Report: Even in Md.’s Wealthiest County, Health Disparities Persist

A health care professional gives a patient a vaccine shot. Photo by Heather Hazzan/Self Magazine

“For decades, Howard County has been known for its forward-thinking approach to creating the highest quality of life, serving as a national example of how people of diverse backgrounds can create a thriving community.”

That’s how a new report from a Howard County-based foundation that focuses on health care outcomes opens. And it’s pretty much accepted wisdom for those who admire Howard County’s utopian vision and values.

Yet the rest of the report, “The 2020 Vision for Health in Howard County,” released Thursday by the Horizon Foundation, is a great big “but”: Despite the county’s wealth, it says, despite its history of racial harmony and inclusiveness, despite the progressive views of local leaders, minorities lag far behind white residents when it comes to overall health.

“While Howard County ranks among the healthiest communities in the state and nation, we still fall
short of our potential,” the report notes. “Unfortunately, even in our county, your zip code, skin color, income and other demographic factors can determine your health in very unfair ways.”

Although Howard is Maryland’s wealthiest and fastest growing county and boasts some of the state’s best schools, a crime rate below the statewide average, and a well-respected medical facility (Howard County General
Hospital, which is part of the Johns Hopkins Medical System), statistics in the report are wide-ranging and stark:

— Black infants in the county die at more than double the rate of white infants.

— Black mothers were 83 percent more likely than white mothers to give birth to a premature baby and twice as likely to have babies of low birth weight.

— Latina and black mothers are twice as likely as white mothers to receive insufficient or no prenatal care.

— Heart disease kills black residents at a rate higher than for any other race.

— Black adults are more likely to report having diabetes than people of other races. Diabetes sends black adults to hospital emergency rooms at a rate four times higher than white adults.

— Nearly 50 percent of Latina high schoolers report feeling sad and hopeless to the point of stopping their usual activities, compared to 23 percent of white students and 26 percent of black students. They are also more likely to consider suicide.

— Among adults in the county, black residents are most likely to say they have been “bothered” by “feeling down, depressed or hopeless” and by “having little interest or pleasure in doing things,” indicators of risk for depression.

— Asian residents are the least likely out of all races to have a signed advance directive, with 82 percent saying they do not have one.

There are multiple explanations for these conditions, the report finds, including historical economic disparities between the races, discriminatory housing patterns, transportation challenges, and an imbalance in school resources throughout the county.

But even for black Howard County families with relatively high incomes and educational attainment, the stress of historic and institutional racism can affect short- and long-term health, the Horizon report said.

In addition, “incorrect beliefs about biological differences in general — and pain sensitivity in particular — date
back to slavery and are perpetuated until this day,” it said.

Black and Latino families also are affected by unhealthy food marketing that targets minority groups.

Health disparities can also adversely affect minorities’ educational attainment, the report found. Health problems can lead to excessive school absenteeism, which can impede a child’s academic progress.

“Howard County is fortunate to have, overall, a high standard of living and strong health measures, but
this report makes clear that we can and must do more as a community to ensure everyone has the opportunity to achieve good health,” Nikki Highsmith Vernick, president and CEO of the Horizon Foundation, said in a statement. “We need immediate action to improve policies and practices now, while continuing to collect disaggregated data, analyze root causes and address broader systemic changes over the long term.”

And, the report suggests, challenges lie ahead: “Population growth, environmental risks, demographic shifts and economic constraints will test our community in the years to come,” the report said.

Yet, the Horizon Foundation finds cause for optimism. Its report outlines recommendations for county leaders to address each health disparity identified.

“Because of our existing strengths, Howard County is uniquely positioned to address these challenges with determination and innovation,” it reads. “Howard County is rich with passionate and well-informed leaders, strong community involvement, substantial educational and economic opportunities and a wide array of
public resources — all of which provide a solid foundation for a healthy and blossoming community.”

The health officer for Howard County government, Dr. Maura Rossman, said county leaders are getting the message.

“By striving to close gaps and create a culture of good health, Howard County can be a model community for health equity and wellness in the state and in the nation,” she said. “Our goal is to achieve the highest quality of life for all.”

Audra Nixon of the African American Community
Roundtable called the report “a call to action for Howard County.”

(Disclosure: The Horizon Foundation is a financial supporter of Maryland Matters.)

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Josh Kurtz
Co-founder and Editor Josh Kurtz is the leading chronicler of Maryland politics and government. He began covering the State House in 1995 for The Gazette newspapers, and has been writing about state and local politics ever since. He later became an editor at Roll Call, the Capitol Hill newspaper, and spent eight years at E&E News, an online subscription-only publisher of news websites covering energy and environmental issues. For seven of those years, he led a staff of 20 reporters at E&E Daily, which covers energy and environmental policy on Capitol Hill and in national politics. For 6 1/2 years he wrote a weekly column on state politics for Center Maryland and has written for several other Maryland publications as well. Kurtz has given speeches and appeared on TV and radio shows about Maryland politics through the years.