Prince Georges County, Maryland: Psychosocial Factors and Health Inequities

Morbidity and Mortality

Infant Mortality by Race/Ethnicity

Infant mortality rate declined by 16% from 2008 to 2017 (Infant Health Fact Sheet, 2018). Infant mortality rate for blacks was 12.0 deaths for every 1000 black babies born in 2017 but 8.2 according the Community Needs Assessment (2018). It was 5.2 for every 1000 Hispanic babies born in 2017. Overall, it was 8.2 for every 1000 babies born in 2017 (Infant Health Fact Sheet, 2018).

County

State

Nation

Whites

5.4

4.4

4.6

Blacks

8.2

10.7

10.8

Asian

--

--

3.6

Hispanic

5.2

4.4

4.9

NA/PI

--

--

8.2

Other

--

--

--

Death Rates/Life Expectancy by Race/Ethnicity

Death rate/life expectancy for the county is 690.4/79 overall. For blacks it was 735.2, with life expectancy of 75, from 2015-2019. For whites it was 719.3 with life expectancy of 80 over the same time span. For Hispanics it was 410.5/82. For Asians it was 387.8/85 (HDPulse, 2022; World Life Expectancy, 2022).

County

State

Nation

Whites

719.3/80

789.97/79

825.86/79.12

Blacks

735.2/75

985.89/74

1067.16/75.54

Asian

387.8/85

388.16/85

469.18/86.67

Hispanic

410.5/82

550.4/82

723.59/82.88

NA/PI

--

--

--

Other

--

--

--

Obesity by Race/Ethnicity

The adult obesity rate is 33.8% in this county (Open Data Network, 2022). The information on obesity by race/ethnicity for the county is the following: 34.6 for whites, 38.9 for blacks, 20.9 for Hispanics. For the entire state of Maryland, for blacks it is 38.6 and for whites it is 28.9, and for Hispanics it is 30.9, so the numbers are slightly higher for whites and blacks in the county vs. the state (Americas Health Rankings, 2022).

County

State

Nation

Whites

34.6

28.9

30.7

Blacks

38.9

38.6

41.6

Asian

--

--

11.8

Hispanic

20.9

30.9

36.6

NA/PI

--

--

38.5

Other

--

--

--

Diabetes by Race/Ethnicity

Information on diabetes deaths for the county shows 87 deaths per 1000 blacks, 65 for whites, and 34 for Asians (Live Stories, 2022). Diabetes is the leading cause of death for blacks and Asian non-Hispanics in the county (Community Needs Assessment, 2018). Overall, for the county 13.7% of White, non-Hispanic (NH) and 13.4% of Black NH residents are estimated to have diabetes, while only 2% Hispanic have diabetes (Community Needs Assessment, 2018).

County

State

Nation

Whites

13.7

9.6

10.5

Blacks

13.4

12.5

15.5

Asian

7

9.4

6.8

Hispanic

2

6.3

11.6

NA/PI

--

--

--

Other

--

--

--

Heart Disease by Race/Ethnicity

Black nonHispanic residents have a higher rate of Emergency Department visits for Heart Disease, but White, non-Hispanic residents have a higher mortality rate (White non-Hispanic men have the highest mortality rate at 250.1 per 100,000 in 2012-2014) (Community Needs Assessment, 2018; Americas Health Rankings, 2022).

County

State

Nation

Whites

10.2

8.4

9.7

Blacks

8.8

7

8.9

Asian

4

4.4

2.9

Hispanic

2.3

3.8

5.7

NA/PI

--

--

--

Other

--

--

--

Community Indicators vs. State Indicators

Diabetes is the leading cause of death in the county and the following chart shows how that compares to the rest of the state and to the US as well, according to race/ethnicity.

Existing Health Disparities

One existing health disparity is found in infant mortality and that may be due to lack of access to care and to socioeconomic status as well as culture, with regard to white communities vs. black communities vs. Hispanic communities. For instance, the infant mortality rate for black infants is nearly double that of white infants in the county and more than double that nationwide. While there are many factors that contribute to this disparity, it is clear that access to quality healthcare plays a role. Black and Hispanic women are more likely to be uninsured than white women, and they are also more likely to live in communities with limited access to quality healthcare. In addition, socioeconomic status is a key factor in health outcomes. Black and Hispanic women are more likely to live in poverty than white women, and they are also more likely to experience other social disadvantages,...

…clear that a variety of factors at different levels contribute to this disparity. At the individual level, health behaviors and access to care are both important factors. For example, black women are more likely to smoke during pregnancy and are less likely to receive prenatal care than white women. At the interpersonal level, racism and discrimination play a role in creating healthcare disparities. Black women may receive poorer quality care from providers or be less likely to have their concerns addressed by medical staff. At the institutional level, systemic problems like unequal funding for public health initiatives or understaffing of hospitals in predominantly black neighborhoods can contribute to healthcare disparities. Finally, at the societl level, structural inequalities like poverty or lack of access to transportation can make it difficult for black women to get the care they need during pregnancy and after childbirth. By understanding how these various factors interact, we can begin to address healthcare disparities among whites and blacks with respect to infant mortality.

Recommendations for addressing healthcare disparities include: increasing access to health care services, improving the quality of health care services, and reducing exposure to risk factors for poor health. Increasing access to health care services can be achieved by providing financial assistance to low-income families, expanding Medicaid coverage, and increasing funding for community health centers. Improving the quality of health care services can be achieved by increasing provider diversity, training providers on cultural competency, and implementing patient-centered care models. Reducing exposure to risk factors for poor health can be achieved by promoting healthy lifestyles, increasing access to healthy food options,…