The Louisville Metro Department of Public Health and Wellness released its 2017 Health Equity Report on Thursday, examining the root causes of disproportionately poor health outcomes in west Louisville among black residents and recommendations to combat those trends.

The health department’s Center for Health Equity produced the detailed 168-page report that measures health outcomes by race, age, gender and geographic area from 2011 to 2015, which it bills as “a tool for policy makers and residents to better understand how they can create more equitable policies and practices.”

“Health equity is everybody’s work,” said Center for Health Equity director Dr. Brandy Kelly Pryor in a press release announcing the new report. “We want policy makers, businesses leaders, government officials, physicians, schools, civic and nonprofit organizations and residents to use the report to create equitable policies and practices so that everyone can thrive and our entire city can become healthier.”

The report reviewed 21 health outcomes and examined 11 root causes for those outcomes among groups, such as income, housing, education, environmental quality and access to transportation and food systems. The three top causes of death in Louisville during this time frame were cancer, heart disease and Chronic Obstructive Pulmonary Disease — all of which are smoking related.

Black residents and the West End of the city, which is majority black, fared much worse in several health outcomes, with the average life expectancy in this area being roughly 70 years — compared to large swaths of the eastern and mostly white areas of Jefferson County, where the life expectancy was up to 10 years longer.

This racial and geographic disparity in health outcomes was particularly striking among children, with black and West End children having much higher rates of lead poisoning and STDs, and an infant mortality rate that was nearly double the city’s average. Black kids aged 10 years old or younger were also twice as likely to be admitted to a hospital for an asthma-related problem, particularly in the Rubbertown area of the west that features notoriously polluting industries.

White men were found to have the highest suicide rate — nearly double the city average — while also having a significantly higher rate of death related to drug and alcohol use. Most of the homicides in Louisville were clustered in the West End over this period, with black men being murdered at a rate that was 5.5 times higher than the city average.

From the 2017 Louisville Metro Health Equity Report

“We want to make Louisville a healthier city overall, and in order to do that, we have to make it a more equitable city,” said Mayor Greg Fischer in the press release. “These reports have shown us that factors such as your income, your ZIP code, your race and your education level profoundly influence how healthy you will be. We need to fully understand these factors to create data-driven approaches for addressing the obstacles that stand in the way of improving health for all.”

Below are the nine recommendations of the report to improve health equity and outcomes, and a copy of the full 2017 report.

  1. Interventions must happen at multiple levels — individual, interpersonal, organizational, community and policy — to have the biggest impact on health.
  2. Increase and improve systems for data collection, data sharing and data analysis across all outcomes. As Louisville Metro we need to examine where data is missing, and for what groups the data does not exist. When possible, break data down by various groups to get a better picture of who is most impacted.
  3. Expand access to healthy foods by examining our policies and practices for areas of innovation.
  4. Promote policies and development that protect and improve our environmental quality.
  5. Build our health infrastructure to ensure that all persons are able to easily receive preventative medical services as well as treatment for mental health, trauma and substance use disorder.
  6. Expand access to healthy foods by examining our policies and practices for areas of innovation.
  7. Continue to examine our criminal justice system for opportunities for improvement and changes that will support the creation of a thriving community.
  8. Support our youngest community members by preventing or mitigating the effects of trauma and adverse childhood experiences.
  9. Create opportunities for all communities to thrive with access to parks, businesses, and community organizations.

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