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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