King County Health Disparities Dashboard, Part II
By Kirsten Wysen
This is part of a series of EQUITY BLOGS that explores the contexts of longstanding disparities in the health and well-being of King County residents. In addition to helping us understand the root causes of some disparities, the blogs show how tightly history is woven into our lives and our futures. They also acknowledge the rich variability of responses within and across groups and generations, from strength and resilience to lasting harm embedded in policy and everyday life.
In July 2019, Communities Count introduced the King County Health Disparities Dashboard. This data tool offers a new way to visualize data about health outcomes and social determinants of health by race/ethnicity. Health disparities, often called “inequities” to highlight inherent unfairness, are higher rates of serious health conditions or deaths that disproportionately affect some groups such as communities of color and low-income populations. As mentioned in the July blog, these disparities are largely rooted in inequities in the ability to access opportunities and resources needed to obtain good health, including education, employment, safe neighborhoods and access to health services. Racial health inequities are often the result of current and historical institutionalized racism or explicit racial bias. The July blog post focused on health measures and this one takes a closer look at underlying factors that shape health, such as income and employment levels and housing costs.
Why does a health dashboard include income, employment and housing indicators?
It can be important to look at housing and economic data because social determinants of health have been shown to constitute 50% of what improves health, compared to health care services which contribute about 20%. “Social determinants of health” have been defined as education, employment, health systems and services, housing, income and wealth, physical environment, public safety, social environment, and transportation. The Health Disparities Dashboard includes data for several of these dimensions of life for King County residents, including measures of jobs and housing costs.
Eligibility for subsidized services is often based upon income criteria. For a single person, 200% of the federal poverty level corresponds to about $25,000/year and for a family of three it equates to approximately $42,700/year. The Health Disparities Dashboard shows that it is more than twice as common for Black, Hispanic, American Indian/Alaska Native and Native Hawaiian/Pacific Islander residents to have low incomes than white residents in King County. The Dashboard also shows that those who identify as multiracial and residents of Asian descent are more likely to have low incomes than white residents. Given the high cost of living in King County, these income levels are below what are considered to be “living wages.” A living wage is defined to be at least $36,000 for a single person and at least $68,000 for a family of three.
The Health Disparities Dashboard shows that Whites and Asians have the lowest unemployment rates in King County, at about 5%. The unemployment rate among Hispanic residents is similar, at 6%. However, Black, American Indian/Alaska Native and Native Hawaiian/Pacific Islander residents are twice as likely to be unemployed, with rates at about 10%. Even with a job, many Black, American Indian/Alaska Native and Native Hawaiian/Pacific Islander residents have income below 200% of the poverty level. When you hover over the colored dots on the Dashboard it shows that 45% of Black, 42% of Native American and 36% of Native Hawaiian/Pacific Islanders in King County earn less than 200% of the poverty level. Communities Count has data showing that there are many times more people looking for living wage jobs than there are openings in the Supply of Living Wage Jobs indicator.
Housing costs
The Health Disparities Dashboard shows that communities of color in King County are more likely to face housing cost burdens, defined as having to spend more than 30% of their income on housing, than white residents. Roughly one-fourth (27%) of White residents pay 30% or more of their budget on housing, compared to 47% of Black, 42% of Hispanic, 38% of American Indian/Alaska Native, 37% of Native Hawaiian/Pacific Islander and 30% of Asian residents.
High rates of housing cost burden is a contributor to housing instability in communities, with impacts such as displacement, overcrowding, evictions and homelessness. Here in King County the number of homeless students has risen steadily since 2010, coinciding with the great recession and continuing with rising housing costs in the region in more recent years. During the 2016-2017 school year 8,938 students experienced homelessness in King County.
Black, Hispanic/Latino, American Indian/Alaska Native and Native Hawaiian/Pacific Islander students disproportionately experience homelessness compared to the total enrolled student population, reflecting higher rates of housing cost burden and fewer financial resources to maintain housing stability in an area with a rapidly rising cost of living. In the 2016-2017 school year, 81% of students experiencing homelessness in King County were students of color (below), yet students of color represent only 55% of the overall student population.
The King County Health Disparities Dashboard visually highlights differences by race and ethnicity, and this blog’s focus has been on the measures with the greatest differences. This kind of analysis is important since we know that indicators where people of color fare worse than white people can be reflections of underlying policies and systems that create disproportionate hardship for people of color and systematic benefits for white people. But data in the Dashboard provides evidence of communities’ strength and resilience as well as inequities. In some instances people of color fare better than whites, on outcomes like suicide, Alzheimer’s and drug and alcohol-use. White, Asian, Black, and Native Hawaiian/Pacific Islander county residents die of the flu or pneumonia at similar rates, and many types of cancers have similar frequencies among different racial groups. Individuals, families and communities across King County do their best to thrive and lead healthy lives. The Disparities Dashboard highlights our differences but it also reveals our similarities.
The Seattle Foundation and King County’s healthy community partnership, Communities of Opportunity, aims to eliminate inequities by race and by place in employment, health, housing, income and wealth, and social environments—an important set of social determinants. For example, last summer ground was broken on a mixed-use housing development near the Othello light rail station in Seattle. This community-led project, supported by Communities of Opportunity and other funders, will create affordable housing and space for local businesses and non-profit organizations. See what else Communities of Opportunity is working on at www.coopartnerships.org.
This blog post was sponsored by Communities of Opportunity.