By Aubrey Hill – Infographic by Sarah Mapes
February is African American History month. In addition, 2013 marks the 150th anniversary of the Emancipation Proclamation and the 50th anniversary of the Rev. Martin Luther King, Jr.’s historic “I Have a Dream” speech. These milestones create the opportunity for us reflect on the health experiences of African Americans in Colorado.
Recently, we have seen a growing dialogue about the disparities faced by racial and ethnic minorities in income, education and other social factors. “Losing Ground,” the series by Colorado Public Radio and I-News, highlighted how the gap in wages has grown from when African Americans earned 73 cents on the dollar compared to white Coloradans in the 1970s, to only 60 cents on the dollar in 2010. Meanwhile, at the legislature, a great discussion occurred last week in the House Health, Insurance and Environment Committee about the significant impact of social factors on health status.
Understanding how these social factors affect a population’s health and how different groups face different challenges when it comes to achieving optimal health is critical to this conversation.
The Colorado Coalition for the Medically Underserved released a series of issue briefs last year that explain how intricately connected these factors are — those with lower incomes, lower levels of education and less access to care, to name a few factors, are also less likely to be in good health. I
n 2011, over a quarter of African Americans in Colorado lived in poverty, compared to only 13 percent of the overall Colorado population. We also know that nearly 11 percent of African Americans in the state are unemployed, compared to just over 6 percent of all Coloradans. Thus, it is not surprising that African Americans are also more likely to be in fair or poor health.
Chronic disease especially affects the African American community. African Americans in Colorado are 1.2 times more likely to have asthma and 1.8 times more likely to have diabetes than the overall population. Whites who are living with diabetes in Colorado have a mortality rate of 13.9 per 100,000 residents, while African Americans who are living with diabetes in Colorado have a mortality rate of 35.5 per 100,000 residents. That’s more than 2.5 times as many African Americans as whites dying from diabetes in our state. Cancer, another chronic disease, is a leading cause of death among African Americans, and the mortality rate is also much higher than the state average.
Interestingly, health insurance does not appear to be a significant factor in these differences. The data indicate that there is no statistically significant difference in the percentage of African Americans that have health insurance as compared to the percentage of the total population that is insured. Both groups have nearly 85 percent coverage rates. While we know that not having health insurance can have a profound impact on a population’s health, in the case of African Americans in Colorado, it appears that other social determinants of health are more responsible for these differences.
Good work is underway across the state. A bill is moving through the legislature to change the name of the Office of Health Disparities to the Office of Health Equity, both to reflect the goals of the state and to raise awareness among legislators about the importance of social factors in a person’s health. Community-based organizations like the Center for African American Health are also working within the African American community to reduce chronic diseases through screening and education initiatives. Colorado HealthStory has traveled the state capturing and sharing the health stories of everyday Coloradans, and the stories they have collected from African Americans are helping to start a conversation about their experiences.
Our state has frequently been applauded for our leadership in health care, with our expansions of coverage and improvements to the health care system. Being a leader, however, means the state can’t merely forge ahead toward the goal, but must not leave anyone behind along the way. It means you do what is best for the whole group and involve everyone in the work and in the success. It means you reflect on what has been successful and where gaps still remain that must be addressed.
It is clear from the data that African Americans face increased obstacles to a healthy life; to achieve a healthier Colorado, we must raise the collective awareness in our state of the challenges individuals from racial and ethnic minority groups face, and tackle them with the same fervor and leadership we have other health issues.
Aubrey Hill is directory of health systems change for the Colorado Coalition for the Medically Underserved.
Sarah Mapes is communications director for the Colorado Coalition for the Medically Underserved.