photo by: LMH Health

Lawrence-Douglas County Public Health's 2021 health equity report was the main topic of Wednesday's LMH Health board of trustees meeting.

From 2017 to 2019, Black people’s mortality rate from diabetes in Douglas County was about four times as high as white people’s. Black infants in Douglas County are more likely than white infants to have a low birth weight. And during the COVID pandemic, Native American residents of Douglas County had a higher hospitalization rate for their share of the population than any other racial group.

Those are some of the statistics found in Lawrence-Douglas County Public Health’s latest health equity report, which was presented to LMH Health’s board of trustees on Wednesday morning. Health department Director Dan Partridge and Director of Informatics Sonia Jordan briefed the trustees on the data, and they said that to fix these kinds of problems, the community would have to look at social policy issues that go beyond traditional health care.

Some of those factors, which Jordan described as “unjust causes,” have to do with race and ethnicity. Others are focused on economic factors, like access to safe, affordable housing or healthy food.

“When we see those unjust causes, that’s when it becomes important to take on the work of the policy system and environment changes,” Jordan said.

The report refers to these factors as the “social determinants of health,” and some of the other ones include access to quality education and health care; economic stability; the neighborhood where someone lives; and social and community support. Jordan said these factors have also been listed by the U.S. Department of Health and Human Services in its Healthy People 2030 plan, and that they can have a striking effect on community health issues.

One example that Jordan cited was infants’ birth weight.

The health equity report shows that Black mothers in Douglas County are more likely to give birth to infants with low birth weight than mothers who identify as white, Asian or Hispanic. More than one in eight babies born to Black mothers in the county from 2015 to 2019 weighed less than 5.5 pounds.

The report suggested that the issue might have a number of root causes, including access to healthy foods, systemic racism, and mothers’ income and education. And Jordan said that because Douglas County doesn’t have a high infant mortality rate, birth weight is one of the most important indicators of how healthy young children in the community are.

“There are a lot of arguments within public health that low birth weight and infant health in general is a key indicator of a community’s health overall, because it’s really all about how that mother is able to stay healthy in pregnancy and that mother is really able to have what she needs to have a healthy pregnancy,” Jordan said. “If that mother’s in a place where she’s unable to get access to prenatal care in the first trimester, for instance, we’re going to see the effects of that.”

Another disparity outlined in the report was health outcomes for people with diabetes, which Jordan described as a “huge issue” that’s emerged in the county since its first health equity report was published in 2018. Diabetes significantly affects mortality for Black people and other people of color in Douglas County, Jordan said. According to the report, from 2017 to 2019, residents identifying as Black had a mortality rate from diabetes roughly four times higher than the diabetes mortality rate of the county’s white population.

Type II diabetes can often be prevented with lifestyle changes such as exercising more frequently and eating a healthier diet, but Jordan said things like low income, a lack of access to green spaces and parks and an inability to access healthy food can make it more difficult for people to take those steps to prevent the disease. She also said this particular statistic had gotten worse from the previous year.

“This, to me, highlights why it is important for us to do continual updating and looking at data, because this one did not raise in the last (report),” Jordan said. “It’s only been more recently, and to me this is really going to have a big effect on things like life expectancy.”

COVID-19 concerns were also on the list. Jordan said the hospitalization rate for COVID was disproportionately higher among Native Americans in Douglas County; Native Americans have been hospitalized at a rate roughly double that of most other races and ethnicities, according to the report.

The report said disparities in the COVID death rate are more difficult to assess, because Douglas County has had relatively few COVID deaths. However, the report said that 89% of the 115 people who died of COVID from March of 2021 to Jan. 10, 2022, were white.

Jordan said one of the goals of the report was to create “energy and action” spurred by the data. She pointed to a page in the report detailing some of the things the department has done so far, including pursuing health-equity-related grants for projects in the community, establishing a Health Equity Advisory Board and paying all of its staff positions at least $16.25 an hour. But she also said the work was just beginning.

“We still have a long way to go,” Jordan said. “This is not everything that we are doing, but I think for many people, you can always do more.”

One of the LMH trustees, Beth Roselyn, said the report did a good job of emphasizing a need for systemic analysis and change, and that it highlighted how systemic racism contributes to health inequity. Roselyn said that American culture is very individualistic and that can lead to blaming individuals for outcomes that are actually caused by broader, systemic problems.

“What that means, then, is as we try to improve outcomes, we have to address systemic racism,” Roselyn said.

The report is available to view in full on the health department’s website.