225654 Patterns of mortality disparities by race/ethnicity and area poverty level across places: The equity gap

Wednesday, November 10, 2010 : 8:45 AM - 9:00 AM

Matt Beyers, MSCRP, MA , CAPE, Alameda County Public Health Department, Oakland, CA
Sandra Witt, DrPH, MPH , Deputy Director of Planning, Policy and Health Equity, Alameda County Public Health Department, Oakland, CA
Steve Sidney, MD, MPH , Division of Research, Kaiser Permanente, Oakland, CA
Randy Reiter, PhD, MPH , Community Health Epidemiology, San Francisco Department of Public Health, San Francisco, CA
Rochelle Ereman, MS, MPH , Epidemiology Group, Marin County Department of Health and Human Services, San Rafael, CA
Bob Prentice, PhD , Bay Area Regional Health Inequities Initiative, Oakland, CA
The relationship between social and health inequity can be shown in a compelling and simple manner. Health departments monitoring disparities in populations by race/ethnicity and income often rely on geocoding death records and linking them to census tract income or poverty levels, since individual death records lack income data. We explain methods and report such analysis for the San Francisco Bay Area, California, Los Angeles, Philadelphia, Cleveland, Minneapolis, and Colorado. Places show consistent patterns—mortality for African Americans and Whites is higher for each level of neighborhood poverty than for Hispanics and Asians; mortality for African Americans and Whites shows stronger gradients by neighborhood poverty than for Hispanics and Asians; and the gap between mortality rates for African Americans and Whites compared to Hispanics and Asians increases with neighborhood poverty level. We also observed a gradient in mortality rate by neighborhood poverty level in Kaiser Permanente Northern California, which covers 30% of the Bay Area population. We discuss key implications of these results for population health epidemiology and public health practice. These include the importance of reporting distributions of population by ethnicity and neighborhood poverty to convey the population burden of mortality disparities by ethnicity and income, and the need to better understand how different factors might result in the observed disparities by ethnicity, neighborhood poverty, and specific combinations of ethnicity and neighborhood poverty.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
At the end of this session, participants will be able to: Explain an interaction of race/ethnicity and neighborhood poverty and their effect on mortality. Design an analysis of the social gradient for their own jurisdiction.

Keywords: Geographic Information Systems, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I ran the analysis or assisted in the analysis of most of these data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.