Why Race/Ethnicity?
Education
Neighbor-hood
Race/Ethnic-
ity
Income/Poverty
Level
What We Heard
Though race and ethnicity wasn’t specifically discussed, several focus group participants reflected on the impact of their race on their quality of life. One participant describes his socioeconomic status as follows:
“I’m always the first to say that I was born a white, American male. I am at the top of the food chain as far as economic opportunities. I don’t think it gets any easier.”
Focus Group Participant (income >75k)
Population by Race/Ethnicity in Spokane County - 2009
Data Source: CHAT Population Estimates for Public Health Assessment, Washington State Department of Health and Krupski Consulting
Population of Ethnic Minorities in Spokane County - 2009
Black NH21.4%
AIAN NH15.0%
API NH29.1% Hispanic
34.5%
Data Source: CHAT Population Estimates for Public Health Assessment, Washington State Department of Health and Krupski Consulting
Percent Growth of Racial/Ethnic Groups in Spokane County 2000 to
2008
Data Source: CHAT Population Estimates for Public Health Assessment, Washington State Department of Health and Krupski Consulting
Overall Percent Growth of Racial/Ethnic Groups in Spokane
County 2000 to 2008
Data Source: CHAT Population Estimates for Public Health Assessment, Washington State Department of Health and Krupski Consulting
Racial/Ethnic Group Population 2000 Population 2008 Percent of Growth
Whites NH 383,128 414,717 8.2%
Blacks NH 8,015 9,481 18.3%
AIAN NH 5,699 6,659 16.8%
API NH 9,536 12,863 34.9%
Hispanic 11,561 15,289 32.2%
Unemployment by Race/EthnicityWashington State
Unemployment by Race among Adults 18 to 65 Years of Age, Washington State, 2000 to 2008
Data Source: Washington State Population SurveyNH=Non-Hispanic, AIAN=American Indian/Alaska Native, API=Asian Pacific Islander
Series10.0
5.0
10.0
15.0
20.0
11.6 11.0
9.5
5.15.1
Hispanic AIAN NH Black NH API NH White NH
Perc
ent o
f Une
mpl
oym
ent
Higher proportions of American Indians/Alaska Natives, Blacks, and Hispanics are unemployed.
Poverty by Race/Ethnicity
Racial/Ethnic Differences in Overall Poverty, 2000 to 2008
Data Source: Washington State Population SurveyNH=Non-Hispanic, AIAN=American Indian/Alaska Native, API=Asian Pacific Islander
Spokane County Washington State0
25
50
75
41.5
38.139.9
58.5
26.3
20.1
20.5
20.8
AIAN NH Black NH Hispanic White NH API NH
Perc
ent o
f Per
sons
in P
over
ty
Higher proportions of American Indians/Alaska Natives, Blacks, and Hispanics live in poverty.
Children Living in Poverty by Race/Ethnicity
Racial/Ethnic Differences in Poverty among Children Less Than 18 Years of Age, 2000 to 2008
Spokane County Washington State0
20
40
60
80
100
62.3
53.4
42.9
65.5
31.925.1
20.8
27.9
AIAN NH Black NH Hispanic White NH API NH
Perc
ent
of C
hild
ren
<18
Year
s o
f Age
in P
over
ty Higher proportions of American Indians/Alaska Natives, Blacks, and Hispanics children live in poverty.
Data Source: Washington State Population SurveyNH=Non-Hispanic, AIAN=American Indian/Alaska Native, API=Asian Pacific Islander
General Health Status by Race/Ethnicity
General Health Status by Race/Ethnicity among Adults 25 Years of Age or Older, 2000 to 2008
Data Source: Behavioral Risk Factor Surveillance System (BRFSS)NH=Non-Hispanic, AIAN=American Indian/Alaska Native, API=Asian Pacific Islander
Spokane County Washington State0
25
50
75
34.3
23.0
25.628.8
16.815.8
14.0
10.3
AIAN NH Black NH Hispanic White NH API NH
Perc
ent o
f Adu
lts >
= 25
Yea
rs o
f Age
w
ith F
air/
Poor
Hea
lth
Poor or fair health is much more common among American Indians/Alaska Natives, Blacks, and Hispanics.
Incidence of HIV by Race/Ethnicity
Spokane Washington State0
15
30
45
60
29.3 43.8
16.1
13.3
10.5
10.9
5.9 6.8
3.9
5.6
Black NH AIAN NH Hispanic White NH API NH
Rate
per
100
,000
The rate of HIV infection occurs more frequently among Black, American Indians/Alaska Natives, and Hispanics.
New HIV Diagnosis Rates (Incidence) by Race/Ethnicity, 2002 to 2008
Data Source: Washington State HIV Surveillance ReportNH=Non-Hispanic, AIAN=American Indian/Alaska Native, API=Asian Pacific Islander
Leading Causes of Mortality per 100,000 (Age Adjusted) by Race/Ethnicity Spokane County
Whites NH Blacks NH AIAN NH API NH Hispanics
Rank Cause of Death Rate Rank Cause of Death Rate Rank Cause of Death Rate Rank Cause of Death Rate Rank Cause of Death Rate
1 Malignant neoplasms 184.4 1 Diseases of the
heart^ 185.5 1 Malignant neoplasms^ 257.2 1 Malignant
neoplasms
108.6 1 Malignant neoplasms 132.7
2 Diseases of the heart 156.5 2 Malignant
neoplasms 154.4 2 Diseases of the heart 137.2 2 Diseases of the
heart 102.2 2 Diseases of the heart 87.6
3Chronic lower
respiratory diseases*
53.9 3 Diabetes mellitus^ 93.3 3 Unintentional
injury^ 97.7 3 Cerebrovascular diseases^ 63.2 3 Diabetes
mellitus^ 49.2
4 Unintentional injury 53.1 4 Cerebrovascular
diseases^ 63.8 4Chronic lower
respiratory diseases*^
75.7 4 Diabetes mellitus^ 40.1 4 Alzheimer’s
disease^ 40.9
5 Cerebrovascular diseases 45.8 5 Unintentional
injury 33.8 5 Alzheimer’s disease^ 64.8 5 Unintentional
injury 32.6 5 Unintentional injury 31.6
^Significantly higher than Spokane County* Includes bronchitis , emphysema, asthmaData Source: Death Certificates, Washington State Department of Health, Center for Health Statistics
Mean age of Death by Race/Ethnicity
Mean Age of Death by Race/Ethnicity Adults 25 Years of Age or Older, 2008 to 2009
Data Source: Death Certificates, Washington State Department of Health, Center for Health Statistics
A Framework for Health Inequity
Upstream Downstream
•Race•Class•Gender•Immigration status•National Origin•Sexual orientation•Disability
Discriminatory Beliefs (ISMS)
•Corporations & other
businesses•Government agencies•Schools
InstitutionalPower
•Neighborhood conditions Social Physical•Residential segregation•Workplace conditions
Social Inequities
•Smoking•Nutrition•Physical activity•Violence•Chronic Stress
•Infectious disease•Chronic disease•Injury (intentional / unintentional)
•Infant mortality•Life expectancy
Social Factors
Health Status
Gen
etics
Indi
vidu
al
Hea
lth
Know
ledg
e
Hea
lthca
re
Acce
ss
Medical Model
Risk Factors & Behaviors Disease & Injury Mortality
Socio-Ecological
“In order to get beyond racism, we must first take account of race. There is no other way. And in order to treat people equally, we must treat them differently.”
Harry A. BlackmunAmerican Supreme Court justice
Adrian E. Dominguez, M.S.Epidemiologist
Spokane Regional Health DistrictDisease Prevention and Response
Community Health Assessment, Planning , and [email protected]
509.324.1670