Report illuminates disparities in health among Kitsap residents
BREMERTON — Non-white babies in Kitsap County are more than twice as likely to die in the first year of life than white babies.
Boys are enrolled in early education programs at a far higher rate than girls.
More teens who identify as LGBTQ report physical abuse by adults than straight teens.
In a relatively affluent county, where residents generally enjoy good health, health-related disparities still exist between people of different genders, race and sexual orientation, according to a forthcoming report from Kitsap Public Health District.
District staff dug into data collected for the agency’s yearly Health Indicators Report to identify gaps between subgroups within the county’s population. They examined direct indicators of health as well as “determinants of health” such as education, income and access to health care that influence the health of individuals.
The report, due out in February, reveals wide-ranging gaps between population groups, reflecting complex social and economic factors at work in the community. Kitsap Public Health administrator Keith Grellner said identifying disparities is the first step to addressing them.
“Until we can frame the problem, which is what we’re trying to do, it’s hard to start developing policy answers,” Grellner said at a Jan. 2 health board meeting where the report was previewed. “… it’s a big, heavy topic, but we have to start somewhere.”
The report — the first of its kind produced by the health district — identified the greatest number of disparities between non-white and white residents. Some, such as infant mortality rates, are stark.
According to the report, the county had an infant mortality rate of five per every 1,000 live births in the years of 2014 and 2015, meaning five out of every 1,000 babies born died before their first birthday.
For white babies, the rate was a better at 4 deaths per 1,000 births. For non-white babies, the rate was 10 per 1,000.
Health district Health Officer Dr. Susan Turner noted the higher ratio of deaths among non-white infants is a nationwide trend.
“The infant mortality data is actually not surprising,” Turner said. “It’s super distressing. Unfortunately that’s what is seen across the United States, although our comparative rates are worse than Washington’s and the United States’.”
Analysis by the health district found non-white babies also were more likely to have low birth weights and young and non-white mothers were less likely to begin prenatal care in the first trimester of pregnancy.
Race and ethnic disparities spanned all ages. More than a quarter of non-white teens reported physical abuse by an adult, compared with 20 percent of white teens. Fewer reported having an adult they could turn to for help if they were feeling sad or hopeless.
Young, non-white adults were less likely to have health insurance than their white counterparts, and 63 percent indicated their daily activities had been limited by their physical or mental health over the previous month.
Health district analysis also found gaps between Hispanic/Latino residents and white, non-Hispanic residents when it came to early prenatal care and access to health insurance. Fifteen percent of Hispanic and Latino residents were living in poverty in 2016, compared with 9 percent of whites, according to the report.
Even in areas where health indicators appear positive, some groups lag behind.
As one example, 60 percent of Kitsap children ages 3 and 4 were enrolled in early education programs in 2016, a marking a large improvement over the prior decade. But when broken down by gender, 75 percent of boys were enrolled compared with 50 percent of girls.
Health-related gender gaps extend into adulthood. Young adult women experienced drug-related hospitalizations at nearly double the rate of men in 2015. Among adults 65 and older, 8 percent of women reported living in poverty compared with 2 percent of men.
Middle-aged men fare worse than women in some areas of health. Fewer men than women report being at a healthy weight and men experience hospitalizations related to diabetes at a higher rate.
The district’s analysis of disparities between people of different sexual orientations was hampered by a lack of data and small sample sizes. But survey results indicated big differences in the experiences of teens identifying as lesbian, gay, bisexual, transgender or queer and those identifying as straight.
Among LGBTQ youth in grades 8,10 and 12, 37 percent reported having been physically abused by an adult, compared with 19 percent of youth who identified as straight. LGBTQ youth were less likely to have an adult to turn to for help, according to the report, and more than twice as likely as their straight peers to smoke cigarettes.
The health district’s was compiled as a snapshot of disparities occurring in Kitsap. With the numbers in hand, agencies in the county can begin explore whether differences between subgroups are related to inequities in the community and how disparities that impact children affect their health as they grow into adults.
“For example, the young adolescent girls who are reporting not feeling supported, will they later on in life become the women who experience drug-related hospitalizations?” Kitsap Public Health epidemiologist Maya McKenzie asked.
Turner said the health disparities report will likely inform the the Kitsap Community Health Priorities initiative, which focuses organizations across the county on common goals to improve health in the county.
Health board member and Poulsbo Mayor Becky Erickson found the report eye-opening.
“That was some pretty sad information we just saw,” Erickson said. “The question becomes, even if we have the data, what are we going to do about it?”
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