The 2012 Virginia Rural Health Action Conference presentation summarized key findings from Virginia's 2012 Health Equity Report. The report found health inequities between racial groups in mortality, life expectancy, HIV, and infant outcomes. These inequities are linked to social determinants of health like socioeconomic status, discrimination, education, and neighborhood conditions. The report introduced the Health Opportunity Index to measure access to health-promoting social conditions and made recommendations to promote health equity, such as improving access to affordable housing, jobs, and environmental health.

1. 2012 Virginia Rural Health
Action Conference
Michael O. Royster, MD, MPH, FACPM
Office of Minority Health and Health Equity
Virginia Department of Health

2. 2012 Virginia Health Equity Report
• Introduction
• Background on health equity and
SDOH; definitions
• Social Determinants & Health Inequities
• SES, neighborhood, discrimination
• Mortality, Life Expectancy
• HIV, Infant Mortality & LBW
• New Features of the Report
• Cost of Health Inequities
• Health Opportunity Index
• Key Recommendations
• Resources & References
http://www.vdh.virginia.gov/healthpolicy/2012report.htm

4. Association Between Food Security and
Health, Virginia, 2008
Source: Behavioral Risk Factor Surveillance System, Virginia, 2008.

5. Association Between Self-Reported
Discrimination and Health, Virginia, 2008
Overall Health Mental Health
Source: Behavioral Risk Factor Surveillance System, Virginia, 2008.

6. 16 Virginia Trends in Low Birth Weight Infants by
Race/Ethnicity, 1999-2009
14
Perent of low birth weight live births
12
10
8
6
4
2
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Non-Hispanic White Non-Hispanic Black Hispanic
Source: Virginia Department of Health, Office of Family Health Services, 2009

7. Source: VDH Division of Health Statistics

8. Source: VDH Division of Health Statistics

9. Health Opportunity Index
Indicator Meaning
Affordability Housing & transportation costs relative to income
Education Enrollment & Attainment
Job Participation Percent of 16-64 yo. employed or looking for work
Townsend Deprivation Percent unemployed; no car; rental; crowding
Income Diversity Diversity of incomes
Racial Diversity Diversity of races
EPA air toxics Cancer risk, respiratory risk and neurological risk
Local Commute of Workers Ratio of in to outflow of workforce
Population Churning In & out migration relative to total population
Population Density Control for population concentration

10. Distribution of the HOI by Race, Virginia, 2009
Virginia
% of Population by Race and Statewide in
Health Opportunity Areas (Quintiles)
2009
40.0
35.0 34.1 %
30.0 27.6 %
26.3 %
24.2 %
25.0 22.5 % 23.0 % 23.3 % 23.0 % 23.1 %
21.1 % 21.1 % 21.4 %
19.6 %
20.0 18.6 %
15.4 % 15.0 %
14.5 %
15.0
10.9 %
9.2 %
10.0
6.2 %
5.0
0.0
Low Health Opportunity 2nd Middle 4th High Health Opportunity
Index Score % Statewide % White % Black % Asian Index Score

11. Health Opportunity in Virginia, 2009

14. Five Health Risks: Heart Disease, Cancer, Stroke, Injuries, Low Birth Weight

15. Recommendations to Promote
Health Equity
1. Raise awareness of the importance of SDOH and their
distribution as root causes of health disparities/inequities
2. Engage communities and build social capital by using
community-based participatory approaches to advance health
equity
3. Conduct health impact assessments to inform public policy
makers about the impacts of their decisions on health equity
4. Enhance access to health opportunity neighborhoods for low
income and racial/ethnic minority families and children in
Virginia
5. Improve educational attainment for all Virginians
6. Address affordability of housing and transportation
1.Assure equitable access to multiple affordable transit
options
2.Assure availability of stable, affordable and quality
housing
7. Enhance job skills and increase access to jobs that match skill
levels of neighborhood residents
8. Reduce disproportionate exposure to environmental air toxins
in low income and racial/ethnic minority neighborhoods
9. Develop policies, programs, and practices within
organizations and communities that support racial,
economic, and gender equality
10. Reduce income inequality; encourage livable wages and
benefits
11. Enhance food security
12. Evaluate the impact of public, health, and social policies and
practices on health equity
http://minorityhealth.hhs.gov/npa/ http://www.vdh.virginia.gov/healthpolicy/2012report.htm