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Note: This article by Kate Schroder originally appeared on LINK nky's website.
The map below of life expectancy in Greater Cincinnati looks like a graphic that you might see in a local college or high school health class. People in some neighborhoods live longer than others–that’s not surprising. Most in our region have a good chance of having their first grandchild. Many will be able to enjoy retirement.
But dig deeper. We see that people in Newport live an average of 62 years. In contrast, people in Indian Hill live an average of 88 years, a difference of 26 years.
That gap could be the difference between meeting your first grandchild and your first great grandchild.
How did we end up here?
In the documentary “America’s Truth: Cincinnati,” filmmaker, George Washington University Public Health Professor and Cincinnati native Wendy Ellis looks at how our systems and policies have shaped disparities among race and class in our region. Dating back to the time of slavery, policies in our region were designed to intentionally create a racial hierarchy in our communities.
In fact, the film notes, the first law in the state of Ohio was the Black Codes, which set about to provide a case for different treatment of people based on the color of their skin. When it was enacted in 1804, Kentucky and the Indiana territory still allowed slavery. Unequal access to voting, education, property ownership, job opportunities, etc. can create disparities that pass on through generations. Even today, data from Cradle Cincinnati, show that in Hamilton County, Black children are two to three times more likely to die before their first birthday than white children.
Looking back at our map of life expectancies in the region, it can be helpful to dig a bit deeper. We see that the neighborhoods with lower life expectancy are more likely to be younger, have more residents who are Black or Hispanic, have less income, rent their homes and do not have a vehicle.
The disparities aren’t driven by the number of doctors’ offices (in fact, neighborhoods with our leading medical centers have some of the lower life expectancies) and rates of medical coverage. In fact, societal factors like education, income and employment are driving these health disparities.
Interact for Health envisions a future where everyone is healthy and thriving, regardless of who they are or where they live. This map shows that it’s not happening now.
Driving change isn’t a simple task. Giving people the tools they need to be healthy isn’t enough. We need to remove the barriers as well.
An example from our life expectancy map. The adult smoking rate in Newport is 36% vs 11% in Indian Hill according to data from CDC Places. So offering some smoking cessation classes at a community center in Newport may seem like a promising idea, right? Well not if the policies and systems aren’t also working toward progress. Public buildings in Newport still aren’t tobacco free—even though 3 in 4 Northern Kentucky registered voters favor a smoke-free law, according to the Greater Cincinnati Adult Tobacco Survey. That means if someone is trying to quit, they may still be exposed to smoke at their place of work. And perhaps our smoking cessation class is offered on a weekday evening, during the time when many may be working or when most childcare centers are closed.
The solutions are not simple.
Ellis presents the challenge in her documentary. “We can accept our truths and not run from them,” she said. “But we must also realize the promise of moving forward.”
At Interact for Health, we’ve spent the last year examining our data, listening to experts and everyday people and beginning to strategize how we can partner with our communities to improve health. My challenge to you is this: The next time you hear of a disparity in health, pause to consider how it came to be. What policies, systems and circumstances may have contributed?
Progress begins with a common, clear-eyed understanding of the problems we aim to tackle. The problems – and solutions – are bigger than one individual, organization or even sector can address. But together, progress is possible. And it starts with each one of us and a shared belief that today’s reality – with gaps in lifespan of up to 26 years – is not okay. We can and must do better, and I firmly believe that our vision of a region where everyone has the opportunity to live their healthiest life, is possible.
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