Changes Over Time in Disparities in Health Behaviors and Outcomes by Race in Allegheny County: 2009 to 2015

Abstract

Racial/ethnic disparities in health behaviors and disease outcomes on the national level have persisted over time despite overall improvements in public health. To better understand the changes over time in racial/ethnic health disparities at the county level, we examined the Allegheny County Health Survey (ACHS) for Pittsburgh, PA and the surrounding area, which was conducted in 2009/2010 and 2015/2016 using random digit dialing of residents aged 18 and older. The prevalence rates and rate ratios at each time period were calculated using survey weights and general linear models. The change in prevalence over time was calculated using race-time interaction terms. The results showed a significant improvement in asthma, stroke, cholesterol, and fair or poor health disparities as well as persistent disparities in diabetes and hypertension after adjustment for socioeconomic factors. The change over time in the prevalence of fair or poor health in black compared to white respondents was significant, with absolute improvement of approximately 5% versus <1%, respectively (p = 0.01). These findings demonstrate that some disparities improved while others persist, noting the importance of monitoring the changes over time at the local health department level.

Pharmacist Involvement in Addressing Public Health Priorities and Community Needs: The Allegheny County Racial and Ethnic Approaches to Community Health (REACH) Project

“…In the United States, heart disease is the leading cause of death among African American people, who are 20% more likely than White people to die of a myocardial infarction ( 2 ). These trends are similar in Allegheny County, Pennsylvania, the 34th largest county in the United States, with more than 1.2 million people residing in 130 municipalities, including Pittsburgh ( 3 – 5 ). African American people comprise approximately 13% of the population of Allegheny County, yet many communities, especially several in Pittsburgh and others along the rivers, are racially segregated, producing census tracts with a predominately African American population and high poverty rates.…”

“…African American people comprise approximately 13% of the population of Allegheny County, yet many communities, especially several in Pittsburgh and others along the rivers, are racially segregated, producing census tracts with a predominately African American population and high poverty rates. Chronic disease rates in the county do not differ significantly from those of the state or nation; however, in census tracts comprising a predominately African American population, rates of chronic disease prevalence are high, driven by health inequities ( 3 ).…”

“…Despite national progress and a narrowing of health gaps by race and ethnicity for some health outcomes, substantial racial and ethnic disparities in health persist for chronic diseases such as diabetes and heart disease (1). In the United States, heart disease is the leading cause of death among African American people, who are 20% more likely than White people to die of a myocardial infarction (2). These trends are similar in Allegheny County, Pennsylvania, the 34th largest county in the United States, with more than 1.2 million people residing in 130 municipalities, including Pittsburgh (3)(4)(5).…”

“…In 2018, the Allegheny County Health Department received a cooperative agreement from the Centers for Disease Control and Prevention (CDC) as part of its Racial and Ethnic Approaches to Community Health Program (REACH) to implement the Live Well Allegheny: Lifting Wellness for African Americans (LWA 2 ) project and work in 6 priority communities in the county to reduce racial health disparities. The LWA 2 project was developed in response to the most recent community health assessment and a review of community-level data; its leadership includes a diverse coalition of more than 25 partners working together to improve nutrition, breastfeeding support, physical activity, and community-clinical linkages (CCLs) for African Americans living in selected communities (www.livewellallegheny.com/reach). LWA 2 partners work across sectors and have strong ties with their communities.…”

An Equity Response to COVID-19 in Allegheny County, Pennsylvania: The Development and Work of the Black Equity Coalition

“…An examination published in 2020 determined that, between 2009 and 2015, there were improvements in outcomes linked with racial disparities between Black and White residents in asthma, stroke, and cholesterol rates. However, Black–White disparities persisted for both diabetes and hypertension (Devaraj et al, 2020).…”