This document discusses the challenges of talking about health inequality on Long Island. It notes that people do not understand what health inequality is, its causes, or solutions. It presents data showing racial and ethnic disparities in premature death rates, diabetes and infant mortality in Nassau County. Segregation leads to unequal conditions in housing, environment, and resources that influence health. Achieving health equality requires addressing social factors and creating healthier living environments for all.

1. WHY IS IT SO
HARD TO TALK
ABOUT HEALTH
INEQUALITY ON
LONG ISLAND?
Martine Hackett, Ph.D., MPH
Hofstra University
School of Health Sciences & Human
Services
Department of Health Professions
Nassau County Minority Health Conference
April 7, 2014

2. It’s hard to talk about health inequality because…
People don’t know what health inequality is
People don’t know what causes health inequality
People don’t know what to do about it

3. There are significant differences in health
outcomes by race/ethnicity in Nassau County.

4. Premature Deaths in Nassau County by
race/ethnicity, 2009-2011
0%
10%
20%
30%
40%
50%
60%
70%
White Black Hispanic
27%
56%
58%
<75 years. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011
http://www.health.ny.gov/statistics/community/minority/county/index.htm

5. Diabetes Mortality in Nassau County by
race/ethnicity, 2009-2011
9.4
21.8
10.5
0
5
10
15
20
25
White Black Hispanic
Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011
http://www.health.ny.gov/statistics/community/minority/county/index.htm

6. Infant Mortality Rate Nassau County
by race/ethnicity, 2009-2011
0
2
4
6
8
10
12
14
16
White Black Hispanic
NYC Black
Infant
Mortality
Rate, 8.6
13.4
Rate per 1000 live births. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011
http://www.health.ny.gov/statistics/community/minority/county/index.htm
2.7
3.8

7. Coronary Heart Disease Mortality Nassau
County by race/ethnicity, 2009-2011
180.1
226.6
134.3
0
50
100
150
200
250
White Black Hispanic
NYC Black
coronary
disease
mortality
rate, 218.1
Rate per 100,000. Source: NYS DOH, Nassau County Health Indicators by Race/Ethnicity, 2009-2011
http://www.health.ny.gov/statistics/community/minority/county/index.htm

8. These health differences are due to behaviors,
and also where you live, your class status,
and how society treats you.

10. Spatial segregation
Source: Vital Signs, 2009

11. Spatial segregation
Source: Vital Signs, 2009

12. The relationship between place & health
• Residential segregation is the
“fundamental cause of health
disparities” (Williams & Collins, 2001)
• Built environment
• Housing hazards
• Environmental hazards
• Fewer options for healthy foods
• Lower high school graduation
rates
• Safety
• Vigilance/chronic stress

13. 11554
.9 Infant
deaths per
1,000 births
11553
11.5 Infant
deaths per
1,000 births
Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011

14. 11554
Teen pregnancy
rate=9.6
11553
Teen
pregnancy
rate=56.8
Source: NYS DOH, Nassau County Perinatal Outcomes by Zip Code 2009-2011

15. 11554
Childhood
Asthma
discharge
rate=13.711553
Childhood
Asthma
discharge
rate=53.2
Source: NYS DOH, Asthma Hospital Discharge rate per 10,000 population, Nassau County, Age 0-17,
2008-2010

16. “Those are places where there really isn’t a trash can, you throw it in
places where people don’t really care. People throw garbage where
they think it is abandoned. Maybe if there if there was someone there
cleaning it would help.”

17. “They [the delis] all serve the same thing, they don’t serve
anything fresh, like vegetables and fruit. There is really not any
other stores in the area. They’ve got a premium.” ”

18. “People dump on these sites. The contamination gets into
peoples homes and causes illnesses and genetic problems.
I worry about this.”

19. “When you say you live in Roosevelt, some people think its like
a ghetto neighborhood. Some times it really isn’t.”

20. Health equality requires a commitment to
social justice to create healthier living
environments for everyone

21. When social factors are equalized, health
disparities dissipate (LaVeist, et al., 2011)

22. Identification and awareness of the differences among
populations regarding health outcomes and health determinants
are essential steps towards reducing disparities in communities at
greatest risk. (World Health Organization, Social Determinants of Health Report, 2011)

23. Where do we go from here?

24. Making it Easier to Talk about
Health Equality
Commitment
Partnerships
Better
Health for
ALL of
Nassau
County