A major report on urban health in America has given Oakland mixed grades. The 2015 Big Cities Health Inventory showed the city has seen mortality rates from most major causes of death drop in the last decade. But it also highlighted deep and, in some cases, widening racial disparities in its residents’ health.
Funded in part by the U.S. Centers for Disease Control and Prevention, and compiled by a national coalition of public health departments, the report collected data on more than 30 health indicators in 27 metropolitan areas with populations over 350,000. The assessment, released November 18, was the first such report issued since 2007.
The inventory includes a staggering amount of data in its examination of the health of more than 52 million people living in the jurisdictions it studied. That’s one in six Americans.
Alameda County Public Health Director Dr. Muntu Davis said the real value in tracking health data comes in looking at shifts over many years. “I think it’s important as we look at these numbers, and the changes, to always track trends, and not just look at these as a point in time,” Davis said. “That’s what’s going to tell us what’s really happening. We have to look at what’s the cause, at the city or the societal level.”
Here are several key findings of importance to Oakland residents. To examine the entire report and the raw data, visit bchi.bigcitieshealth.org.
1. Overall, the city is healthier than it was a decade ago.
The 2015 report’s snapshot of urban health across the country is rosy in the big-picture view. In nearly every city analyzed, mortality rates for major causes of death dropped.
Oakland follows that trend. The rate of new HIV diagnoses fell slightly, and dropped in proportion to other major cities. The HIV mortality rate in 2012 was nearly half what it was in 2004, mirroring a similar drop in the total U.S. rate. And for many health indicators, the city has met “2020 Healthy People Objectives,” benchmarks for improvement set by the U.S. Department of Health and Human Services. The overall cancer death rate has dropped below the 2020 target of 161.4 deaths per 100,000 people. The city is also beating the targets for suicide rate (below 10.2 per 100,000), infant mortality rate (fewer than 6 deaths per 1,000 live births) and the rate of babies born with low birth weights (less than 7.8 percent of babies).
Another good sign: Oakland tied with four other West Coast cities for longest life expectancy—just shy of 82 years—among the 27 metro areas measured. While comparable data from the 2007 report wasn’t immediately available, Davis said the life expectancy for all of Alameda County at the time the earlier report was compiled was approximately 80 years.
2. Racial disparities in residents’ health are stark, and for some measures, they’re growing.
The report reconfirmed a troubling if well-known fact: While the overall health picture has improved in urban areas, black people in America’s cities suffer disproportionately from disease and have higher mortality rates than the general population. (The report uses “black” to describe people of African-American descent.) A chart showing 2012 mortality rates by race for each study city indicates it’s a particularly big problem here. The disparity in Oakland between the mortality rate for all residents and the much higher rate for black residents is among the greatest measured in the 2015 Big Cities Health Inventory.
The 2015 report shows the disparity has grown in Oakland since the last inventory was released in 2007. According to the 2015 report, which cites data from 2011, the mortality rate from all causes of death for all races was 605.9 deaths per 100,000 residents. Among black people, it was 938.6 deaths, or 1.5 times higher. That gap is slightly wider than the one reported in 2007, which showed a black mortality rate that was 1.4 times higher than the overall mortality rate.
The growing gap is evident in other health measures in Oakland. In 2013, the rate of black people living with HIV and AIDS in the city was double the rate among the city’s general population, an increase since 2004 when it was 1.7 times higher.
Not every measurement of health indicated increasing disparities, however. The differences in the infant mortality rate for black people versus the rest of the population, while large, shrank slightly since the last report, as did the disparity in the mortality rates for those with heart disease.
Davis said there’s a complex web of factors that contribute to racial disparities in health. “Many areas with higher populations of African Americans may be lower-income and have poorer air quality because they’re located next to freeways,” he said. Those neighborhoods may not have access to fresh, healthy food, he added, and even something like a lack of banking institutions that can keep people relying on payday loans can have an effect on public health.
That’s not news, Davis said, but city officials can use data on disparities to implement policies that can help fix the problem: An “equity roadmap” to push for affordable housing where it’s needed most, for instance.
“We know what needs to be done in general,” he said. “The question is, how do we go about getting each city and each county to get those things in place?”
3. When it comes to homicide rates, the news isn’t good.
Oakland’s homicide rate—18.3 slayings per 100,000 residents in 2011, the most recent year for which the city provided data—was among the highest reported. Only four other cities out of the 27 in the inventory had higher rates: Cleveland; Kansas City, MO; Philadelphia; and Detroit, which at 40.5 per 100,000 had the highest rate.
Oakland’s homicide rate for that year, which had increased slightly since the 2007 report, is more than three times the federal target rate of 5.5 per 100,000 people.
More recent data indicates Oakland’s homicide rate is now higher than it was in 2011, but dropped last year. According to a January, 2015, story in the East Bay Express, there were 92 homicides in 2013 and 86 in 2014. Using available population data from the U.S. Census, that puts the homicide rate at 22.6 deaths per 100,000 in 2013 and 20.8 in 2014.
Davis said that, as with so many issues, he sees housing affordability as one of the root causes of the city’s homicide problem. The country went through a major recession since the last health inventory was compiled, and Davis said the boom associated with the economic recovery now underway is squeezing some Oakland residents even more.
“As populations with higher incomes are moving in, places that were affordable are now no longer affordable,” he said. “People are really struggling to make ends meet.”
4. Oakland is hitting targets in improving infant mortality and low birth weight.
Oakland’s overall infant mortality rate—the number of deaths per 1,000 live births—was 4.2 in 2011, the only year for which that data was provided. That’s better than the national average of 6.1 for the same year, and below the federal 2020 target of 5.5.
Oakland’s black infant mortality rate was much higher than that of the city’s general population, a disparity found in most American cities. But at 10.4 per 1,000 births, it was still better than the national average for black infant mortality of 11.6 per 1,000 births in 2011. The overall infant mortality rate and the black infant mortality rate in Oakland both fell since the last health inventory report in 2007, as did the percentage of babies born with low birth weight.