新县健康排名显示不同地区和种族的健康和机会差异
One of the connections this report illuminates between race and place is that segregated communities of color are more likely to be cut off from investments that promote good schools, affordable housing, and other opportunities for health. The U.S. has a long history of racism and discriminatory policies and practices that have limited the opportunities of people of color in choosing where to live, including practices like denying housing loans to people of color. Poor health exists in places segregated from opportunity. Decades of research show that residential segregation is a fundamental cause of health disparities in the U.S. This year’s report shows blacks in more segregated counties fare worse in rates of child poverty, infant mortality, and high school graduation than those in less segregated counties.
“As an organization committed to improving health and well-being, we can’t tolerate the reality that some American’s don’t have the same opportunity to be healthy because of where they live, how much money they make, or the color of their skin,” said Besser. “As a nation, we will be healthier and stronger together when we remove barriers to opportunity for everyone in America.”
This year’s Rankings explores important trends happening among the nation’s children and youth:
- Teen Births: There are strong ties between poverty and births among teens. Teen birth rates have been declining across community types and racial groups for more than a decade, with most recent data showing a U.S. rate of 27 per 1,000 females, ages 15-19. Hispanic teens have seen the most improvement in birth rates, falling from 77.7 to 31.9 births per 1,000 females—ages 15-19, from 2006 to 2016. Black and American Indian/Alaskan Native teens have also seen notable improvements. Teen birth rates are highest among counties in the Southwest and Southeast as well as parts of Appalachia, the Mississippi Delta, and the Plains regions. These regions have seen little change over the last decade, while the East and West Coasts have seen improvements.
- Children in Poverty: Poverty limits opportunities and increases the chance of poor health. Today, 1 in 5 children grow up in poverty. Available data show that, for the majority of U.S. counties, child poverty rates for American Indian/Alaskan Native, black, or Hispanic children are higher than rates for white children, and these rates are often twice as high.
“The time is now to address long-standing challenges like child poverty and residential segregation,” said Julie Willems Van Dijk, PhD, RN, director of County Health Rankings & Roadmaps. “This year’s Rankings are a call to action to see how these persistent health gaps play out locally, take an honest look at their root causes, and work together to give everyone a fair shot at a healthier life.”
The Rankings website also features What Works for Health, a database of nearly 400 evidence-informed strategies to support local changemakers as they take steps toward building healthy communities. Each strategy is rated for its evidence of effectiveness and likely impact on health disparities. The Rankings’ Take Action Center and Community Coaches also provide valuable guidance for local leaders and community partners to move with data to action. Visit www.countyhealthrankings.org to learn more.
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普林斯顿,新泽西州和麦迪逊,威斯康星州——近十年来,县健康排名显示,我们居住的地方对我们的生活质量和寿命有很大影响。今年,我们的分析表明,有意义的健康差距不仅因地区而存在,而且因种族和民族而存在。这些健康差距在很大程度上受到机会差异的影响,这些机会对有色人种的影响尤为严重,例如获得优质教育、工作和安全、负担得起的住房的机会。
今年的报告显示了一些令人不安的趋势。例如,经过近十年的改善,我们看到越来越多的婴儿出生时低出生体重(2016年为8.2%,比2014年增加2%)-低出生体重是母亲和婴儿生活质量的关键指标。在全国各地都可以看到低出生体重的种族差异模式,黑人更有可能出现不良的出生结果。与白人婴儿相比,黑人婴儿出生时体重过低的可能性是白人婴儿的两倍,在一周岁前死亡的可能性是白人婴儿的两倍。
RWJF总裁兼首席执行官Richard Besser医学博士说:“如果我们继续把整个社区和人口抛在后面,我们就不可能成为一个健康、繁荣的国家。”“每个社区都应该使用他们的县健康排名数据,共同努力,找到解决方案,以便所有婴儿,儿童和成年人-无论他们的种族或民族-都有同样的机会尽可能健康。”
罗伯特·伍德·约翰逊基金会(RWJF)和威斯康辛大学人口健康研究所(UWPHI)合作的《县健康排名和路线图》对每个州的县进行了30多项健康影响因素的比较,如教育、就业和获得优质医疗保健的机会。该排名可在以下网站获得www.countyhealthrankings.org.
本报告阐明的种族和地区之间的联系之一是,种族隔离的有色人种社区更有可能被排除在促进优质学校、负担得起的住房和其他健康机会的投资之外。美国有着悠久的种族主义历史和歧视性政策和做法,这些政策和做法限制了有色人种选择居住地的机会,包括拒绝向有色人种提供住房贷款。健康状况不佳的地方与机会隔绝。几十年的研究表明,居住隔离是美国健康差距的根本原因。今年的报告显示,在种族隔离程度较高的县,黑人在儿童贫困率、婴儿死亡率和高中毕业率方面的表现要比种族隔离程度较低的县更糟糕。
贝瑟说:“作为一个致力于改善健康和福祉的组织,我们不能容忍这样的现实,即一些美国人因为居住的地方、收入的多少或肤色而没有同样的机会保持健康。”“作为一个国家,当我们为每个美国人消除机会障碍时,我们会变得更健康、更强大。”
今年的排名探讨了美国儿童和青少年中发生的重要趋势:
- 青少年生育:在青少年中,贫穷和生育有着紧密的联系。十多年来,不同社区类型和种族的青少年生育率一直在下降,最近的数据显示,美国15-19岁女性的生育率为千分之27。西班牙裔青少年的出生率改善最大,从2006年到2016年,每1000名15-19岁女性的出生率从77.7降至31.9。黑人和美洲印第安人/阿拉斯加土著青少年也看到了显著的进步。青少年出生率最高的县在西南部和东南部,以及阿巴拉契亚的部分地区,密西西比三角洲和平原地区。这些地区在过去十年中几乎没有变化,而东海岸和西海岸则有所改善。
- 贫困儿童:贫穷限制了机会,增加了健康状况不佳的机会。今天,五分之一的儿童在贫困中长大。现有数据显示,在美国大多数县,美国印第安人/阿拉斯加原住民、黑人或西班牙裔儿童的儿童贫困率高于白人儿童,而且往往是白人儿童的两倍。
“现在是解决儿童贫困和居住隔离等长期挑战的时候了,”县健康排名和路线图主任、注册护士朱莉·威廉姆斯·范戴克博士说。“今年的排名呼吁我们采取行动,了解这些持续存在的健康差距是如何在当地发挥作用的,诚实地审视其根本原因,并共同努力,让每个人都有公平的机会过上更健康的生活。”
该排名网站还提供了一个名为What Works for Health的数据库,该数据库包含了近400项循证战略,旨在支持地方变革者采取措施建设健康社区。每项战略都根据其有效性证据和对健康差距可能产生的影响进行评级。该排名的行动中心和社区教练也为地方领导人和社区合作伙伴提供了宝贵的指导,将数据转化为行动。访问www.countyhealthrankings.org了解更多。
About the Robert Wood Johnson Foundation
For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit www.ottomotal.com. Follow the Foundation on Twitter at www.ottomotal.com/twitter or on Facebook at www.ottomotal.com/facebook.
" data-isabstract="false" class="cmp-text">关于威斯康星大学人口健康研究所
的威斯康星大学人口健康研究所通过制定和评估干预措施,并在地方、州和国家各级促进以证据为基础的政策和做法,促进所有人的健康和福祉。该研究所的工作涉及促进健康的各种因素。该研究所是威斯康星-麦迪逊大学内外卫生和保健对话的协调中心,也是利益攸关方的召集人,促进学术界人士与政策和实践领域人士之间的专门知识交流。该研究所领导了县卫生排名和路线图以及RWJF卫生文化奖的工作。欲了解更多信息,请访问http://uwphi.pophealth.wisc.edu.
关于罗伯特伍德约翰逊基金会
40多年来,罗伯特·伍德·约翰逊基金会一直致力于改善健康和医疗保健。我们正在与其他国家合作,建立一种全国性的健康文化,使每个美国人都能活得更长、更健康。欲了解更多信息,请访问www.ottomotal.com.在Twitter上关注基金会www.ottomotal.com/twitter或者在Facebook上www.ottomotal.com/facebook.
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