By Kara D. Ryan, Senior Research Analyst, Health Policy Project
Think for a minute: do you live in a healthy community? Think about whether your friends, family, and neighbors are in good physical health, but also consider the whole host of factors that affect your opportunity to be healthy. Access to health care, for example, plays a role. So does whether your neighborhood is physically set up to make healthy behaviors easier for residents. Don’t forget social and economic factors, such as quality jobs, that have bearing on our ability to make healthy choices. Now, how do you think your community compares to others in your state, or across the nation?
It’s important to understand how your community stacks up in order to successfully organize for change. Last week, the interactive website County Health Rankings was re-released with updated data, allowing you to see at a glance how your county compares with the rest of the state and nation. This is a powerful tool for health equity for Latinos and other communities of color, as we know that racial and ethnic health disparities are closely linked to how and where we live. As Hispanics struggle with escalating rates of child obesity and complications such as undiagnosed diabetes, policy change at all levels—federal, state, and local—is necessary.
To that end, we wanted to know how the communities for our Comer Bien families stacked up compared to their states, the nation, and each other. We took a look at the numbers for Bexar County, Texas (home of San Antonio and 58% Hispanic); El Paso County, Texas (82% Hispanic); Canyon County, Idaho (home of Caldwell and 22% Hispanic); and Washington, DC (9% Hispanic). Here are some of the interesting patterns we spotted:
- Fast food saturation: In the U.S., quick-service restaurants (fast food chains) make up a substantial share of our eating establishments. Studies have found links between increased fast food exposure and obesity. County Health Rankings researchers suggest that fast food establishments should make up no more than 25% of restaurants in a given community. Yet in each location we visited, more than half of all restaurants are fast food chains. This was a common observation among the families we spoke to—fast food restaurants selling cheap, calorie-dense food were often concentrated near their homes. (Watch Emily’s video, also below, for a description of how fast food restaurants dominate her San Antonio neighborhood.)
- Healthy food access: Bexar (TX), El Paso (TX), and Canyon (ID) counties each had higher percentages of the population with limited access to healthy foods, compared to the rest of their states. (Hear from April, also below, about the food retail options for a farmworker community in Idaho.) Washington (DC) was the exception—just 1% live in a food desert as defined by the U.S. Department of Agriculture, more than one mile from a grocery store for urban areas and more than ten miles in non-metro areas. This pattern supports our findings, where access to healthy food was less likely to be raised as problem in DC, which has a robust public transportation system. Finally, it’s important to recognize that even if low-income Latino neighborhoods are not technically defined as food deserts, there is no guarantee that the food for sale is fresh, healthy, high-quality, and affordable. For example, Emily (linked above) felt that her local supermarket offered fewer healthy options and lower-quality items than the same chain in an affluent neighborhood across town.
- Violent crime rate: It is difficult for Latinos who live in areas prone to violence to be healthy. When you fear for your safety, you don’t want to run out for groceries, especially if your only free time to shop is between jobs at odd hours or after dark. According to the County Health Rankings, Washington (DC) had the highest rate of violent crime, at 1,400 incidents per 100,000 people. Bexar County (TX) and Canyon County (ID) had higher than average crime rates. The crime rate for El Paso County (TX) was lower than the state average. This, too, reflects our conversations with families, as fear of crime or violence came up more frequently in the nation’s capital. (Listen to José, also below, from DC describing his worries for friends and community members living in areas where violence is commonplace.)
- Fair/poor health: Researchers set a national benchmark for the percentage of people living with fair or poor health at no more than 10% of the population. All of the locations we visited exceeded this measure. Washington, DC’s rate was the lowest, at 13%, followed by both Bexar County (TX) and Canyon County (ID), each at 18%. El Paso County (TX) had the highest rate, with more than one in four (26%) people living with fair or poor health outcomes. (Watch Crystal, also below, from San Antonio as she explains how she pinches pennies to afford healthy food—important for managing her son’s lupus.)
The Latino families that sat down with us in these locations came up with examples of how factors like these play out in their communities even without having the data at hand. Their stories show how these gaps in access and infrastructure play out, narrowing the options for low-income Hispanics and making it harder to be healthy and to specifically promote good nutrition. To create healthy families, it’s important to acknowledge that part of the process is about creating healthy communities. Location matters.
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