Determinants of Health and Equityin King County

Marguerite Ro, DrPHNovember 8, 2018

Today’s sessionPurpose: • Gain a deeper understanding of the social

determinants of health and equity in King County

Social determinants of health are the conditions in which people are born, grow, live, work, and age

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What determines health?

Source: New England Journal of Medicine. We Can Do Better Improving the Health of the American People, Sept. 2007

Genetics – 30%Environment, behavior & social circumstances –60%

King County

Over 170 languages spoken at home

Population of about 2.1 million

Half of population growth due to foreign-born

Top 5% makes 28x more than lowest 20%

10+ years difference in life expectancy by neighborhood

A lot of people are moving here

The “Amazon rush” has topped the Gold Rush in annual population growth

And the economy is booming

“I am a single mother. It has been hard to raise two kids. I have to work part-time on the weekend so that I can be home with my children because childcare is so expensive. On the weekend, I leave the children with a friend so that I can work. Buying supplies such as diapers, clothing, and toys for my daughter is a big expense."

Seattle single mom responding to 2016 BSK Health survey

39.345.7 47.1

56.4 59.3 60

Asian White NHPI Hispanic AIAN Black

Renters paying >30% of income for housing Seattle-area home prices this spring

rose at fastest rate since 2006 bubbleOriginally published July 31, 2018 at 6:56 am Updated July 31, 2018 at 2:36 pm

The typical house now costs $813,000 in Seattle or $978,000 on the Eastside. Meanwhile, a median house will run you $511,000 in Snohomish County or $351,000 in Pierce County.

Gentrification and displacement

• More than 20,000 households in King County include at least one adult immigrant who receives health insurance through Medicaid, or a child who receives health coverage through Medicaid or CHIP.

• More than 30,000 households in King County have at least one immigrant who accesses basic food assistance. It is unknown how many people in the Supplemental Nutrition Assistance Program may also be receiving Medicaid.

LGB youth more likely than heterosexual youth to report:

The importance of a safe and supportive clinical environment . . .

“Every time my doctor uses the wrong name and pronouns… if they’re not respecting what I need, you can’t trust them; you don’t want to tell them anything. You don’t want their help because they’re not helping you the way you need. It can feed into your dysphoria, make you feel really bad about yourself, and it’s very invalidating.”

What is King County Doing to Build Equity and Opportunity?

Developing strategies that address root causes of inequities and engage communities:

Access to health services

Strong, vibrant neighborhoods

Early childhood development

Access to safe and efficient transportation

Equitable law and justice system

Local food initiative

Making a Difference