By Kaushik Venkatesh
There is no doubt Loudoun County has a remarkable health care system. Residents, public health professionals, and politicians pride themselves in reporting the measures. Yet, a deeper dive into the statistics reveals that some people are systematically washed out by the game of averages. Put simply, the rankings rely on calculations of the “average” health of the population, and the high average indicators hide the fact that there is a significant minority of the population silently experiencing poor health care outcomes.
Loudoun County has consistently topped the charts of thenational yearly health ranking, currently considered the healthiest county in Virginia. Premature death is less than half the national average. Adult obesity is 6 percent below the national average. Sexually transmitted infection rates are less than half the national average. Flu vaccination compliance is 10 percent above the national average. Inova, the local hospital system, recentlyreportedin its community assessment several instances in which the community was passing health benchmarks, but disparities were worryingly high. The categories with 100 percent differences in a majority of health measures include chronic health conditions (heart disease, diabetes, dementia, cancer), maternal and child health, and substance abuse. Areas of disparity where benchmarks were not met include life expectancy and quality of life.
Importantly, these problems are not spread evenly among the population. According tocensus tract data, the burden of poor health disproportionately falls on the Hispanic and African American populations in the county who are at socioeconomic risk as less educated or lower income. Diving deeper into the county ranking report,we find the teen birth rate is three times greater in blacks than whites, and a whopping nine times greater in Hispanics than whites.Other examples of disparity by race include percent of people vaccinated, mammogram screenings, and rates of preventable hospitalization.The data reveal geographic “islands of disadvantage” consisting of people in socioeconomic pockets who live with the brunt of these healthcare disparities.
Fortunately, the county is taking steps in the right direction and making progress in remediating disparities with improvement in numerous health categories. Making adequate progress is not easy given the multifaceted healthcare system. Disparities in health result from a confluence ofsocioeconomic, cultural, and legislative considerations. Lack of healthcare insurance, language barriers, lack of knowledge regardingfree clinics, and many other factors can result in higher costs and lack of access to care.
One major obstacle ironically lies in Loudoun’s high rankings and stellar health indicators. With measurement averages so high, local officials and budget-makers mistakenly allocate less than necessary funds towards solving healthcare issues. In this way, these small pockets of highly unhealthy populations are systematically left out of the planning conversations, because the attention of the public naturally shifts to other topics of concern for the county.
As a community that prides itself in healthcare, opportunity, and optimal living conditions, Loudoun is ripe for innovative and invigorated interventions. Loudoun County has “Live Healthy Loudoun:Community Health Dashboard,” a web-based data resource started in 2017 for exploring local health data reports and promoting community health. Key changes to resolving disparities include increasing access to and timely utilization of health care. Interventions should promote healthy families via healthy environments.There is a need for greater appropriate child care for obesity and basic health.
Interventions for these issues must involve connecting at-risk populations with community resources and community healthcare intervention efforts through government-funded and volunteer-driven campaigns. A few examples of community resources include:Loudoun Mobile Hope,free clinics, Loudoun Medical Reserve Corp vaccination drives, and school-driven drug and sexual education programs.Interventions should focus on bringing access to “islands of disadvantage.”
All things considered, there is no doubt that Loudoun is a fantastic county; and yet, our neediest populations in our community are lost in the shuffle of our remarkably high rankings and the glow of frequent accolades. There is no silver bullet for the issue. Coordinated county planning must attempt to bridge the gaps present in the county’s health care outcomes.Awareness of these hidden disparities, along with dedicated community effort, can create significant change towards improving the lives of our neighbors in our county.
[Kaushik Venkatesh is an MBA and graduate certificate in clinical research student at George Washington University living in Ashburn.]