Rationale for Selection
[Pages:2]H E AHLETAHLTI NHDIINCDAITCOARTO2 1R: 1L: IIFNEDEIXVPIEDCUTAALNSCBYELOW 200% FEDERAL POVERTY LEVEL (FPL)
D E SDI RE SEIDR RE DE SRUELSTU: LITN:CDREECARSEEALSIEFETEHXEPNECUTMABNECRYOF PEOPLE LIVING IN POVERTY
Rationale for Selection:
CURCRUENRRTENT TARGTAERTGET
783.60.8% 82.207%
year(s2013-17)
years
Life expReacttiaonacyleifsoar Sperloecxtyiomn:easure for the total health of a population.
DispariItinecsoinmleifeleevxepleicstaansctyrobnetgwepernedpiocptourlaotifoansppeorisnotnto's aarcecaessws htoere issues orfehsoeaulrthceesqaunitydmhueastltbhesatdadturess.sLeodw. income restricts access to
quality housing, transportation, food, and education, which
DEFIDNEIFTIIONNITION
CThoenulttimexaltteimmeiatssuroe opfpheoalrthtuthnatimtiaensy pfeooprlepcoenosidpelrewhteon tlhivinekinhgeofaplotphulyatiloinvehesa.lthF,iGs life
expectancy. For most of human history, average life expectancy has steadily increased with improvements
AveraPgeernceunmtboefrinodf iyveidarusaolsf wlifiethreinmcaoimniensgat or in health care, sanitary conditions, decreases in disease epidemics, and improved safety measures. Yet, in
for pebresolonws w20h0o%haovfethaettaFiPnLed a given age
the past seCveoranl yteearxs,tthe United States average life expectancy has been slowly creeping down, from 78.9
DETADILESTAILS Life eNxpoetcatpanpcliycalibstleed is for a person born in that year
NC PERCENT OF INDIVIDUALS BELOW NC LI2F0E0E%XPFEPCTLA(N20CY13(2-1071)6-18) 78.0 years
years in 2014 to 78.6 in 2017.193 This is due to an increase in deaths from drug overdose and suicide.194 The 2016-1P8osvteartetyaivsedriargeectlliyfelienxkpeedcttaonnceygwaatisv7e8h.0e,awlthithosuitmcoilmaredse. cIrnecaosmeseaiss tcheentnraatliotonaalcacveesrsaingge r(e2s0o1u4rces life expectanneceyd: e78d.3to).bTehehetoaplththyresuecchauassessaofef yheoaurssionfgl,ifneulotrsittiionuNsofortohdC,aerdoulicnaatiaorne,isacnhdemtraicnhspeaorrttadtiisoena,se; trachea, braosncwheulsl ,aasnhdelaulnthgscearnvciceerss;aanndd trroeaadtminejunrti.eIsn.cSoemlf-ehaisrmonaenodfdtrhueggurseeatdeissot rpdreerdsicrtaonrkssoixftdhisaenadse
and mortality rates.21 Low-income adults have higher rates of heart disease, diabetes, stroke, seventh, reasnpdecotitvheelyr,cinhrtoonpiccaduissoesrd, merisrrtohrainngththeeirnwaetiaolnthailetrrecnodusnitmerppaacrttins.g22oIvnecroamll leifieseaxnpeecvteanncsytr.onger
37%
predictor of health disparities than race when considering the rates of disease within racial/
2030 TARGET 82.0 2ye0a3r0s TARGET
27% RANGE AMONG NC COUNTIES 73.1 R?A8N2.G1 EyeAaMrsONG NC COUNTIES
Not Available RANK AMONG STATES Not ARvAaNilaKblAeMONG STATES (2017)
39th* DATA SOURCE NC StDatAeTCAenSteOrUfoRrCHEealth Statistics, Vital StatisAtimcserican Community Survey
STATESTPALATNE SPWLAINTHSSWIMITILHASRIIMNDILIACARTORS Not AIpNplDicIaCbAleTORS
North Carolina Perinatal Health Strategic PlanF- indicator of addressing social and
economic inequities for families
Dispariettihensic groups.22 People below 200% of the Federal Poverty Level (FPL) are more likely to rate There are sttahrekmdisseplavreitsieisninfaliifreoerxppeocotarnhceyaalcthro(s2s0ra%c)e,,hgaevoegrhaipghhye, ranradtgeesnodfeor,baesswiteyll(3as6%int)e,rasnecdtiaornes mofothreese characteristliicksetlhyattoshboewawciudreregnapt ssmbeotwkeeren(2g5r%ou)p.2s3.TAhfreiycahnaAvme eferiwcaenrsm, AemdeicriaclacnaIrnedoiapntsi,opneso,palereinmruorrael lairkeealsy, and men typtoicablelyuhnaivnesluowreedr,liafendextpheectuapncfrieosntthcaonstthseoafvseerravgiec.eAsmaorengaAgfrreicaatneAr mbuerridceannsf(oinrctlhuedming.22thMoseental of Hispanichetehanltichitsy)e,rtvhieceasvecraangeallsifoe ebxepiencatacncceyssfiobrlewofomreand(u7l9ts.0wyeitahrsl)oiws silnigchotmlyeasb.o24veAdthueltsstawteitahvefaramgiely (78.0 years)i,nacltohmouegshbleolwoewr tahnadnntheeaarvpeoravgeertfyoer xwpheitreiewnocme emno(rinecslutdreinsgs,tphoasreticouf lHairslpyafninicaentchinailcisttyr)e(s8s1,.1which is years).195 FodreAtfrriimcaennAtamletroictahnemireonve(inracllul hdienagltthhoasnedowf Heilslp-baeniicnget.hnicity) the average is much lower at 72.2
years compLaorewdetro-i7n6c.5omyeearesafronrewrhsiateremceonn(sintrcaluindiendgitnhothseeiorfoHpistpioannsicfeotrhnwichietyr)e.19t5oThliveed.isLpoawrietire-scofosrtAhforiucasning Americans ctoemndpsarteodbteo winhaitreesaasrethdauteainrepfaarrttthoeirssrueems ostveemdmfrinogmfrsoemrvliicmeiste, drehqeuailrthe chairgehaecrcetrsas,n19s6plaocrktaotfiotrnust in medical pcroosfetss,sihoanvaels,osvoecricarloawnddeincgon, oamndichfaacvteorgsrleikaeterarceisxmpo(es.ugr.,ewteoahthaezrainrdgo, suesetoPxaignes3s1ucinhIanstrmodoulcdt.ioTnh)ese and unempplooyomrehnot,u19s6ianngdcfoirneadrimtiodnesacthosrroeflyaoteunwgietrhAtfhriecapnoAomr hereicaaltnhmcoenn.d19i7tiOonntshoefoltohwer-ihnacnodm, Heicshpailndircen such populationsasseaestthhemhaigahnerdliefeleevxapteecdtalnecaidesledveesplsi.t2e2lower average socioeconomic status. This is largely due to lower rates of smoking, leading to lower cancer and cardiovascular disease mortality in adults, but also lower rates
of suicide anCdhialdccriednen'stahlepaoltishonisinpgoasmitiovneglyycoournrgelHatisepdantoicspcaoremnptasr'eindctoomwehsit,ews.1i9t8h children born to low-income
mothers having a greater risk of low birth weight and higher rates of heart conditions, hearing Geographicpdriospbalerimtiess, aarnedalisnotecsletainraalcdroisssoNrdoerrths.C22aCroolnintaro(SlleinegFifgourrceh3il6d)r.ePne'osphleeablothrnaint bSiwrtahin, tChoousnetybhoarvnettohe lowest life elxopweectrainnccyo(maveerpaagreefnotrs2a0r1e6-l1e8s)sahte7a3l.t1hyyeianrsa,dwuhlitlheothoodsethinanOrtahnegirewCoeuanltthyihearvpeetehresh25i.ghest at 82.1
years. Factoring race and geography together reveals the multiple levels of disparities. Life expectancy for the
Early Childhood Action PlanG- Families living white populTahtieonfivineS-yweaairnaisv7e5ra.6gyeeaorfsinanddiviisd6u7a.5lsybeealroswfor2t0h0e%AmFPeLricbaentwInedeiann2p0o1p3u-l1a7tioinn.NInoOrtrhanCgaeroCloinuanty the
at or below 200% of FPL is a sub-target of all life expectanwcaysfo3r7t%hecwohmitpeaproepdutlaotiaopnpisro8x3im.1ayteealrys3co3m%poafrefadmtoil7ie5s.2nyaetaiorsnfworidthee.26AfFroicra2n0A1m9e, r2ic0a0n%poFpPuLlafotiron in
10 goals in the Early Childhood Action Plan the same coiunndtiyv.i1d99uals was $24,980.27
*Rank of 1st for state with lowest percent of individuals below 200% FPL
DDD The life expectancy averages listed here are averaged across three years, 2016 to 2018. EFtyFEFE%NE2so0triLmtihfaeFGC%taNeN2drooo0rllrEitiftnhxehpaCeCeSxacaptrtaroaeotlncelitincnaCiaeanescDnD%yteee2fppor0arafaorrtttrht%mmeH2eeeH0nanibtslttiporhoatffhSnHH.tiheacetatampilsoltttlhpihcuasal,nan2dtd0ioH1Hn6uu-im2mn0aNa1nno8SrSCteheorruvCvinaicctereyosslL..iinNfNeaooErfrotxthrphe2CCc0aat1raro6onllictinoynaa2a0PtE1eBa8rirrilntiyshaC,9tNah0.lio8lHdrtyheheoaaColtradhsr.oASTlcthirntiaisaoteneCsgoPtiiuclmanPnatli.taeeFnse.h:bha2rts0tup1bas6er:-ey/2/n20s0ce2hx10cs9.l..udMhdpatehtrd.pcnshfc:rd/o2/hm0fhi1lset6h.s.ge.honHtvct/.NpgdsCoa:v/t2a//0wn/3lchi0fdbehrx.enhppcseop/cEruttaCbdAnlaiPccyt-ha/Re2epa0prl1etoh6sre-.tc2-noF0tIma1N8t/iA/opL2nh-0Wsb1pe8E/c%Ba-2uf.0spSedtoaf ftec%on2c0earnnds %th2a0t2it0m16a-2y0b1e8%un2r0eClioaubnle-.
NORTH CAROLINA INSTITUTE OF MEDICINE. HEALTHY NORTH CAROLINA 2030: A PATH TOWARD HEALTH. MORRISVILLE, NC: NORTH CAROLINA INSTITUTE OF MEDICINE; 2020.
H E AHLETAHLTI NHDIINCDAITCOARTO2 1R: 1L: IIFNEDEIXVPIEDCUTAALNSCBYELOW 200% FEDERAL POVERTY LEVEL (FPL)
D E SDI RE SEIDR RE DE SRUELSTU: LITN:CDREECARSEEALSIEFETEHXEPNECUTMABNECRYOF PEOPLE LIVING IN POVERTY
AVERAGE LIFE EXPECTANCY AT BIRTH (YEARS)
FIGURE 35
Rationale for Selection:
Life eCxUpRecRtEaNncTy acrosTsApRopGuElTations in North Carolina and distance to 2030 target
36.980 %
(201830-17)
27% TARGET
82.0
Income87le.0v*el is a strong predictor of a person's access to
resources and health status. L8o0w.3 income restricts access to 78.3* 75.5* quality housing, tr7a5n.6s*po7r4ta.8tion, food, and education, which
70
CURRENT
limits opportunities for people to live healthy lives. F, G
DEFINITI6O0N
78.0
Percent of5in0dividuals with incomes at or
below 2004%0of the FPL
Context
DETAILS 30
Poverty is directly linked to negative health outcomes. Income is central to accessing resources
Not applic2ab0le
needed to LIFE EXPECTANCY be healthy such as safe housing, nutritious food, education, and transportation, ESTIMATES FOR
as well as THE HISPANIC
POPULATION ARE
health
services
and
treatment.
Income
is
one
of
the
greatest
predictors
of
disease
NC PERC1EN0 T OF INDIVIDUALS BELOW
200% FPL (2013-17)
0 37%
W
and mortality UNSTABLE. THE
ESTIMATE FOR 2016-
ratesN.O21
DLAoTwA -income
adults
have
higher
rates
of
heart
disease,
diabetes,
stroke,
1a8 InS d90.o8 YtEhAReSr. chronicAdVAisIoLArdBeLErs than their wealthier counterpaNrOtsD.2A2 TIAncAoVmAIeLAiBsLaEn even stronger
B/AA prHe/dLiXctor of hOealth dAi/sPpIarities AthIan racMeAwLhEenFcEoMnAsLidEering< 2t0h0e% ra2t0e0s-39o9f%di4s0e0a%s+e within racial/
W = WHITE
O = OTHER
RACE / ETHNICITY
SEX
FEDERAL POVERTY LEVEL
B/AA = BLACK/AFRICAN AMERICAN A/PI = ASIAN/PACIFIC ISLANDER
ethnic groups.22 People below 200% of the Federal Poverty Level (FPL) are more likely to rate
2030 TARGET H/LX = HISPANIC/LATIN(X)
AI = AMERICAN INDIAN
* 2016-18 AVERAGthEemselves in fair or poor health (20%), have higher rates of obesity (36%), and are more
27%
likely to be a current smoker (25%).23 They have fewer medical care options, are more likely
2030 Target and Potential for Change to be uninsured, and the upfront costs of servicLees vaerersa fgoreraCtehrabnugrdeen for them.22 Mental
The HNRCAN20G30EgArMouOp NreGvieNwCedCdOaUtaNacTrIoEsSs several years, populahtieoanlst,hasnedrvsitcaetessc,aanndalasofobrecinasatcecdesvsailbuleeffoorr adul?ts wSietehLleovwerisnfcoor mCheasn.g24eAthdruoultgshwouitththfiasmreiplyort
NorthNCoatroAlvinaailabbalseed on historical data to set a target for 2030. Winictohmtheesbbeesltolwifeaenxdpneectaarnpcyov(aevrteyraegxepeforirence more stress, particularly financial stress, which is
2016-1R8A)NinKNAorMthOCaNroGlinSaTAcuTrEreSn(t2ly0a1t78)2.1 FFF years in Orange Cdoeutnrtiymtehnetgalrotoupthcehiorsoevteoraslelthaenalatghgarnedsswivell-being.
target3o9fth82*.0 years for indicators discussed in
the this
population overall for 2030. If report, overall life expectancy
improvements are made across the health will likeLloywseeer-ainncionmcreeaesaer.nIenrcsreaarseecsotnoswtraaridntehdisin
their
options
for
where
to
live.
Lower-cost
housing
targetDwAilTl AbeSsOeeUnRaCsEsuccess, particularly past sAevmeerarlicyaenarCso. mmunity Survey
as
they
will
signal
a
chtaenngdes itnotbhee idnoawrnewasarthdattreanrde sfaeretnheorverermthoeved from services, require higher transportation costs, have overcrowding, and have greater exposure to hazardous toxins such as mold. These poor housing conditions correlate with the poor health conditions of low-income children such
F I GSTUARTEE P3L6ANS WITH SIMILAR
as asthma and elevated lead levels.22
AveIrNaDgeICLAifTeOERxpSectancy for People in North Carolina CCohuinldtrieesn,'s2h0e1a6l-t2h0i1s 8positively correlated to parents' incomes, with children born to low-income
North Carolina Perinatal Health Strategic
mothers having a greater risk of low birth weight and higher rates of heart conditions, hearing
PlanF- indicator of addressing social and econ7o3m.1ic-in7e5q.9ui(t2ie7sCfoournftaiems)ilies
76.0 - 76.9 (25 Counties)
problems, and intestinal disorders.22 Controlling for children's health at birth, those born to lower income parents are less healthy in adulthood than their wealthier peers25.
Early7C7h.0ild-h7o7o.9d A(2c0tiCoonunPtlaiens)G- Families living at or7b8e.l0ow- 7290.09%(2o1fCFoPuLntiisesa) sub-target of all 10 go7a9l.s0in- 8th2e.1Ea(7rlCyoCunhtiiledsh)ood Action Plan
The five-year average of individuals below 200% FPL between 2013-17 in North Carolina was 37% compared to approximately 33% of families nationwide.26 For 2019, 200% FPL for individuals was $24,980.27
Sourc*eR: Naonrtkh Coafro1lisnat SftoartesCteantteer fworiHthealltohwSteatsisttipcse; hrtctpesn:/t/sochfs.dph.data/lifexpectancy/2016-2018/2018%20State%20and%202016-2018%20County%20Life%20Expectancies%20at%20birth.html Note:inLifdeievxipdecutaanlcsy bisethleoawve2ra0g0e %numFbPeLr of additional years that someone at a given age would be expected to live if current mortality conditions remained constant throughout their lifetime.
F North Carolina Department of Health and Human Services. North Carolina Perinatal Health Strategic Plan: 2016-2020. March 2016. G North Carolina Department of Health and Human Services. North Carolina Early Childhood Action Plan. February 2019.
NORTH CAROLINA INSTITUTE OF MEDICINE. HEALTHY NORTH CAROLINA 2030: A PATH TOWARD HEALTH. MORRISVILLE, NC: NORTH CAROLINA INSTITUTE OF MEDICINE; 2020.
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