The 2017 Louisville Health Equity report was released on November 30. The detailed 168-page report is designed as a tool for policy makers and residents to better understand how they can create more equitable policies and practices. The study looks at health-related factors like suicide, mental health, asthma, housing, drug and alcohol use and homicides in the Louisville region.
Health equity means that everyone has a fair and just opportunity to be healthy and reach their full human potential. Meaning, a person’s identities, whatever they may be, should not predict how long or how well one will live. This requires creating systems and policies where environments, economics and government work for everyone.
Mayor Greg Fischer praised the Center for Health Equity for its work on the Louisville Metro Health Equity Report 2017, which builds on reports released in 2011 and in 2014 by including root causes for inequitable health outcomes in our community.
Fisher said this is the most comprehensive report the Metro has ever released on health equity. He added, “Louisville is the first city in the United States to have created a health equity center in a municipal government. This report is being used across the nation as a model.
“We want to make Louisville a healthier city overall, and to do that, we have to make it a more equitable city,” the Mayor said. “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.”
Fisher continued, “The report offers an unvarnished look at health equity in our city so we can see gaps and weaknesses, as well as points of opportunity. The report provides guideposts on how Louisville can become a healthier city, as well as a more equitable city.”
It reviews 21 health outcomes such as infant mortality, homicide and heart disease, and examines 11 root causes for those outcomes, ranging from food systems to neighborhood development. These health outcomes are arranged in the order of the life course, from infancy through old age.
“Health equity is everybody’s work. 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,” said Brandy Kelly Pryor, PhD., director of the Louisville Metro Center for Health Equity.
Also new to this report are evidence-based best practices assembled from comprehensive research programs which have assessed and evaluated many policies and programs. The goal is to recommend evidence-based actions which have proven to make a difference for health.
The most alarming discrepancy was in life expectancy for people living in different ends of town. The life expectancy for Louisville Metro is 76.8, but some areas, especially the West End, have a 12.6 year difference in life expectancy.
Another issue that stands out in the report was the number of deaths directly attributable to diabetes. Geographically, the downtown area has the highest rates of death due to diabetes. Black men are dying at rates almost two times higher than the rate for Louisville Metro. Men generally had rates that were 1.75 times higher than women, per the report.
The report makes several evidenced-based suggestions to reduce diabetes in Louisville. For example, on the public policy level, we should continue to ensure that Medicaid, Medicare and private health insurance cover screenings and preventive healthcare services, especially those that support diabetes education and disease management. Additionally, we should also promote zoning policies that encourage mixed use development and create places that encourage physical activity. On an organizational level, we can encourage worksites, faith-based and community groups organize and support diabetes education and support programs for their members.
Improving Health Equity
Below are the nine recommendations of the report to improve health equity and outcomes:
- Interventions must happen at multiple levels – individual, interpersonal, organizational, community and policy- to have the biggest impact on health.
- 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.
- Ensure more opportunities for wealth-building, education, and employment in our community for those that need it most.
- Promote policies and development that protect and improve our environmental quality.
- 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.
- Expand access to healthy foods by examining our policies and practices for areas of innovation.
- Continue to examine our criminal justice system for opportunities for improvement and changes that will support the creation of a thriving community.
- Support our youngest community members by preventing or mitigating the effects of trauma and adverse childhood experiences.
- Create opportunities for all communities to thrive with access to parks, businesses, and community organizations.
Health Equity Report
Hard copies of the report can be found at each of the Louisville Free Public Libraries and also can be found online at https://louisvilleky.gov/ government/center-health-equity/health-equity-report.