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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Black Population. Chapter outline. Chapter Outline. Background Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Key points Data Demographic and socioeconomic data Access to health care

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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Black Population


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    1. Healthiest Wisconsin 2020 Baseline and Health Disparities ReportBlack Population

    2. Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Key points Data • Demographic and socioeconomic data • Access to health care • Overall health and mental health • Risk behaviors • Chronic disease outcomes • Reproductive and sexual health References Links to additional reports and resources Contacts

    3. Report overview Report Overview • This chapter is part of a larger report created by the Wisconsin Department of Health Services to track the progress on objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf • The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. • Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. • Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

    4. Report overview Report Format Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated PowerPoint slide set • Intended uses: presentations to • Decision-makers • Service providers • Community leaders • The public

    5. Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes

    6. Report overview Report Outline: Detail Section 3: Health focus areas Section 4: Infrastructure focus areas

    7. Report overview Report Outline: Detail Section 5: Data summaries by population

    8. Report overview Data notes • Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf • The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. • Population estimates that are considered unreliable are excluded. • Misclassification of racial/ethnic groups may affect the accuracy of rates. • Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

    9. Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

    10. Report overview Historical trauma • Historical trauma is the cumulative exposure to traumatic events that not only affect the individual exposed, but continue to affect subsequent generations. • Descendants of those who experienced the traumatic stressor may still exhibit symptoms. • Populations affected by historical trauma include American Indians, African Americans/Blacks, Hispanics/Latinos, Asians, immigrants and refugees, war veterans, and families experiencing intergenerational poverty. • Current manifestations may include: • Mistrust of health care, legal, and educational systems; • Higher rates of risk behaviors such as alcohol and drug abuse, suicide, homicide, and domestic violence; and • Higher rates of chronic diseases. • Sources: SAMHSA, Fact Sheet: Historical Trauma http://gainscenter.samhsa.gov/cms-assets/documents/93078-842830.historical-trauma.pdf, Texas Department of Health Services, Trauma Informed Care Training, http://www.dfps.state.tx.us/Training/Trauma_Informed_Care/page35.asp

    11. Key points Key Points: Black population • Demographics: The Black population in Wisconsin is younger than the general population and is concentrated in the Southeastern part of the state. • Socioeconomic status: Blacks in Wisconsin are more likely to live in poverty and less likely to have a college degree compared to Whites. • Access to health care: Blacks have lower rates of health insurance and dental care coverage, similar rates of cancer screening, and higher rates of doctor visits compared to Whites.

    12. Key points Key Points: Black population Health risk behaviors and outcomes: Blacks face significant health disparities compared to Whites, and in some cases compared to other racial/ethnic groups. • Worse overall health and mental health outcomes. • Less of a sense of safety at school, neighborhood, and personal levels. • Higher rates of risk behaviors that bear upon chronic disease, such as obesity, lack of exercise, and smoking, but lower rates of binge drinking.

    13. Key points Key Points: Black population Health risk behaviors and outcomes (continued): • Worse chronic disease outcomes, including for stroke, diabetes, high cholesterol, and asthma. • Higher rates of cancer incidence and mortality. • Higher rates of reproductive and sexual risk behaviors and outcomes, including unintended pregnancies, sexually transmitted diseases, and HIV. • Higher infant mortality rates, despite a significant decrease in recent years.

    14. Demographic and socioeconomic data

    15. Wisconsin's Black population, 2010: 336,056; 6.2%of state total Change in the Black population, 2000 to 2010: 20%increase Median age, 2010: Black, 27years (White, 41.5 years) The median age is the age at which half the population is older and half is younger. Percent of Blacks who are living with a disability, 2010: 28% (White, 21%) Percent of Blacks who are foreign-born, 2010: 3% (Total population, 4%) Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau. Demographics and socioeconomic data Demographic Characteristics

    16. Wisconsin’s Black population has a higher poverty rate and less education compared to Whites. Median household income in Wisconsin, 2008-2010: Blacks, $27,400 (Whites, $53,000) Poverty rate, 2010: Blacks, 39%(Whites, 10%) The poverty rate is the percent living below the federal poverty level. Bachelor’s degree or more education (age 25 and older), 2007-2010: Blacks, 14%(Whites, 27%) Married couple households as a percent of family households, 2008-2010: Blacks: 33% (other racial/ethnic groups range from American Indians, 52% to Whites, 82%) Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau, American Community Survey. Demographics and socioeconomic data Socioeconomic data

    17. Demographics and socioeconomic data Black population by county, Wisconsin, 2010 Source: U.S. Census, 2010.

    18. Demographics and socioeconomic data Level of urbanization of Wisconsin residents, by race/ethnicity, 2007-2011 Source: American Community Survey, 2007-2011. .

    19. Access to health care

    20. Access to health care Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    21. Access to health care Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

    22. Access to health care Lack of routine preventive medical and dental care among children, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

    23. Access to health care Age-adjusted rates of use of and barriers to health care among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    24. Access to health care Emergency room utilization among Wisconsin residents, by race/ethnicity, 2008-2010 Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

    25. Physical health and safety and mental health

    26. Physical health Age-adjusted indicators of poor health status among Wisconsin adults by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    27. Environmental health Neighborhood environment of children less than 18 years of age, by race/ethnicity, Wisconsin, 2011-2012 Source: 2011-2012 National Survey of Children's Health. *Neighborhoods that include all four of these amenities. Data were not available for other racial/ethnic groups.

    28. Injury and violence Perceptions of school safety among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    29. Injury and violence Intentional injury deaths by race/ethnicity, age-adjusted rates per 100,000, Wisconsin, 2008-2010 Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.

    30. Injury and violence Partner violence among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    31. Mental health Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by race/ethnicity, 2010 and 2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset Note: Question asked in 2010 and 2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    32. Mental health Age-adjusted rate of frequent mental distress among Wisconsin adults, by race/ethnicity, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Question asked in 2009-2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    33. Mental health Depression among Wisconsin high school students by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS). Note: 95% confidence intervals are denoted by the error bars; larger confidence interval s may indicate less reliable estimates that should be interpreted with caution.

    34. Mental health Suicide risk during past 12 months among Wisconsin high school students by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS). Note: 95% confidence intervals are denoted by the error bars; larger confidence interval s may indicate less reliable estimates that should be interpreted with caution. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    35. Risk behaviors for chronic disease

    36. Physical activity Physical activity and sedentary behaviors among Wisconsin high school students by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

    37. Physical activity Age-adjusted rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset

    38. Nutrition Age-adjusted rates of overweight and obesity among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    39. Tobacco use and exposure Age-adjusted smoking rates among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. .

    40. Tobacco use and exposure Rates of secondhand smoke exposure among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: The smoking at work question was only asked in years 2009 and 2010.Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    41. Alcohol and other drug abuse Rates of current drinking, binge drinking, and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011 Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    42. Alcohol and other drug abuse Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    43. Chronic disease outcomes

    44. Environmental health Age-adjusted rates of asthma among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    45. Environmental health Asthma hospitalizations by race/ethnicity, age-adjusted rate per 10,000, Wisconsin, 2010 Source: Wisconsin Inpatient Hospitalization Discharge file, 2010. Note: Race groups include both Hispanic and non-Hispanic people; Hispanics may include people of various races.

    46. Chronic diseases Age-adjusted rates of diabetes and prediabetes among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2. diabetes. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    47. Chronic diseases Hospitalizations due to long-term complications from diabetes among Wisconsin adults, age-adjusted rate per 10,000, by race/ethnicity, 2010 Source: Wisconsin Inpatient Hospitalization Discharge file, 2010. Note: Hospitalization rates considered unreliable are excluded.

    48. Chronic diseases Incidence of end-stage renal disease incidence among Wisconsin adults, age-adjusted rate per 100,000, by race/ethnicity, 2009 Source: United States Renal Data System (USRDS), Renal Data Extraction and Referencing (RenDER) System. Note: Incidence rates considered unreliable are excluded.

    49. Chronic diseases Age-adjusted rates of high cholesterol and high blood pressure among Wisconsin adults, by race/ethnicity, 2009 and 2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Questions only asked in 2009 and 2011.Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

    50. Chronic diseases Age-adjusted rate of arthritis among adults, and percent of those with arthritis whose activity is limited due to joint pain, by race/ethnicity, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Arthritis question was asked in 2009-2011. Question about limited activity due to joint pain question was asked in 2009 and 2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.