We’ve all heard the old adage: The Spokane area is a great place to raise a family. Central to this statement is a belief about our residents’ health as a resource that enables our community to achieve its fullest potential. But the Spokane Regional Health District’s recent report, Health Inequities in Spokane County, paints a different picture of the town where I was born. In reality, health inequities are affecting the lives and futures of people all over the world. Spokane is no different.
So what is health inequity? We define it in our report as “differences in a population’s health that can be traced to unequal economic and social conditions that are systemic and avoidable — and thus inherently unjust and unfair.” It’s a pretty complex concept.
For me, I think of it as particular groups of people having poorer health than the rest of us.
Maybe you’re like me and made a mistake right out of the gate by assuming health inequity had to do with limited access to quality health care or insurance. Although that’s a contributor to health inequity, it’s only one. There are many factors — we call them determinants — that affect health. Things like place of residence, race, religion, education, socio-economic status and social capital. For this special Women’s Health issue of InHealthNW, I’ll focus on one of the more pervasive: gender.
Women are more likely to face health inequities simply because our biological make-up demands more care. Pregnancy and childbirth are life events that expose women to greater risks.
Women also tend to earn less than men regardless of occupation. In Spokane County, average earnings for men in 2010 equaled $46,707; for women the figure was just $30,926.
Single moms are especially at high risk of entering poverty because of these generally lower wages — and because the difficulty in finding affordable and high-quality day care can force women out of the job market altogether. Thus, in Spokane County, 50 percent of children with a single mom are living in poverty.
Poverty often cuts off access to the resources that improve health while limiting treatment options when women and their families become sick. To translate that locally, in Spokane County, lowincome parents are 17.4 times more likely to rate their child’s health as “fair” or “poor” than parents earning an average income. Our data also show that babies born to mothers who do not finish high school are 2.5 times more likely to die before their first birthday than babies born to mothers with a bachelor’s or advanced degree. It becomes clear that these imbalances between men and women can prevent women from exercising control over their own health.
These circumstances forever affect the health of their children.
So here I am, a mother telling my children it’s up to them to reach their full potential. But in reality, their potential is affected by my education, my income, my race, my socioeconomic status. In turn, mine was affected by the social, economic and environmental conditions I was raised in.
It’s actually a common misconception about well-being — that health is a matter of making good choices. If there is one thing I hope you take from this editorial and the Health District’s report, it’s that you begin to see how health outcomes are inextricably linked — for better and worse — to the social conditions that surround and shape our lives.
Now, bolstered by data from Health Inequities in Spokane County, Spokane has a unique opportunity to join in a nationwide effort toward health equity. The health district and its partners will begin hosting a series of community dialogues starting in October to engage the community in our efforts to develop, implement and evaluate interventions. The views and voices of local women, of all residents, will be critical to our efforts. Please plan on attending.
The first of five community dialogues on the findings of the Spokane Regional Health District’s new study will be Wed., Oct. 10, at 6 pm at the East Central Community Center, 500 S. Stone St., Spokane. Subsequent dialogues will be conveniently located throughout Spokane County. For more information, visit www.srhd.org. You can access Health Inequities by going to: srhd.org/documents/PublicHealth- Data/HealthInequities-2012.pdf.