Nov 22, 2016

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PRESS RELEASE: Vital Signs report reveals how race, place and income determine health in Colorado

FOR IMMEDIATE RELEASE

PDF version available here.

MEDIA CONTACT:
Bob Mook
bmook@copolicy.org
303-573-5669, ext. 311

DENVER – Research consistently shows a direct correlation between income, race, where you live and your health. In general, health outcomes for low-income Latino and Black people are not as favorable as the outcomes for affluent White people. Colorado is no exception to this scientifically validated but preventable trend – despite making significant gains in providing health coverage to its residents and boasting the lowest obesity rate in the country.

Vital Signs,” a new online report by the Colorado Center on Law and Policy, highlights the dramatic influence of income, race and place on health and reveals stark disparities in this state and the effect on those who live here. The report is particularly relevant as Colorado becomes an increasingly multiracial state. Between 2000 and 2015, people of color increased from one-quarter of the state’s population to nearly one-third. By 2040, an estimated 45 percent of the state’s population will be people of color. Communities of color in Colorado are disproportionately low-income, more likely to live in high poverty neighborhoods and attend high poverty schools, and are at a greater risk for poor health outcomes. As the state’s demographics shift, the race-based economic and health chasm will drive the overall health and economic vitality of the state as a whole.

While Colorado’s economy has grown substantially in recent decades, data shows that the benefits of that growth have not been broadly shared. In fact, income gains have disproportionately flowed to families at the top of the income distribution. Wages for workers in the top 20 percent of earners are up nearly 9 percent since 2000 while earnings for the bottom 20 percent are down nearly 2 percent. Meanwhile, Colorado’s wage gap by race and ethnicity persists. Latino and Black workers tend to experience higher rates of unemployment, higher rates of poverty and lower wages compared to their White counterparts. Median income for Latino and Black workers is a paltry 65 percent of income for White workers.

Median household income by race and ethnicity, 2015

Disparities in income and health care in rural and urban areas also result in disparities in health outcomes. In general, White, urban and affluent residents have easier access to quality health care and fare better than low-income, non-White and rural residents.

Among the report’s other findings:

  • Income affects life expectancy of Coloradans – Wealthier Coloradans live 6 to 10 years longer than people at the other end of the income spectrum. Men in the bottom quarter of the income distribution in Colorado, in particular, have not seen any improvement in life expectancy in the last 14 years. And the longevity gap between low- and high-income people varies substantially depending on where you live.
  • Nearly 23 percent of Coloradans living at the federal poverty level report experiencing poor or fair physical health –  At each progressively higher income level, a declining share of people report poor or fair health.
  • Living in poverty is taxing and stressful on both adults and children – Research has shown that growing up poor can impair brain function and mental health as an adult. Hence, it’s not surprising that Coloradans living in poverty were three times more likely to report poor mental health compared to people in higher income brackets.
  • The share of Coloradans reporting poor physical and mental health is substantially higher among lower-income people across racial and ethnic groups – Disparities in health outcomes by race and ethnicity are well-documented. When broken out by income, however, differences in physical and mental health outcomes between White, Black and Latino Coloradans narrow. This finding points to the importance of addressing income disparities as a means of eliminating racial disparities in health outcomes in Colorado.
  • The economic gap between urban and rural areas of the state has continued to widen since the Great Recession which has direct consequences on health outcomes – Median household income is 29 percent lower in rural areas of the state compared to urban areas. Poverty and unemployment rates are also higher in rural counties. Incidentally, the poorest health outcomes are concentrated in the southern part of the state.

“We live in a state of abundant resources, said Claire Levy, Executive Director of CCLP. “Yet, disparities persist that policy-makers have the power to address. With change coming in Washington and the 2017 Colorado legislative session approaching, we hope that ‘Vital Signs’ will help lawmakers and stakeholders identify the areas for improvement and the work to be done. Shared prosperity is essential to a sustainable state economy and the health and well-being of all Coloradans, regardless of income, race or place.”

In addition to these findings, Vital Signs also features the perspectives of four individuals who suffered because of health disparities but found assistance or a path to sustainability through a Colorado organization dedicated to improving health. The project was funded through a grant from The Colorado Trust’s Health Equity Advocacy program.

Colorado Center on Law and Policy is a nonprofit, non-partisan research and advocacy organization that engages in legislative, administrative and legal advocacy on behalf of low-income Coloradans.

Recent articles

Recap: Special Legislative Session 2023

In the aftermath of the 2023 November election and the failure of Proposition HH, Colorado Governor Jared Polis called a special session of the Colorado General Assembly, held from November 17 to November 20.  Over the course of a fast-paced and grueling weekend of...

Systemic failure in Colorado’s PHE Unwind

During this post-COVID year of Medicaid renewals, known as the Public Health Emergency (PHE) Unwind, Colorado is terminating members at rates that are among the highest in the country, many for procedural reasons.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.