HEALTH EQUITY SCORECARD PENDLETON COUNTY

INTRODUCTION

The equity scorecard is a tool and resource for evaluating how the various geographical, economic, and population make-up affect the health of a particular area or group. Inequities can be found in people of varying races and ethnicities, as well as in people who live in a particular geography, regardless of race or ethnicity. The scorecard framework is aligned with social determinants of health and will aide in the development of practical strategies to assist with implementing institutional change that will lead to equitable health outcomes for all persons.

CENSUS TRACTS

Census tracts are small, permanent statistical subdivisions of a county. Each is uniquely numbered with a numeric code. Each tract generally averages about 4,000 inhabitants with a minimum population of 1,200 and a maximum of 8,000.

POPULATION

Understanding the data: Each number highlighted in red indicates the highest ratio and green represents the lowest ratio of the population to whites for the geographic area measured. Higher areas of segregation are often associated with poorer health outcomes and equity.

IndicatorMeasureYearsTypeCT9301.01CT9301.02CT9302CT9703
PopulationWhite2018-21Quantity2,8473,5702,6734,797
 Black/African American2018-21Quantity0582614
 Other Race(s)2018-21Quantity14634630118
 Hispanic2018-21Quantity66136272
 Not Hispanic2018-21Quantity2,9273,9612,6674,857
 Ratio of Whites to each African American Resident2018-21Ratio062103343
 Ratio of Whites to each Other Race Resident2018-21Ratio20108941
 Ratio of Not Hispanic to each Hispanic Resident2018-21Ratio432754367
CommunityDissimilarity Index2018-21Index0.530.480.560.35

Observations

  • The African American population is primarily segregated into Census Tract 9301.02, Butler, Gardnersville, Demossville and Knoxville areas, in Pendleton County where there are only 62 whites for each African American resident. Conversely, there are 343 whites per African American in CT 9303 and no African American residents in CT 9301.01 for the Mt. Auburn and Peach Grove areas.

  • To completely desegregate Pendleton County, 20 African Americans would need to move into CT 9301.01, 65 abd 29 into CT 9303, from the CT 9302.02 areas. It is important to note however that segregation can occur in smaller geographic areas including neighborhoods or even streets. Consequently, simply increasing the population dispersal by census tract may have little to no impact on health status and/or segregation. Given the rurality of the county and the size of the population, neighborhood and street level data is not available.

EDUCATION AND INCOME

Understanding the data: There is generally a direct correlation between level of education and median household income for a population. Income affects health in a variety of ways including access to care, higher rates of obesity, and higher rates of smoking all of which are linked with poorer health outcomes.

The Gini index measures the distribution of income across a population. The higher the index value, the less income is spread across the population and the more income fewer people have than the majority of the population.

Indicator Measure Years Type CT9301.01 CT9301.02 CT9302 CT9303
Income Median HH Income 2018-21 Dollars 17,600 9,048 -2,317 -19,606
Inequality Index – Gini 2018-21 Index 0.3833 0.4006 0.4236 0.4728
Education Individuals 25 and over with no high school diploma 2018-21 Percent 11.7 11.9 17.5 22.8

Observations

  • Persons living in CT 9303, encompassing Falmouth, Morgan and McKinnesyburg communities, are at a significant economic disadvantage when compared with the median household income for Pendleton County, having a median household income of -$19,606 less than the average Pendleton County household.

  • Income is spread most equally among households in CT 9301.01 with a Gini index of .3833 which measures the dispersion of income across the entire income distribution. Where 0 is perfect income distribution and 1 is perfect inequitable distribution. The U.S. Gini index 5-year estimates for 2018-21 is .4848 and Kentucky is .4767.

HOUSING

Understanding the data: Poor housing quality and inadequate conditions such as overcrowding, incomplete or the lack of a kitchen, and access to a vehicle can lead to poorer health outcomes including chronic disease and injury. Areas with higher rates suffer more disadvantages that can affect health outcomes than in other areas of the same population.

Indicator Measure Years Type CT9301.01 CT9301.02 CT9302 CT9303
Housing Homeowner with a mortgage 35% or more of HH Income 2018-21 Percent 18.0 14.3 18.9 15.0
Homeowner without mortgage 35% or more of HH Income 2018-21 Percent 12.4 2.0 10.6 28.5
Rental costs 35% or more of HH income 2018-21 Percent 27.6 23.3 37.8 65.1
Occupied housing units without access to a vehicle 2018-21 Percent 1.2 1.3 4.4 8.4
Occupied housing units lacking a complete kitchen 2018-21 Percent 0.0 0.0 0.8 0.4
Occupied housing units with more than 1.51 occupants per room 2018-21 Percent 0.0 0.0 0.8 0.5
Proportion of children under 18 in single parent household 2018-21 Percent 8.0 12.0 13.0 67.0
Median owner-occupied housing unit value 2018-21 Dollars 174,600 137,100 140,800 99,400

Observations

  • Sixty-seven percent of children under 18 living in a single parent household live in CT 9303, including the Falmouth, Morgan and McKinneysburg areas.
  • In the same areas, 8.4% of households are without access to a vehicle and 65.1% of the rental households there are in excess of more than 35% of the householder’s income.

HEALTH STATUS AND HEALTH RISK BEHAVIORS

Understanding the data: Each measure highlighted in red reflects poorer health status, less compliance with prevention services and higher rates of the population participating in risky health behaviors.

A population’s current health status and health risk behaviors are good indicators for identifying opportunities for action to help improve health outcomes.

Indicator Measure Years Type CT9301 CT9302 CT9303
Health Status Physical health not good for >=14 days among adults aged >=18 years 2020 Percent 12.4 13.9 16.8
Fair or poor self-rated health status among adults aged >=18 years 2020 Percent 17.5 20.1 25.6
Mental health not good for >=14 days among adults aged >=18 years 2020 Percent 17.4 18.9 20.4
Prevention Cervical cancer screening among adult women aged 21-65 years 2020 Percent 82.5 80.9 78.2
Cholesterol screening among adults aged >=18 years 2019 Percent 90.4 89.0 87.3
Fecal occult blood test, sigmoidoscopy, or colonoscopy among adults aged 50-75 years 2020 Percent 71.9 69.4 67.0
Mammography use among women aged 50-74 years 2020 Percent 71.0 70.8 69.5
Older adult men aged >=65 years who are up to date on a core set of clinical preventive services: Flu shot past year, PPV shot ever, Colorectal cancer screening 2020 Percent 46.8 44.1 39.7
Older adult women aged >=65 years who are up to date on a core set of clinical preventive services: Flu shot past year, PPV shot ever, Colorectal cancer screening, and Mammogram past 2 years 2020 Percent 37.4 35.5 31.3
Taking medicine for high blood pressure control among adults aged >=18 years with high blood pressure 2019 Percent 76.9 76.6 77.7
Visits to dentist or dental clinic among adults aged >=18 years 2020 Percent 58.6 53.9 46.7
Visits to doctor for routine checkup within the past year among adults aged >=18 years 2020 Percent 75.5 76.0 75.7
Current lack of health insurance among adults aged 18-64 years 2020 Percent 9.9 10.6 13.0
Health Risk Behaviors Binge drinking among adults aged >=18 years 2020 Percent 16.6 16.3 15.2
Current smoking among adults aged >=18 years 2020 Percent 22.1 25.4 29.7
No leisure-time physical activity among adults aged >=18 years 2020 Percent 29.1 31.9 37.4
Sleeping less than 7 hours among adults aged >=18 years 2020 Percent 38.3 40.1 41.1

Observations

  • Census Tract 9301 was redistricted into 9301.01 and 9301.02 as of the 2020 census.
  • The vast majority of health status measures and prevention actions are the poorest in CT 9303, encompassing the Falmouth, Morgan, and McKinneysburg areas.
  • Additionally, populations with the highest level of health risk behaviors also live in CT 9303.

HEALTH OUTCOMES

Understanding the data: Health outcomes are those conditions or events that occur as a result of lack of intervention, poor health behaviors, and other social determinants of health that affect one’s health status. Outcomes can have a direct impact on one’s overall health. As an example, those who have strokes can lose their ability to care for themselves, experience paralysis, and lose their ability to get exercise resulting in obesity and additional health issues.

Indicator Measure Years Type CT9301 CT9302 CT9303
Health Outcomes All teeth lost among adults aged >=65 years 2020 Percent 16.3 19.0 25.2
Arthritis among adults aged >=18 years 2020 Percent 30.1 30.9 33.9
Cancer (excluding skin cancer) among adults aged >=18 years 2020 Percent 6.6 6.1 6.4
Chronic kidney disease among adults aged >=18 years 2020 Percent 2.7 2.9 3.5
Chronic obstructive pulmonary disease among adults aged >=18 years 2020 Percent 8.9 10.1 13.0
Coronary heart disease among adults aged >=18 years 2019 Percent 6.7 7.0 8.4
Current asthma among adults aged >=18 years 2020 Percent 10.7 11.4 12.3
Depression among adults aged >=18 years 2020 Percent 25.5 27.1 28.5
Diagnosed diabetes among adults aged >=18 years 2020 Percent 10.3 11.2 13.1
High blood pressure among adults aged >=18 years 2019 Percent 37.5 38.6 41.9
High cholesterol among adults aged >=18 years who have been screened in the past 5 years 2019 Percent 36.1 36.0 37.3
Obesity among adults aged >=18 years 2020 Percent 38.1 40.9 43.0
Stroke among adults aged >=18 years 2020 Percent 3.0 3.2 4.1

Observations

  • Persons living in CT 9303 have the poorest health outcomes in the county ranking highest in 12 out of the 13 health outcomes.

MORTALITY

Understanding the data: Ratios are a comparison between two numbers. In this case we are comparing the rate at which the dominant race dies from a particular cause with the rate of which another race dies from the same cause. For example: 6.5 African Americans die for every white person that dies from hypertension or hypertensive renal disease.

#Parkinson disease (G20-G21) 1999-20Ratio16.50.0

IndicatorMeasureYearsTypeWhitesAfrican American/BlackOther Races
Cause of death#Diseases of heart (I00-I09,I11,I13,I20-I51)1999-20Ratio10.40.0
 #Malignant neoplasms (C00-C97) 1999-20Ratio10.40.3
 #Accidents (unintentional injuries) (V01-X59,Y85-Y86) 1999-20Ratio10.00.0
 #Chronic lower respiratory diseases (J40-J47) 1999-20Ratio10.00.0
 #Cerebrovascular diseases (I60-I69) 1999-20Ratio10.00.0
 #Alzheimer disease (G30) 1999-20Ratio10.00.0
 #Diabetes mellitus (E10-E14) 1999-20Ratio10.01.9
 #Influenza and pneumonia (J09-J18) 1999-20Ratio10.00.0
 #Intentional self-harm (suicide) (*U03,X60-X84,Y87.0) 1999-20Ratio10.00.0
 #Nephritis, nephrotic syndrome and nephrosis (N00-N07,N17-N19,N25-N27) 1999-20Ratio14.80.0
 #Septicemia (A40-A41) 1999-20Ratio10.00.0
 #Chronic liver disease and cirrhosis (K70,K73-K74) 1999-20Ratio10.00.0
 #Essential hypertension and hypertensive renal disease (I10,I12,I15) 1999-20Ratio10.00.0
 #Parkinson disease (G20-G21) 1999-20Ratio10.00.0
 #Pneumonitis due to solids and liquids (J69)1999-20Ratio10.00.0
 #Certain conditions originating in the perinatal period (P00-P96)1999-20Ratio10.00.0

 

Observations

  • The African American population in Pendleton County is very small with less than 100 persons estimated in the 2021 American Community Survey. As such, mortality information is limited to protect the privacy of our African American populations.
  • Of particular note however is the ratio of deaths from Nephritis, nephrotic syndrome and nephrosis among the African American population whereby 4.8 African American’s die for each White from the same cause.
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