after accounting for socioeconomic differences.
Such trends have persisted for decades, with deadly effects: Another study using 2002 data found there were 229 excess deaths daily that could be avoided by closing the mortality gap between blacks and whites. That's like a Boeing 767 with all black passengers crashing every day, as David Williams of the Harvard T.H. Chan School of Public Health points out.
But the detriments of race- and ethnicity-based disparities don't stop at the individual level.
An analysis of U.S. News Healthiest Communities data found there is a clear link between community health and well-being – meaning a place's overall performance in measurements of health, such as life expectancy and access to care, and in areas connected to health, such as economic performance and natural environment – and the racial and ethnic makeup of a community.
The analysis showed a strong, positive correlation between how white a community is and its performance in Healthiest Communities measurements, but an even stronger negative link between a community's performance and the share of black residents in its population. Larger Hispanic and Native American populations also can predict worse community outcomes, while the share of Asians in a population has a positive relationship to overall community well-being – though far from the extent that it does for whites.
Examining the relationships between race and drivers of community health illustrates the multidimensional layers of wellness and the strength that factors far outside health behaviors and genetic disposition alone can have on health outcomes, many of which are deeply rooted in U.S. history and institutions.
"Health disparities reflect the culmination of advantages for some and disadvantages for others," says Tyson Brown, a sociologist and director of the Center for Biobehavioral Health Disparities Research at Duke University. "Population health is a mirror that reflects societal arrangements, and there is a great deal of empirical evidence that societal arrangements affect biology and lead to the health disparities we observe."
The 2018 U.S. News Healthiest Communities platform, released in March, assesses nearly 3,000 counties and county equivalents across 80 metrics in 10 categories that span the social determinants of health, including education, economy, food and nutrition, and more. To explore the connections between race, ethnicity and health, U.S. News paired this data with population compositions from the U.S. Census Bureau's 2012-2016 five-year estimates.
Drawing relationships between the data sets spotlights potential drivers of change that could prove key to bridging the nation's gaps in health.