The District’s latest “health equity” maps shows a city divided by race and income. How well you live, or sometimes whether you live at all, can depend on what side of the line you are on.
On one of the maps, we see that Woodley Park in Northwest Washington is the neighborhood where residents have the longest life expectancy, 89.4 years on average. Residents in the St. Elizabeths neighborhood, in Southeast, have the shortest, 68.2 years.
Woodley Park is wealthy and predominantly white. St Elizabeths is poor and predominantly black.
The difference that makes: 21 years of life.
“Your zip-code may be more important than your genetic code for health,” says the report that accompanies the maps, which can be found on the D.C. Department of Health website.
The disparities are stark, the consequences appalling. And the cause is no mystery. As the report notes, they are the result of “historical forces that have left a legacy of racism and segregation, as well as structural and institutional factors that perpetuate persistent inequities.”
But when it comes to solutions, the report is less precise.
“The only way to truly discard this legacy is to craft a new one, built on a shared vision for equity,” it says.
For starters, the report advocates adopting “an overall approach that recognizes the cumulative impact of multiple stressors and focuses on changing community conditions, not on blaming individuals or groups for their disadvantaged status.”
The stressors to be acknowledged include “continued exposure to racism and discrimination that may in and of itself exert a great toll both on physical and mental health.”
That’s fine. But acknowledging racism will not cure hypertension. It will not make fresh fruit and vegetables magically appear at the dinner table.
Attacking structural roots of racial disparities is certainly a noble endeavor. But that tends to take a very long time to pull off. Time that some people just don’t have.
On the health equity map, we see that infant mortality for babies with black mothers is three times higher than for babies with white mothers. We know that the mothers’ hypertension is a factor in these premature deaths — and that financial stress, relationship stress, work stress have a lot to do with it. But while working for gender equity in pay, let’s get that blood pressure down.
Every black beauty shop ought to have someone trained to take and talk about blood pressure.
Every black church should have a healthy heart ministry.
In neighborhoods that are in “food deserts,” where residents have no easy access to fresh vegetables, fighting for a grocery store is fine. But in the meantime, start a community garden. That’s not blaming the victim. It’s saying that even if racism caused the problem, you still have to help solve it.
You may not be able to cure racism, but you can manage the stress that it causes. Or else it will kill you.
The National Institutes of Health funds all kinds of research aimed at reducing blood pressure, heart disease and other health disparities. The National Heart, Lung and Blood Institute (NHLBI) recently funded a research project in Los Angeles County that successfully demonstrated the effectiveness of barbershops in curbing hypertension in black men.
The D.C. region should be applying for every available cent of such funds.
The idea for the barbershop project did not come from NIH, but from a university partnership with a community that was suffering from disproportionately high rates of blood pressure related deaths.
“The important thing is, we cannot design these interventions from just the ivory tower,” George Mensah, director of the Center for Translation Research and Implementation Science at NHLBI, told me. “We look for active community engagement. An application for implementation research funding that comes from a university medical center alone is not as appealing as one that comes from a university medical center in partnership with the local community.”
The D.C. Health Department report suggests engaging “a broad spectrum of the community in essential multi-sectorial solution development.”
Whatever way you word it, the bottom line is that the people most burdened by health disparities must participate in their healing. They must start expecting to live longer.
And they need to be quick about it, “lest the persistently inequitable outcomes be mistaken as either natural or inevitable,” as the report notes.
Given the deepening segregation and widening disparities, that day may be closer than you think.
To read previous columns, go to washingtonpost.com/milloy.