Baltimore Draws 10-Year Blueprint To Cut Racial Health Disparities

Baltimore officials presented a 10-year plan Tuesday that sharply highlights the poor health status of African-Americans and aims to bring black rates of lead poisoning, heart disease, obesity, smoking and overdoses more in line with those of whites.

“We wanted to specifically call out disparities” in racial health, said Dr. Leana Wen, who became the city’s health commissioner early last year. “And we have a moonshot. Our moonshot is we want to cut health disparities by half in the next 10 years.”

Black Baltimore leaders praised Wen for putting disparities squarely in the conversation even as they acknowledged the difficulty of achieving the plan’s goals.

“It’s a big challenge. There’s no debating that,” said Diane Bell-McKoy, CEO of Associated Black Charities, a Maryland nonprofit. “She takes a step forward more so than anybody else I’ve seen because she calls it out. Most of the time we find code words for it. We don’t call it out.”

Violence last year following the death of Freddie Gray, a black man who died after being injured in police custody, exposed Baltimore’s health divide as well as its criminal justice differences, officials said. Gray’s family had won a settlement for alleged lead-paint poisoning, which is blamed for low test scores and cognitive challenges among thousands of Baltimore children.

“What happened last year with Freddie Gray put Baltimore in the national media spotlight,” said Helen Holton, a Baltimore councilwoman who represents a portion of the city’s west side. “That made people stop and take notice of what had been going on and stop treating it as business as usual.”

The health plan, called Healthy Baltimore 2020, was first reported by the Baltimore Sun. Officials plan to track blood-lead levels, overdose deaths, child fatalities, healthy-food availability and other indicators year by year. It’s called Healthy Baltimore 2020 because officials have set ambitious goals to achieve before 10 years is up, Wen said.

Tentative targets include cutting youth homicides by 10 percent and disparities in obesity, smoking and heart-disease deaths by 15 percent — all by 2020.

Tactics include more programs to reduce street violence, expanded anti-smoking campaigns, more home visits for pregnant women and increased access to naloxone, which blocks the effects of heroin.

The blueprint is “an ongoing document” that will be amended with community participation and results closely scored, Wen said.

“Our community is sick of us overpromising and underdelivering,” she said.

Baltimore officials have made substantial progress in reducing lead poisoning, lowering teen pregnancy and cutting infant mortality.

But as in many other areas, Baltimore is still divided by health. Residents of Gray’s west-side neighborhood of Sandtown-Winchester live 10 years less on average than Marylanders in general. Poor neighborhoods have far higher rates of heart disease, diabetes, addiction, HIV infection and other illness than more prosperous parts of the city.

Black leaders emphasized that Baltimore’s health won’t improve unless policymakers address deeper causes of illness such as poverty, unemployment and poor housing.

“It is affirming to see someone in Dr. Wen’s role address the uncomfortable truths behind health inequities,” said Debbie Rock, CEO of LIGHT Health and Wellness, which offers health and other community services on Baltimore’s west side. “This is a great platform to also address upstream factors” such as low incomes, she said.

Holton compared the health blueprint to a Justice Department report this month alleging a pattern of excessive force and violation of constitutional rights by the Baltimore Police Department.

Both documents address racial differences and offer challenges for improvement, she said.

“You can travel 5 miles from one neighborhood to another and it’s like you are in two different communities” in health levels, Holton said. “Freddie Gray was like the tipping point. Let’s take this and make it a teachable moment of how to be better moving forward.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.


Source: Kaiser Health