The annual County Health Rankings – a project of the Robert Wood Johnson Foundation – were published last week, along with a report emphasizing the importance of affordable housing on overall health. As is typical for these kinds of reports, Santa Clara County looks great – ranked third in California behind Marin and San Mateo counties. Overall, the county scores well in length of life, quality of life, health behaviors, clinical care and social economic factors, but lags behind 34 other California counties on the physical environment measures – and, even there, the only measure where our county performs worse than the state average is in the percentage of the workforce that drives alone to work. Surprisingly, the county scores well below the state average in the “Severe housing problems” metric, defined as “the percentage of households with at least 1 of 4 housing problems: overcrowding, high housing costs, lack of kitchen facilities, or lack of plumbing facilities”.
However, a number of the measures allow you to click on the average number to see the data broken down by race (categorized as “Black”, “Hispanic” or “White”) and when you do that, the picture looks considerably less positive. Focusing on just the metrics directly affecting young children and their families, the data shows 50% higher rates of low birth weight among African-American than White newborns, ten-fold higher rates of teen births among Hispanic women than White women, rates of childhood poverty among African-American and Hispanic children that are five times the rate for White children, and incomes for White households close to double those for African-American and Hispanic households. Even without the ability to break out data for Asian children and families – and now that Santa Clara County has a plurality Asian population that is a big issue – its clear that there are significant, race-based, inequalities in health outcomes in our county. For those of us interested in improving early care, health and education, this is another indication that we can’t be satisified with a color blind, averages-based approach to data and policy making. Without digging deeper to unearth and recognize race-based inequalities in the data, we stand little chance of addressing the systemic inequities that lead to them.