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Place Mattersfor Health in Orleans Parish

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Place Mattersfor Health in Orleans Parish JUNE 2012 PLACE MATTERS FOR HEALTH IN ORLEANS PARISH: Ensuring Opportunities for Good Health for All A Report on Health Inequities in Orleans Parish, Louisiana © 2012 JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES PLACE MATTERS FOR HEALTH IN ORLEANS PARISH: Ensuring Opportunities for Good Health for All A Report on Health Inequities in Orleans Parish, Louisiana PREPARED BY THE JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES ORLEANS PARISH PLACE MATTERS TEAM IN CONJUNCTION WITH THE CENTER ON HUMAN NEEDS, VIRGINIA COMMONWEALTH UNIVERSITY VIRGINIA NETWORK FOR GEOSPATIAL HEALTH RESEARCH JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES JUNE 2012 The contents of this report reflect the views of the authors and do not necessarily reflect the views of the Joint Center for Political and Economic Studies or its Board of Governors, the Center on Human Needs at the Virginia Commonwealth University, and the Virginia Network for Geospatial Health Research. Opinions expressed in Joint Center publications are those of the authors and do not necessarily reflect the views of the staff, officers or governors of the Joint Center for Political and Economic Studies or the organizations that support the Joint Center and its research. This research was supported by Award Number 1RC2MD004795-01 from the National Institute on Minority Health And Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health And Health Disparities or the National Institutes of Health. The Joint Center for Political and Economic Studies, Place Matters and the Orleans Parish Place Matters team are supported by a generous grant from the W.K. Kellogg Foundation. Joint Center for Political and Economic Studies, Washington, DC 20005 www.jointcenter.org © 2012 All rights reserved. Published 2012. Printed in the United States. Cover photos courtesy of Andre Perry. TABLE OF CONTENTS Executive Summary ..................................................................................................................................................................................................1 Introduction ...............................................................................................................................................................................................................3 I. Background: Population, Community Characteristics, Education and Health in New Orleans ........................................................4 II. Socioeconomic Status, Education and Health ..............................................................................................................................................16 III. Crime and New Orleans Communities ........................................................................................................................................................22 IV. Conclusions: Education as a Predictor of Community Risk, Health Status and Crime Rates .........................................................28 PLACE MATTERS FOR HEALTH IN ORLEANS PARISH: ENSURING OPPORTUNITIES FOR GOOD HEALTH FOR ALL c d JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES FOREWORD Place matters for health in important ways, according to a growing body of research. Differences in neighborhood conditions powerfully predict who is healthy, who is sick, and who lives longer. And because of patterns of residential segregation, these differences are the fundamental causes of health inequities among different racial, ethnic, and socioeconomic groups. The Joint Center for Political and Economic Studies and the Orleans Parish Place Matters team are very pleased to add to the existing knowledge base with this report, “Place Matters for Health in Orleans Parrish: Ensuring Opportunities for Good Health for All.” The report, supported by a grant from the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health, provides a comprehensive analysis of the range of social, economic, and environmental conditions in Orleans Parish and documents their relationship to the health status of the Parish’s residents. The study finds that social, economic, and environmental conditions in low-income and non-white neighborhoods make it more difficult for people in these neighborhoods to live healthy lives. Among the study’s key findings are that life expectancy in the Parish varies by as much as 25 years depending on the zip code. Zip codes with the lowest life expectancy tend to have a higher percentage of people of color and low-income residents. Community-level risk factors, such as high concentrations of people living in poverty, overcrowded households, households without a vehicle, and vacant housing are among the factors that predict health inequalities in the Parish. The overall pattern in this report – and those of others that the Joint Center has conducted with other Place Matters communities – suggests that we need to tackle the structures and systems that create and perpetuate inequality to fully close racial and ethnic health gaps. Accordingly, because the Joint Center seeks not only to document these inequities, we are committed to helping remedy them. Through our Place Matters initiative, which is generously supported by the W.K. Kellogg Foundation, we are working with leaders in 24 communities around the country to identify and address social, economic, and environmental conditions that shape health. We look forward to continuing to work with leaders in Orleans Parrish and other communities to ensure that every child, regardless of their race, ethnicity, or place of residence, can enjoy the opportunity to live a healthy, safe, and productive life. Ralph B. Everett President and CEO Joint Center for Political and Economic Studies PLACE MATTERS FOR HEALTH IN ORLEANS PARISH: ENSURING OPPORTUNITIES FOR GOOD HEALTH FOR ALL e f JOINT CENTER FOR POLITICAL AND ECONOMIC STUDIES tract (as many as 72% of residents without a high EXECUTIVE SUMMARY school education) correlate with the highest levels of Place matters for health in important ways. Differences in community risk factors and the lowest life expectancy neighborhood conditions powerfully predict who is healthy, rates. who is sick, and who lives longer. And because of patterns of residential segregation, these differences are the fundamental • Higher violent crime rates are associated with areas causes of health inequities among different racial, ethnic and that have higher rates of repopulation since Hurricane socioeconomic groups. Katrina and lower levels of educational attainment. This study examined the relationships between place, race and The overall pattern suggests that socioeconomic conditions ethnicity, and health in Orleans Parish, LA,i and attempted to in low-income and non-white neighborhoods make it more address specific questions raised by the Orleans Parish Place difficult for people in these communities to live healthy lives. Matters Team: And while there is a strong moral imperative to enact policies to improve health for all, there also is a powerful economic • What is the relationship between community levels incentive. A study released by the Joint Center for Political of individual indicators of socioeconomic status and and Economic Studies in 2009 found that direct medical costs educational attainment? associated with health inequities among African Americans, Hispanics, and Asian Americans approached $230 billion • What is the relationship between the level of between 2003 and 2006. When indirect costs, such as lowered individual indicators of socioeconomic status and the productivity and lost tax revenue resulting from illness and rate of risk behaviors? premature death, were included, the total cost of health inequities exceeded $1.24 trillion. Thus, for both moral and • What is the relationship between socioeconomic status economic reasons, we must address health inequities and their and health outcomes? root causes now. • What effect did Hurricane Katrina and its resultant In the context of these findings, the Orleans Place Matters Team displacement have on the rate of risk behaviors? has chosen to focus its recommendations on keeping children in The study found that: quality schools and in providing access to educational services for youth and adults who have been out of school for significant • Life expectancy in the poorest zip code in the city is periods of time. Consistent with this focus, the Place Matters 54.5 years, or 25.5-years lower than life expectancy in Team offers the following recommendations: the zip code with the least amount of poverty in the Keeping Students in School and Out of Prison city, where it is 80. • Develop a centralized/uniform expulsion policy among • Heart disease mortality in the poorest zip code in the charter and non-charter schools within Recovery city is almost five times higher than the next highest School District and New Orleans Public Schools. rate in the city. • Provide standardized training for school resource • The mortality rate for black residents of Orleans Parish officers, security guards or school-based police officers. in 2007 was 1½ times the mortality rate for white residents. • Institutionalize a bi-annual external review of expulsions and long-term out of school suspensions • There is a wide difference across census tracts in the (over one day). community-level risk index, which was calculated by combining measures of population below 150% of • Eliminate
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