New London — In southeastern Connecticut and just about everywhere else in America, your zip code is apt to say more about your health than your genes do.
Average life expectancies in the region range from 77.2 years in New London to 83.9 years in Stonington. Drilling deeper, it’s possible to find a New London neighborhood — more precisely, a census tract — where the average life expectancy dips below 70 years, while in Stonington Borough it approaches 86 years.
Such town-by-town disparities and the link between social and economic factors and health, or wellness, are at the core of the Health Improvement Collaborative of Southeastern Connecticut’s latest Community Health Assessment, a 73-page report being reviewed by health care professionals and community officials. The collaborative, a partnership of providers, educators, social service agencies and nonprofit organizations, based the report on data it collected from the 10 southern New London County towns that constitute Lawrence + Memorial Hospital’s primary service area.
What the data suggest — or confirm — is that more resources and attention should be focused on improving social and economic conditions in poor communities and less on health care itself, said Laurel Holmes, L+M Health’s director of community partnerships and population health and a primary contributor to the collaborative.
“We spend a lot on health care instead of on what would really help,” she said.
Responses to collaborative surveys show a strong correlation between a person’s economic security — the ability to pay for such basic needs as food, housing and transportation — and health issues. Low-income residents “report lower well-being, less access to basic resources, including high-quality fruits and vegetables, lower rates of feeling safe and trusting their neighbors, and more incidences of discrimination,” the collaborative found.
Surprisingly, food insecurity — the inability to provide family members with sufficient, nutritious food — was more prevalent among those with annual incomes between $30,000 and $75,000 than among those with lower incomes.
The region’s older and in some cases hazardous housing stock and a lack of affordable housing continue to pose challenges for many families, as does inadequate public transportation, the report says. Those with incomes below $75,000 were found to be more likely to be sedentary and to suffer from diabetes, asthma and heart disease than those with higher incomes.
People of color reported significantly higher rates of anxiety and depression than whites in the region.
So poverty’s a factor, but not the only factor, said Fawatih Mohamed-Abouh, a community health epidemiologist at L+M Hospital, who noted that some middle- and higher-income people have poor health. One reason, she said, is that people don’t always make the best choices as their incomes rise. They may incur greater expenses associated with improved lifestyles and, as they move to more rural locations, may lose access to services more readily available in urban centers.
While low-income families qualify for food stamps and school meals, those with only slightly more income may not, Mohamed-Abouh said.
In analyzing data relating to drug overdose deaths in the region, Mohamed-Abouh found that while such deaths occurred among all ethnicities in all communities, the victims were younger in rural towns than in New London and Groton, the region’s urban centers. She calculated that the average age of the victims in the towns was 41 while in New London and Groton it was 44. Finding an explanation will require further study, she said.
The collaborative’s report found that the region’s makeup is becoming more diverse, with the Hispanic population increasing from 10.4 percent of the total in 2015 to 11.7 percent in 2017. In that span, the white population fell from 76 percent to 74.5 percent, and the African American population from 5.5 percent to 5.3 percent. School enrollments are more racially and ethnically diverse than the overall population.
In New London and Groton, the population is trending younger.
Another primary contributor to the collaborative, Jen Muggeo, supervisor of special projects in population health for Ledge Light Health District, said it’s important for those who implement the Community Health Assessment to focus on “systemic issues” rather than the choices low-income people make affecting their health.
“They don’t have the luxury of choices,” she said. “We’re not going to improve (health) trends by focusing on (telling people) what not to eat. Time and time again, data show people living in poverty understand the benefits of a healthy diet. They just don’t have the means …”
Muggeo said evidence continues to grow that shows the chronic stress of living in poverty causes physiological symptoms.
“That’s why it’s important for public health to be involved in housing, transportation …,” she said. “We need to be part of driving policy changes.”
L+M plans to host a community meeting Sept. 11 to discuss the report, and afterward will post it on its website.