The Child Opportunity Index: Improving Collaboration Between Community Development And Public Health

Abstract

Improving neighborhood environments for children through community development and other interventions may help improve children's health and reduce inequities in health. A first step is to develop a population-level surveillance system of children's neighborhood environments. This article presents the newly developed Child Opportunity Index for the 100 largest US metropolitan areas. The index examines the extent of racial/ethnic inequity in the distribution of children across levels of neighborhood opportunity. We found that high concentrations of black and Hispanic children in the lowest-opportunity neighborhoods are pervasive across US metropolitan areas. We also found that 40 percent of black and 32 percent of Hispanic children live in very low-opportunity neighborhoods within their metropolitan area, compared to 9 percent of white children. This inequity is greater in some metropolitan areas, especially those with high levels of residential segregation. The Child Opportunity Index provides perspectives on child opportunity at the neighborhood and regional levels and can inform place-based community development interventions and non-place-based interventions that address inequities across a region. The index can also be used to meet new community data reporting requirements under the Affordable Care Act.

The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013

“…The Index includes 19 variables across three domains specific to educational, health and environmental, and social and economic opportunities, conditions, and resources. (15) Z-scores are calculated and standardized for the metropolitan area based on the distribution of the variables within that area – these Z-scores enumerate the number of standard deviations that census tract’s variable (or domain) is from the region’s mean tract. The Z-scores allow for analyses of within-region variation with respect to each variable, each domain, and for the COI as a whole.…”

“…The COI, crafted by diversitydatakids.org in collaboration with the Kirwan Institute, defines “opportunity” as “neighborhood-based conditions and resources conducive to healthy child development.”(15) This publically-available and easily-accessible index includes a range of measures, enumerating relative opportunity in educational, health and environmental, and social and economic domains across all census tracts within metropolitan areas. (16, 17) Though the index has been previously linked to life expectancy, low birth weight, and preterm birth,(15) it has not yet been linked to asthma morbidity. Establishing such a link could provide a more informed approach to identifying and addressing potentially-correctable inequities across or within metropolitan areas.…”

Social Justice, Social Determinants of Health, Interprofessional Practice and Community Engagement as Formative Elements of a Nurse Practitioner Managed Health Center

“…Individuals with low education and income are more likely than better-educated, higher-income individuals to lack a stable job, safe housing, food security and adequate income to meet health needs. Inequity in resources result in increased morbidity and mortality and these interactions have a cumulative effect over the life course for individuals, families and communities [10][11][12][13][14][15][16].…”

Power, Politics, and Health: A New Public Health Practice Targeting the Root Causes of Health Equity

“…Research that accounts for historical context [19] in patterns of health over space and time will be especially valuable to understanding the social processes underlying health development. Local level data revealing the spatial patterns of health outcomes and correlations to income, housing, education, and other important social determinants of health can be used in a call to action to develop cross-sector partnerships, policy analysis, and innovative solutions [20]. Public health departments and epidemiologists can also partner with local organizations to lend data expertise and a credible voice to policy advocacy efforts [21].…”