Draft MTP/SCS Comments Received - sacog

EQUITY
METRIC: EQUITY
f. Measure and stratify all indicators by race/ethnicity; income; geography (neighborhood,
census block or tract, or Community of Concern); age; disability.
EVIDENCE BASE
Health Impacts
Neighborhoods are shaped by specific policies that guide development and, consequently, individual
well-being. cclxvi A growing body of research demonstrates a strong relationship between health and
the environments in which people live. The disproportionately high rates of heart disease, asthma,
diabetes, and other chronic diseases among residents living in high-poverty neighborhoods – often
disproportionately residents of color cclxvii – can be linked to many aspects of the built environment,
including access to healthy foods and physical activity, quality affordable housing, and transportation
options. Such cumulative inequities can have dire health outcomes. For example, African American
children growing up in high-poverty urban neighborhoods (such as Harlem or Chicago’s South Side)
are more likely to die or become disabled far before reaching old age; in these neighborhoods, onethird
of African American girls and two-thirds of boys who reach their fifteenth birthdays do not live
to celebrate their sixty-fifth. cclxviii cclxix In comparison, only 10 percent of girls and about 25 percent of
boys nationwide fail to live to age sixty-five. cclxx
Alameda County is an example of an area of California with large differences in placed-based health
outcomes. A recent report by the Alameda Department of Public Health highlighted the ways
inequities clustered in certain neighborhoods over time. cclxxi Through their research they found:
Compared with a White child in the Oakland Hills, an African American born in West Oakland
is 1.5 times more likely to be born premature or low birth weight and seven times more likely to
be born into poverty.
As a toddler, this child is 2.5 times more likely to be behind in vaccinations. By fourth grade, this
child is four times less likely to read at grade level and is likely to live in a neighborhood with
twice the concentration of liquor stores and more fast food outlets.
As an adult, he or she will be five times more likely to be hospitalized for diabetes, twice as likely
to be hospitalized for and to die of heart disease, and twice as likely to die of cancer. This person
can also expect to die almost 15 years earlier than a White person born in the Oakland Hills.
West Oakland residents also breathe air that contains three times more diesel particles than in
the rest of the Bay area.
Alameda County households earning less than $20,000 per year spend over half of their income
on transportation.
The United States spends more than any other nation in the world on health care. cclxxii Yet despite
consistent increases in spending, health disparities among different demographic groups persist.
David Satcher, former Surgeon General of the United States, stated that “Although critical to
eliminating disparities, access [to health care] only accounts for 15 to 20 percent of the variation in
morbidity and mortality that we see in different populations in this country.” cclxxiii In order to address
the root causes that account for the other 80 to 85 percent of poor health, we must look beyond
health care and health insurance and towards the policies that affect where we live, how we get to
work, what we eat and the air we breath.
Because each of the proposed Health & Equity metrics has the potential to affect various
populations differently, and often disproportionate burdens accumulate in low-income populations
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