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- What makes this Report Card different?
- What are the social determinants of health?
- What is health equity?
- How can this Report Card make a difference?
- Report Card Sponsors
- Past Report Cards
Since publication of the first Report Card in 1996, Community Choices has been telling the story about the health of Clark County. Much of this has been done by reporting on disease, illness, injury and associated risk factors. This report takes an approach that will more quickly advance and sustain the health of our community and all of its residents.
In this Report Card we propose a new lens for examining the health of our county. It is time to zoom out to examine another layer to what constitutes health. These are factors that have an obvious or not so obvious influence on how healthy we are as a community, and that eventually influence how healthy we are as individuals. Scientific research indicates that often this is a more powerful approach to creating a healthy community than focusing on individual behavior change, even though behavior change is critical to our health as well. This Report Card addresses our collective health and, as part of this approach, the factors evaluated are social determinants.
Taking the view that health, as defined by the World Health
Organization, “is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity”
we understand that what determines our health reaches far beyond
medical care. The broader impact is from conditions in which we live,
from birth to old age, that are determined by social and economic
policies. These conditions determine our ability to be healthy, such
as access to healthy food, access to education, access to transportation,
a non-toxic and safe environment, an ability to be socially
involved, the ability to be employed, etc. These are largely determined
by the priorities a community sets and are mostly responsible
for health inequities – the avoidable differences in health between
individuals within a community.
One may ask how social determinants ultimately impact health status.
Take the health issue of obesity for example. A person may be obese
for several reasons: lack of physical exercise, eating unhealthy foods,
using food as a means of coping with stress, etc. While individuals
have personal responsibility to employ preventive or remedial measures
to deal with unhealthy weight, the choices individuals make are influenced by the choices individuals have. A person is limited in
choice of physical activity if they do not have a safe neighborhood,
nearby park for walking or enough money to get to a gym. Or if
people do not have access to a supermarket that carries fresh fruits
and vegetables, they may depend on getting less healthy foods from
mini-marts or fast food restaurants that are easier to get to. These are
just a few examples of how social structures impact healthy weight.
Instead of reporting on the status on the health of individuals in this county, this Report Card will focus on the outer circle - those determinants that are based on social, ecological and economic factors - and report on the data we have that reflect those. As we examine the data, it is important that we not only look at how the county as a whole is doing, but also examine the data for various sub-parts of our county to tell the story of health equity among our neighborhoods.
Our ability to be healthy is not only affected by our knowledge of healthy behaviors and our motivation to change, but also by our opportunities to take advantage of healthy behaviors. Research shows that the more access the entire community has to health opportunities, the better the health of the individual members in that community.
Once we take a look at our assets and honestly appraise the areas in which we need to make improvements, we can take action to strengthen our community. We can take action both as individuals and as a collective.
As this Report Card goes to print, a severe recession is greatly impacting our community and the nation as a whole. Many of the impacts are not yet reflected in the available data. For example, as of October 2009, the unemployment rate for Clark County was 13.7 % (not seasonally adjusted) – notably the highest unemployment rate in Washington. In addition, city, county, and state governments, as well as non-profit organizations and private sector businesses, are experiencing budget shortfalls not seen in most of our lifetimes. This is resulting in a loss of public services, safety net services, and jobs that are sure to impact our communities, our residents, and ultimately, everyone’s health.
This Report Card examines six social determinants of health based on the data we have available. For each determinant, we indicate steps that will improve our indicators and thus our community’s health in the years ahead. We hope that the information we present in this report will cause our county to become the healthiest community in a state striving to be the healthiest in the nation.
Community Choices would like to thank the following sponsors who supported the development and distribution of the 2009 Community Report Card:
