King County recently launched a Health Disparities Dashboard on the Communities Count website. This new information tool uses color and spacing to display the magnitude of race/ethnicity differences on 50+ indicators of health and well-being in King County.
Rate Ratio display on Disparities Dashboard
By clicking on tabs at the top of the visualization, users can see race/ethnicity comparisons in colored-coded bar charts or as colored-dot rate ratios. The rate- ratio display represents disparities for communities of color as multipliers of a standard reference group (users can select “whites” or “King County average” as the reference group).
For some indicators, users can choose to filter disparities data by gender. And on both kinds of charts, hovering above a bar (or dot) brings up an information-rich tool tip.
Doing a simple visual scan of the rate-ratios display enables users to quickly identify indicators with the largest disparities. In the 2012-2016 period, the following indicators showed at least a 10-fold difference between people of color compared to whites:
Tuberculosis incidence: Compared to the white rate, the Asian rate was 34.1 times greater, the African American rate was 31.6 times greater, the native Hawaiian/Pacific Islander rate was 28.6 times greater, and the American Indian/Alaska Native rate was 27 times greater.
Homicide deaths: The African American rate was 10.7 times the white rate.
Teen births: The American Indian/Alaska Native rate was 10.5 times the white rate.
Opioid-related deaths and drug-related deaths: For both, the white rates were 10 times the rates for Asians.
TEEN BIRTH DETAILS
Bar chart
For teen births, the bar chart above shows that from 2012 to 2016 the average rate of teen births in King County ranged from 1 birth per 1,000 Asian females age 15-17 to 18.2 births per 1,000 American Indian/Alaska Native (AIAN) females age 15-17.
Selecting whites as the comparison group, the rate-ratio chart below sets the value for whites (dark vertical line) at 1.0; the values for all other groups are shown as multiples of the rate for whites.
Rate-ratio chart
In this display, the birth rate for Asian teens (turquoise dot) appears to the left of the dark vertical line; hovering above the dot reveals that the Asian teen birth rate is 6/10s of the rate for white teens. The birth rate for American Indian/Alaska Native teens (orange dot) is shown here as 10.5 times the rate for white teens.
HOMICIDES: DIGGING DEEPER
The disparities tool can also be used to follow up on intriguing findings. For example, the substantial racial disparity for homicide might lead to the question, “Are the racial disparities for homicide mirrored in the data on suicide?”
The answer is a resounding “no.” While African Americans are almost 11 times more likely than whites to die of homicide in King County, the African American suicide rate is half the rate for whites.
These differences are even more dramatic when looking only at data on males: While African American males are only 40% as likely as white males to die of suicide, they are 14.4 times more likely than white males to die from homicide. [NOTE: If rate ratios are equal, the dots will overlap. If you can’t see the dot for one group, click on the missing race in the legend and select “keep only” -- all the other dots will disappear.]
EXPLORING DISPARITIES IN A SINGLE POPULATION: FOCUS ON HISPANICS
What if you want to explore disparities for a specific population? This section describes how to use the tool with a focus on results for Hispanics.
To see a quick overview of all disparities, select the Rate Ratios tab; if you don’t want the comparison group to include data from Hispanics, select the “white” group.
Data for Hispanics are shown in rose-colored dots, so to find indicators where Hispanics fall at the highest or lowest ends of a distribution, look for rose-colored dots at the extreme right or left side of the line of dots next to each indicator name. For example, in the first category -- demographic data from the American Community Survey (ACS) -- the rose-colored dot for adults with “less than high school” education is way over to the right.
Hover the cursor over the dot to see a tool tip which shows that 28.9% of Hispanic adults in King County have less than a high school education. If you select whites as the comparison group, you see a rate ratio of 7.6, meaning that Hispanics are 7.6 times more likely than whites to have less than a high school education. If you select the King County average for comparison, the rate ratio changes to 3.8, indicating that Hispanic adults are only 3.8 times more likely than the average of all King County adults to have less than a high school education. This makes sense since the King County average includes data from Hispanic adults.
The rose-colored dot is also at the far right for “Uninsured,” the last indicator in the ACS category. Hovering over that dot – and toggling between the “white” and “KC average” comparison groups – reveals that 27.7% of Hispanic adults in King County are without health insurance, which is 5.4 times the rate for whites and 3.5 times the King County average.
Scrolling down to the BRFSS category (data from the Behavioral Risk Factor Surveillance System), you see that Hispanics were more than twice as likely as whites – and the King County average – to report that in the past year they needed to see a doctor but could not do so because of cost. Hispanics were also at least twice as likely as those in comparison groups to report their health as “fair” or “poor.”
The disparities tool also displays good news about the health of Hispanics: Of all race/ethnicity groups in King County, Hispanics have the lowest overall death rates for lung cancer, colorectal cancer, suicide, and chronic lower respiratory diseases. There’s even better news about Hispanic women, who have the lowest death rates from breast cancer, lung cancer, and all cancers; infectious/parasitic disease; primary hypertension; and suicide. They also have the lowest rates of death related to diabetes and use of opioids. Finally, Latinas and Asian women are tied – at 87.8 years -- for the longest life expectancy in King County.
As data are updated in the future, the dashboard may expand to include more indicators.
***
For detailed visualizations of the indicators in the Disparities Dashboard, see Community Health Indicators. Most visualizations include trends, maps, and multiple demographic and geographic breakdowns.
Communities Count offers visualizations, with interpretive narrative, on: Income, Housing Affordability for Renters and Owners, Adult Smoking, Physical Activity, Obesity, and Infant Mortality.