Did you know that your zip code says a lot about your health? In fact, it is “the most important risk factor” in determining our wellness, according to Dr. Adewale Troutman, president of the American Public Health Association in Washington. He is one of the nation’s leading experts on health inequities.
Troutman says a new study reveals a strong link between where we live and our health. It shows that people living in richer neighborhoods live the longer. What does that mean for minorities and the poor who disproportionately reside in less affluent areas? That question worries Troutman who says communities nationwide should organize to improve the health of all residents. He says good health should be a “basic human right” and that failing to make it so can be costly in more ways than one.
“There are something…called ‘opportunity neighborhoods,’ that describes safe neighborhoods with highly efficient and functioning school systems, equitable transportation, and opportunities for jobs and development,” Troutman explains. “If you don’t have that, you find that the structure of the community is more akin to segregation by race and/or socioeconomics. Then we know, by definition, that the status of those communities tend to go down dramatically. Service levels go down dramatically.”
According to Troutman, it costs society more than a trillion dollars over a two-and-a- half-year period for “the continued existence of health-status inequities.” He says those numbers come from research done by John Hopkins University and the University of Maryland. And everyone pays for “the injustice of health inequities,” through higher health-insurance rates, Troutman says. But a heavy price is also paid by less wealthy citizens, he adds. That price is late detection of serious diseases, shorter life expectancies, and lack of access to “good preventive primary-care services,” because they are often uninsured or under-insured.
In the U.S. about 50 million people are uninsured, a figure that is climbing, Troutman says. But a number he sees as troubling yet less talked about is another 50 to 90 million individuals who are underinsured. While they may have insurance, Troutman says it either fails to cover needed services or has deductibles as high as $2,000.
According to Troutman, “It results in bankruptcy (and) increased homelessness with people losing their homes because they can no longer pay the cost of the hospital bills because they don’t have insurance...The No. 1 cause of bankruptcy is medical-care issues.”
Troutman headlined Kalamazoo County’s first Health Equity Summit that drew nearly 200 people. He is executive director of the Center for Leadership in Public Health Practice at the University of South Florida in Tampa. Before that, he headed the Metro Louisville Department of Public Health and Wellness where he created the country’s first Health Equity Center in a local health department. The purpose of such centers is to generate public awareness and civic engagement surrounding health disparities, and push for policy change, Troutman says. Kalamazoo County opened its health equity center in 2010.