Hampden County is sick and losing years of life. Hampshire County is healthy and living long.
That’s the conclusion of a recent county health rankings report released by the Robert Wood Johnson Foundation’s County Health Rankings and Roadmaps project. Hampden County ranks dead last in the state for health outcomes (how healthy people are right now) and health factors (how healthy people can expect to be in the future).
I dove into the data and on the following measures Hampden County ranks last (asterisked) or second-to-last (typically behind Suffolk County):
- High school graduation rate
- Teen birth rate*
- Smoking rate*
- Years of potential life lost due to poor health*
- % reporting fair/poor health*
- Chlamydia rate*
- HIV prevalence rate
- % Diabetic*
- Income ratio, highest earners to lowest earners*
- % kids with free or reduced lunch
- % children in poverty
It’s especially striking in contrast to the health outcomes of Hampshire County, which ranked third for health factors, and fifth for health outcomes (out of 14 counties). What is Hampshire County doing right, and Hampden County doing wrong?
When I ran some correlations across all counties, I was struck by the relationship between poverty and negative health outcomes (insert the usual caveat that correlation is not causation). These are the following correlations for child poverty:
- 0.83 for fair/poor overall health
- 0.78 for teen birth rate
- -0.88 for high school graduation rate
- 0.90 for firearm fatalities rate
Also, Chlamydia rate, HIV prevalence, and infant low birth weight rate all also have strong correlations.
That’s bad news, because poverty is tough. Most of all for the families struggling through it, but also for the communities trying to solve the problems that come with it. Incomes have stagnated among the lowest earning households, and public programs haven’t been able to fill the gap. Cities are left with an incomplete tool set to address poverty – tinker with the school budget, or increase law enforcement, or offer incentives they can’t afford to redevelop blighted properties.
And I’m also reminded that the most common tool cities use, out of a lack of other good alternatives, is to just push out poverty (also known as displacement or gentrification). This is usually accomplished through zoning that restricts multifamily housing and mandates lot sizes that only the affluent can afford. In hot real estate markets, abandoned buildings are torn down and luxury condos are built in their place.
Poverty is a deeply cyclical problem, intertwined with race and racism, and I continue to be vexed by the limited things cities can do to lift its residents out of the cycle. Historically, state and federal government have taken the lead through welfare programs, Medicaid, food stamps, Section 8 and public housing, and Head Start, just to name a few. All of these programs have stagnated over recent years, and are threatened with being slashed in the near future.
The fact that Hampden County residents are going to live shorter, sicker lives than their neighbors in Hampshire County underscores the life and death urgency of figuring this out.