September 26, 2018

There are clear links between race, ethnicity, geography and drivers of health outcomes in the U.S., a special report from U.S. News & World Report finds.

In one of the largest assessments of social determinants of health to date, U.S. News found that communities with a greater share of white residents generally score better, differing from the negative link between communities' scores and their share of black residents. Larger Hispanic and Native American populations also are linked to worse Healthiest Communities outcomes.

Released today, this report analyzed social determinants of health across nearly 3,000 U.S. counties that were part of the initial Healthiest Communities rankings. The report identifies factors that influence overall well-being such as economy, housing and access to health care, and highlights diverse areas outperforming the norm.

Key Findings include:

  •     Nearly 700 communities have a black population share larger than the national average of about 13 percent. Yet just 26 of those communities rank among the top 500 Healthiest Communities overall, with many of those in the Washington, D.C., and Atlanta areas.
  •     Some of the strongest predictors of community performance in the U.S. News assessment are also areas in which communities with large black populations generally struggle. These factors include homicide rates, low birth weight and, in particular, access to healthy and affordable food.
  •     Low segregation is one of the top 15 drivers of community performance for places with larger than average Hispanic populations. Proximity to jobs and good child care quality reveal some of the largest gaps in social determinants of health between communities with both a Hispanic population share above the national average of about 17 percent and communities with smaller Hispanic populations.
  •     There is a negative relationship between the size of a community's Native American population and its Healthiest Communities score. The strongest drivers of improved community performance in areas with larger- than-average Native American populations are better access to supermarkets and household utilities for heat, as well as lower rates of cancer prevalence.

"In-depth analysis and data-driven journalism powers the Healthiest Communities platform, allowing us to examine the relationship between public health initiatives and community health as a whole," said Brian Kelly, editor and chief content officer of U.S. News. "Our reporting highlights communities that are making important strides to advance health for economically and socially diverse populations, while also empowering community leaders to seek positive change in counties facing disparities."

"Your ZIP code can influence your health more than your genetic code. However, even within the varying health outcomes that we see across different geographies, we also see inequality across racial and ethnic groups," said Dr. Garth Graham, president of the Aetna Foundation and vice president of Community Health for Aetna, Inc. "In order to improve health equity in our country, we need to truly understand where these problems exist so that we can help support local solutions that address these unique needs. The new report from U.S. News not only uses data and research to help identify issues in different locations, but also features communities that are striving to improve health for diverse populations."

These findings are accompanied by an editorial package that examines how communities in New Mexico, Kentucky and Georgia are working to overcome barriers to health:

  •     A Better Place to Be Black? Georgia Counties Excel in Community Health: Defying a national trend, four Georgia counties with significant black populations land among the nation's Healthiest Communities.
  •     Majority-White Kentucky County Struggles On, Decades After War on Poverty: A spotlight on how the worst-performing majority-white county in the Healthiest Communities analysis is trying to do better.
  •     New Mexico Counties Divided by Care: An in-depth look at why Grant County and bordering Luna County– two heavily Hispanic counties in New Mexico – fare differently in terms of health outcomes and community prosperity.

The Race and Community Health in America package is part of the growing Healthiest Communities platform, featuring in-depth reporting and analysis on public health issues in nearly 3,000 communities. Developed in collaboration with the Aetna Foundation, the independent charitable and philanthropic arm of Aetna, Healthiest Communities includes comprehensive data covering the full spectrum of factors that influence population health. The project is part of U.S. News' expanding civic journalism initiative, which measures government progress locally and globally. Civic includes the Best States and Best Countries portals.

The analysis relies on U.S. Census five-year population estimates of race and ethnicity paired with the U.S. News Healthiest Communities dataset. The rankings encompass 80 metrics drawn from sources such as the Centers for Disease Control and Prevention, the Institute for Health Metrics and Evaluation, the U.S. Census Bureau, the Dartmouth Atlas of Health Care and the U.S. Environmental Protection Agency.


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