Health

The Health Subcommittee of the West Palm Beach Mayor’s Task Force on Racial & Ethnic Equality is in the process of identifying health-related racial and ethnic disparities in West Palm Beach.

Committee members are identifying best practices, knowledge and research needed to eliminate the disparities before making recommendations for change.

We recognize that YOU have knowledge to share about health and wellness in West Palm Beach. Members of this committee are listening!

Draft Priorities

At the December 5th Racial & Ethnic Equality Action Summit held by the Task Force, West Palm Beach residents shared two top priorities regarding Health. The subcommittee is currently discussing these priorities:

  1. Improving access to and education about healthcare services and wellbeing resources
    • Determine policies to increase access to healthcare services
    • Determine opportunities to increase access to healthy, affordable food options
    • Explore ways to improve education about proactive and preventative health and resources
  2. Addressing unequal distribution of information and building trust between marginalized communities and health institutions
    • Identify community partners for information-sharing
    • Develop strategies for addressing historical mistrust, cultural differences, and other barriers from marginalized communities

The Health subcommittee meets monthly on the 1st Tuesday of the month from 5:30 pm – 7 pm. The next meeting is March 2, 2021. 

Sign up for updates about the subcommittee meetings (and Zoom links) and/or for our monthly Task Force email newsletter. Share comments about these priorities on our Facebook page.

We update this page regularly. Last updated 2/5/2021.

Did You Know?

  • In Palm Beach County, the infant mortality rate for African Americans is more than twice as rate for white non-Hispanics.
  • A 2020 Commonwealth Fund analysis ranks Florida’s health system among the worst in the nation. In 2018, Florida had more than a 5% disparity in uninsured rates between white adults and black and Hispanic adults. Florida’s lowest scores were for access and affordability and prevention and treatment.
  • Coronavirus is twice as rampant among blacks and Latinos in Florida than it is among white people, a Palm Beach Post analysis of internal Health Department testing data shows.

African-American neighborhood in West Palm Beach have an average life expectancy of 67 years. In Jupiter, near the beach, the white population has a life expectancy of 90 years.

Why Does Racial Equity Matter?

By 2044, people of color will become the majority in the U.S., and yet these communities continue to disproportionately experience poor health, chronic disease, lower wages, disinvested neighborhoods, and limited access to educational, health and employment opportunities.

1. Poverty and unemployment take a big toll on the health of people of color.

People of color, and especially African Americans, face health risks rooted in centuries of racial discrimination that have limited access to jobs, healthy food, safe neighborhoods, home ownership, and good schools, among other things. Claiming health as only an individual’s responsibility distracts from the fact that our lives are shaped by structural forces, too.

Health researchers have been paying closer attention to the social determinants of health. Research by the University of Wisconsin Population Health Institute (2016) has found that over 40% of the factors that contribute to the length and quality of a person’s life are social and economic; another 30% are health-related behaviors directly shaped by socioeconomic factors.

For most working-age people, employment is their predominant source of income. Studies show a strong association between unemployment or lack of sufficient income and physical and mental illness, drug addiction, and suicide.

Children who grow up in poverty have a greater risk of starting school behind their peers and scoring lower on achievement tests. They are more likely to end up unemployed or to earn less as adults. And when they grow up, they are more likely to have to cope with poor health. Due to lower economic productivity and increased costs of health care and other social services, child poverty alone costs an estimated $1 trillion per year to the U.S. economy.

A 2020 Commonwealth Fund analysis ranks Florida’s health system among the worst in the nation. In 2018, Florida had more than a 5% disparity in uninsured rates between white adults and black and Hispanic adults. Florida’s lowest scores were for access and affordability and prevention and treatment.

In West Palm Beach:

  • 17% of African Americans and black immigrants are unemployed, compared to 3% of whites (and 5% of white and Latino immigrants) and 6% of U.S.-born Latinos.
  • 42% of African American residents live below the poverty line.
  • 40% of black immigrants live below the poverty line.
  • 25% of Latino residents and immigrant Latinos live below below the poverty line.
  • 18% of Asian residents live below the poverty line.
  • 12% of White residents live below the poverty line.

Workers in West Palm Beach may work full-time and still struggle to pay their bills, with little or no money to invest in the future. When workers earn low wages they may find it extremely difficult to find affordable childcare, and thus experience greater family instability and worse health than higher-wage workers.

2. Lack of access to health information and services for the uninsured/underinsured.

According to Tanya Young Williams, an African American resident of Delray Beach and co-owner and CEO of an addiction-treatment center in the West Palm Beach area, very few African Americans approach her for help. The people of color who do reach out to her for treatment are uninformed and unaware that there is support available to them, she says.

According to a 2018 National Survey on Drug Use and Health, 6.9% of African Americans have a substance use disorder, a number nearly equal to the 7.4% of the total population purported to have this disorder. The opiode crisis has hit African Americans in West Palm Beach particularly hard.

According to Dr. Karl Michel, a board member of the Thomas Leroy Jefferson Medical Society in Palm Beach Gardens, many African American communities lack access to information like where they can get treatment if uninsured or what opioids do to those prescribed for chronic pain. Williams agrees.

In West Palm Beach, 65% of Hispanics and 29% of African Americans ages 26-34 years old lack health insurance, compared to only 18% of non-Hispanic whites. (Source: American Community Survey, 2019)

3. Decades of disinvestment and legacies of racial segregation have negatively impacted black and Hispanic neighborhoods.

Today, too many people do not have the opportunity to be healthy because they live in places that make choosing healthy behaviors extremely challenging: they lack access to healthy foods and places that make physical activity easy and are exposed to environmental toxins. A building or project’s impact extends beyond its physical walls. Some neighborhoods or real estate developments offer little opportunities for building social ties and connections and/or lack easy access to important sites, like parks and playgrounds, job centers, libraries, schools, grocery stores, etc.

One recent study of Palm Beach residents examined the relationship between race and access to the ocean. Professor Howard Ernst, a Seiden-Levi Fellow at the Eisenhower Institute, pointed to the fact that the most of Palm Beach Spring’s minority residents live well outside walking distance to the ocean, in part because of lack of available parking.

Student Micaylah Bowers, who worked on the research project, notes that many residents are severely restricted by barriers put in place by gated communities where most residents are wealthy and white. The researchers also discovered that public parking access funnels minority beachgoers into places with the lowest water quality. This is an example of environmental racism.

Finally, the study found that the clear water of incoming tides attracts crowds of mostly white snorkelers that push out minority residents. Read more.

4. Limited or no access to the Internet is cutting low-income individuals from telehealth options.

Some healthcare organizations are using telehealth to fill the care gap caused by COVID-19 limitations, but access to reliable broadband is not something every resident can afford. In early 2020, the American Health Association and  American Medical Informatics Association (AMIA) asked the Federal Communications Commission to consider broadband and digital health access a social determinant of health.

According to AMIA president and CEODouglas B. Fridsma, MD, PhD, FACP, FACMI: “Race, ethnic, and age disparities in patient portal use and readiness and preferences for using digital communication for health-related purposes have shown to be significant, and this, in turn, reduces their ability to participate in many new and exciting mHealth solutions.”

5. Racial disparities specific to certain groups are not well documented or tracked.

In terms of health disparities, research often focuses on major demographic characteristics like race and ethnicity. The United States comprises a diverse ethnic/racial population, which is typically categorized into five distinct groups: African Americans/Blacks, Latinos/Hispanics, American Indians/Alaska Natives, Asian Americans/Native Hawaiians/Pacific Islanders, and Whites. Despite these broad categories, however, significant variation exists in the histories and experiences within each of those ethnic/racial groups, all of which can influence health outcomes as well as risk factors for poor health and well-being.

The inequities in health outcomes that persist in American society do not show up just at the level of broad racial categories but as disparities experienced by more specific groups. When Afro-Latinos make the case to be recognized, not obscured within a much larger, undifferentiated Hispanic category, they are seeking information about their own community and also to be a more visible part of the American fabric. When members of individual Hispanic groups, or refugees from Central America, seek to be counted and have their life circumstances documented, theirs is a call for visibility and full inclusion as well.

What Do Experts Recommend To “Close The Gap”?

1. Engage anchor institutions, public service providers and other community partners as advocates for health equity.

Populations rely on community partners that will advocate for health equity and “support for the public good,” with a focus on addressing racial disparities. For instance, neighborhoods that are filled with trash need more support from public sanitation departments. Examples of partners include the housing department working with homeless patients or health navigators helping a population’s surplus of single mothers. Partnerships with other sectors, community leaders, and advocates can help communities work together to identify common goals, align strategies, and identify opportunities for future engagement. These initiatives can develop trust through long -term involvement with community residents, leaders, and stakeholders.

CASE STUDY: In Palm Beach County, for example, the Palm Health Foundation engaged the Racial Equity Institute (REI) of Greensboro, NC for two-day workshops. They sponsored residents to participate alongside the foundation, and its partners helped to develop a shared language and a clearer understanding of how institutions and systems produce unjust and inequitable outcomes, making them better equipped to begin to work for change. In addition to the work at a community level, the foundation realized it had to take a careful look at all aspects of their work and activities with an equity lens. First steps included convening an ad hoc equity committee comprised of board members, staff and community members to help the foundation formalize its commitment to health equity.

2. Conduct a community health needs assessment.

Racial and ethnic health disparities and inequities can only be eliminated if there is an effort to identify where disparities exist. A community health needs assessment can also pinpoint the assets and gifts within communities, because these may hold solutions to complex health challenges.Identifying the problems, and their underlying social determinants, as well as local assets, can help guide the design and application of culturally specific medical and public health approaches.

3. Invest in supportive housing.

Hospitals treating a large homeless patient population can forge partnerships with housing departments to help drive housing in the community. Housing development partners can help place individuals who are homeless in houses and offer support that will help individuals maintain that housing.

“Access to safe, quality, affordable housing – and the supports necessary to maintain that housing – constitute one of the most basic and powerful social determinants of health,” wrote the Corporation for Supportive Housing (CSH) in a 2014 white paper. Supp

“Supportive Housing, an evidence-based practice that combines permanent affordable housing with comprehensive and flexible support services, is increasingly recognized as a cost-effective health intervention for homeless and other extremely vulnerable populations,” CSH wrote.

4. Track more detailed health data in order to discover where racial/ethnic disparities exist.

When data is too broad and generalized, policymakers and community leaders may fail to realize the significant variation that exists within those broad categories, which the ability to target resources where they are most needed: the communities experiencing disparities. Experts recommend tracking data beyond simply the level of broad racial categories.

In West Palm Beach, for instance, if health data only encompasses category of “Hispanic,” it hides disparities between Cuban and Puerto Rican communities, for instance, and disparities between Spanish-speakers and indigenous Latin American immigrants who do not speak Spanish or English. If the category Hispanic is not broken down by race, it can hide disparities that exist betweeen white and black Hispanics, too.

Note these racial and ethnic disparities among the working poor in West Palm Beach:

  • 23% of all African American workers work full-time have a family income below 200% of the poverty level, compared to only 6% of all white workers. Yet even greater numbers of black immigrants — 27% are among the working poor.
  • Among Latinos in West Palm Beach, 14% are among the working poor. For Latino immigrants, the number more than doubles, to 29%.

5. Address racial bias within the healthcare system.

The attitudes and behaviors of health care providers have been identified as one of many factors that contribute to health disparities. Implicit attitudes are thoughts and feelings that often exist outside of conscious awareness, and thus are difficult to consciously acknowledge and control. 

A 2015 study published in the American Journal of Public Health found that most health care providers appear to have implicit bias in terms of positive attitudes toward whites and negative attitudes toward people of color.

Major Support Organizations

Leading organizations that strive to advance new state and local policies.

National Collaborative for Healthy Equity
NCHE’s goal is to undo the health consequences of racism, particularly its less visible – but more insidious – structural manifestations, such as the heavy concentration of health risks in communities of color. NCHE’s believes its 3 pillars addresses these structural issues in order to bring about necessary changes in achieving health equity. These include: (1) Racial Healing – Dismantling the belief in racial hierarchy and its harmful consequences; (2) Research & Data-Driven Policy, and Practices; and (3) Leadership for Health Equity.

Research Resources

Online resources focused on new state and local policies.

Building a Movement, Transforming Institutions: A Guide for Public Health Professionals (PolicyLink)
PolicyLink convened leaders in the field of public health field to learn, connect, and strategize with one another about how health equity can be advanced. PolicyLink interviewed them and documented their evolution and activities, seeing in them the emergence of a movement for positive change in the field. Their ideas and actions have informed this document, which is intended to advance this work. The opening section is an account of why it will be important to institutionalize equity in public health practice and what its early advocates have learned about how to bring that about. The second part of the document is a guide to the growing array of resources in the field, designed for easy access to materials on the Internet.

Racial Equity Resource Guide – Family & Education
These resources on racial equity include journal entries, books, magazines, videos and more.

Articles and Publications

Articles, reports, and papers focused on new state and local policies.

Counting a Diverse Nation: Disaggregating Data on Race and Ethnicity to Advance a Culture of Health (PolicyLink)
The Robert Wood Johnson Foundation commissioned a multiphase process that first aimed to level-set across ethnic/racial populations in terms of what is known and then sought to identify needs, gaps, and next steps for the field. The project brought together a diverse set of experts, demographers, practitioners, decision makers, and advocates to encourage leaders across sectors and ethnic/racial groups to talk to and work with each other. This report represents the culmination of those activities and the Foundation’s first step toward identifying solutions for improving ethnic/racial data disaggregation with the aim of promoting health equity in our nation.

Disrupting Narratives and Shifting Frames: Ambassadors for Health Equity Broaden the Meaning of Health
Too often, health is framed simply as an individual’s physical well-being. Individuals, alone, are assumed to be responsible for bettering their health. And when a community experiences high rates of illness or disease, a question often asked is “what is wrong within the community?” rather than “why are these poor health outcomes occurring?” Read more in this article.

Health Care and the Competitive Advantage of Racial Equity: How Advancing Racial Equity Can Create Business Value
Focuses on actions taken by companies in the health care sector to create business value by addressing the unique challenges faced by communities of color. The companies featured in this report — ProMedica, Kaiser Permanente, Cigna, and UnitedHealth Group — have adopted several business strategies that improve health outcomes for people of color and create a competitive advantage through reduced costs, avoided readmissions, and greater member satisfaction.

Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review
This article shares findings from an investigation into the extent to which implicit racial/ethnic bias exists among health care professionals. Researchers examined the relationships between health care professionals’ implicit attitudes about racial/ethnic groups and health care outcomes. Based on their findings, they concluded that significant racial bias exists among healthcare workers, with more favorable attitudes towards whites and negative attitudes towards blacks and other people of color.

Racial & Ethnic Economic Inequality and the COVID-19 Pandemic
The Democracy Collaborative prepared a report, created for the Healthcare Anchor Network, that looked at how racial and ethnic disparities in the economy are showing up in the COVID-19 pandemic and in the public policy response to the pandemic. The report also covers how the economic effects of the pandemic will likely impact racial and ethnic inequality.

What are the Top Common Social Determinants of Health?
This article explores the most common social determinants of health and how the healthcare industry is beginning to tackle them. Some of these social determinants are housing, public goods, geographic location, and education.

Toolbox

Practical resources and interactive tools designed to help both on-the-ground practitioners and citizens.

The Anchor Mission Playbook
Anchor institutions can play a key role in helping the low-income communities they serve by better aligning their institutional resources—like hiring, purchasing, investment, and volunteer base—with the needs of those of communities. The recommendations in this “playbook,” drawn from research carried out to help Rush University Medical Center (RUMC) align around its Anchor Mission, are being published to help other hospitals and health systems accelerate their own efforts to drive institutional alignment with community needs.

Building a Culture of Health (Robert Wood Johnson Foundation)
Building a Culture of Health means working together to develop scalable solutions and take targeted action in our communities. Inspired by the ten underlying principles for a Culture of Health, the Action Framework identifies priorities, organized under distinct Action Areas, for driving measurable, sustainable progress and improving the health and well-being of all people.

Building Healthy Places Toolkit: Strategies for Enhancing Health in the Built Environment
Building Healthy Places Toolkit: Strategies for Enhancing Health in the Built Environment outlines evidence supported opportunities to enhance health through changes in approaches to buildings and projects. Developers, owners, property managers, designers, investors, and others involved in real estate decision making can use the strategies described in this report to create places that contribute to healthier people and communities and that enhance and preserve value by meeting the growing desire for health-promoting places.

Mental Health Issues Facing the Black Community: This collection of resources raises awareness on the impact that racism and discrimination have had on the mental health of African American Communities (Including light-skin privilege vs dark skin, especially for females).

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