Report Shows Health Disparities in Valley ZIP Codes

FRESNO — A recent report on health inequities in the San Joaquin Valley gives new meaning to the real estate mantra: location, location, location.

The report by the Joint Center for Political and Economic Studies and Fresno State’s Central Valley Health Policy Institute found that location plays a very real role in health — so real in fact that life expectancy rates can vary by as much as 21 years in the valley, depending on the ZIP code.

There are generally much smaller gaps in life expectancy rates, even between developing countries and industrialized nations.

The valley’s life expectancy gaps are drastic, said John Capitman, who oversaw the report, “Place Matters for Health in the San Joaquin Valley: Ensuring Opportunities for Good Health for All.” Five to six year differences are the typical extremes found in most U.S. cities, he said.

Residents living in poor and minority neighborhoods experience adverse health effects from social, environmental and economic conditions and these conditions are often perpetuated by public policy decisions, said Capitman, who is also the Fresno State Nickerson Professor of Public Health and executive director of the Central Valley Health Policy Institute.

The report, funded by a grant from NIH’s National Institute on Minority Health and Health Disparities, was prepared in conjunction with the Center on Human Needs, Virginia Commonwealth University and Virginia Network for Geospatial Health Research.

Poverty, Lack of Education Affect Health

Poverty and lack of education are two huge constraints to living a healthy life, according to the report. In 2009, more than one-fifth of households in the Valley had incomes below the federal poverty level. The rate of premature death in the lowest-income ZIP codes of the Valley is nearly twice that of those in the highest-income areas. Adults without a high school diploma are three times more likely to die before the age of 65 than those with a college education.

Meanwhile, wealthier neighborhoods, such as Woodward Park in Fresno and Lincoln Village in San Joaquin County, are among the ZIP codes with the highest life expectancies — 90 years or more. Both are populated mostly by white residents with high levels of education and household incomes.

Capitman said the report is important in that it uses life expectancy rates to crystallize the very real differences in communities in terms of health outcomes. “It picks out the kinds of places that benefit and those that are most troubled,” he said.

The report “helps solidify or give academic legitimacy to what residents already feel is happening,” said Veronica Garibay, community education outreach coordinator for California Rural Legal Assistance. “There’s been a historical lack of investment and discriminatory lending patterns with regard to unincorporated communities.”

Public Policy Plays Role in Perpetuating Cycle

“The thing that is important is to begin to identify that there are straightforward pieces of policy and choices we’ve made as a community that create and sustain those patterns,” Capitman said.

In central Fresno, for instance, there are thousands of environmental pollution sites, commonly referred to as brown fields, along a three-mile corridor, Capitman said. A meat rendering plant in Fresno is right in the middle of a poor, urban neighborhood and doesn’t even have a legal conditional use permit, he added.

Schools are another example. “In the Central Valley, we fund schools at a very local level,” he said. “So we’ve created a structure where the power of the local economy, the ZIP code level, ends up shaping the quality of education.”

In many poorer neighborhoods, residents also don’t have access to fresh fruits and vegetables or a full service grocery store. “It’s a combination of zoning policies and the kinds of incentives the public sector has given to food suppliers,” he said.

Eric Payne, program manager for the Fresno Youth Council for Sustainable Communities, said his neighborhood in Southwest Fresno has few options for healthy food. He is working with youth and one of the country’s leading brown field reclamation experts to create an urban garden from a brown field in that neighborhood. “Southwest Fresno has been identified as a food desert. We want to turn it into a food oasis,” Payne said.

Recommendations Include ‘Equity in All Policies’ Approach

Capitman said people living well in the Valley need to engage and show a willingness to talk about inequity. Economic prosperity in the Valley goes hand in hand with improved standards of living for everyone, he said.

During the formation of this study, the Place Matters team consulted with more than 80 advocacy organizations in the Valley. “We did come to a strong consensus that there is a need to talk about fair chances,” Capitman said. “We need to focus on this notion that people in some communities just don’t have what it takes to live a good life available to them and let that shape how we think about zoning and school funding.”

Recommendations for improving communities include adopting an “equity in all policies” approach. Seattle, for instance, has adopted such a policy and every time the city or county makes a choice about zoning or contracting, it must at least consider how that choice affects life in every ZIP code.

Other recommendations include enforcing existing air quality standards, promoting environmental and social sustainability in agriculture and adding infrastructure to unincorporated communities.

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