Updated on: 05/07/2022

Overall Health Indicators

Individuals and communities that have experienced poverty and racism may also face multi-generational trauma. This can result in chronic stress, increased risk of disease, and overall poorer health for communities of color.

Note: Hispanic is used to reflect current data collection practices. We acknowledge this may not be the preferred term. Throughout this report, NH refers to Non-Hispanic. People of color refers to individuals identifying as Black, American Indian/Alaska Native, Asian, Hispanic, Native Hawaiian, Pacific Islander, and Other. Unless otherwise noted, adults are ages 18+. Data are most recently available for the specified data source.

Individuals and communities that have experienced poverty, racism, discrimination, and racial segregation may also face trauma as a result. Historical trauma is “multi-generational trauma experienced by a specific cultural group.” Historical trauma can impact people living in families that have previously experienced severe trauma, war, genocide, poverty, and/or discrimination.13 This lived historical experience can continue to burden future generations and be compounded with the trauma from the ongoing experience of racism today. Trauma can result in post-traumatic stress disorder and increased stress. Chronic stress increases the risk of developing chronic diseases including cardiovascular disease, diabetes, and hypertension.14, 15, 16

Equity Spotlight

Sometimes common race and ethnicity groupings can mask important differences in the experiences of subgroups. For example, Asian Americans and Native Hawaiians and Other Pacific Islanders are often shown as one category. Some subgroups within this category have very high average incomes which can mask others in the group that have extremely low incomes.17, 18, 19, 20 These variations are often a reflection of the different pathways and circumstances of how groups entered the USA.
Learn more about how income and employment impact your experience and health.

Adults Reporting Fair or Poor Health (2017-2020)

Download the raw data (accessible version) used to create these visualizations.

13 Bryant-Davis, T. & Ocampo, C. (2005). The Trauma of Racism: Implications for Counseling, Research, and Education. The Counseling Psychologist, 33.4, 574-578. DOI: 10.1177/0011000005276581

14 Denham, A. (2008). Rethinking Historical Trauma: Narratives of Resilience. Transcultural psychiatry, 45.3, 391-414. DOI: 10.1177/1363461508094673

15 Bichell, R. (2017). Scientists Start to Tease Out the Subtler Ways Racism Hurts Health. National Public Radio; Shots. Retrieved from https://www.npr.org/sections/health-shots/2017/11/11/562623815/scientists-start-to-tease-out-the-subtler-ways-racism-hurts-health

16 Sotero, M. (2006). A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research. Journal of Health Disparities Research and Practice, 1(1), 93-108. Retrieved from https://ssrn.com/abstract=1350062

17 Edlagan, C. & Vaghul, K. (2016). How data disaggregation matters for Asian Americans and Pacific Islanders. Retrieved from https://equitablegrowth.org/how-data-disaggregation-matters-for-asian-americans-and-pacific-islanders/

18 Roelofs, C., Azaroff, L., Holcroft, C., Nguyen, H., & Doan, T. (2008). Results from a Community-based Occupational Health Survey of Vietnamese-American Nail Salon Workers. Journal of Immigrant Minority Health, 10, 353–361. DOI: 10.1007/s10903-007-9084-4

19 Azaroff, L., Levenstein, C., & Wegman, D. H. (2003). Occupational health of Southeast Asian immigrants in a US city: a comparison of data sources. American journal of public health, 93(4), 593–598. https://doi.org/10.2105/ajph.93.4.593

20 Quinn, M.M., Sembajwe, G., Stoddard, A., Kriebel, D., Krieger, N., Sorensen, G., Hartman, C., Naishadham, D., & Barbeau, E. (2007), Social disparities in the burden of occupational exposures: Results of a cross‐sectional study. American Journal of Industrial Medicine, 50: 861-875. DOI: 10.1002/ajim.20529

Indicator selection

This report gathered equity metrics found throughout DPH published data reports in one common location. When choosing the indicators to feature in this dashboard, we focused on publicly available data and the State Health Assessment (SHA) priority indicators. In some instances proxy measures were used if race/ethnicity data were limited (e.g. Hepatitis B Vaccinations Rates in place of Viral Hepatitis Prevalence Rates). Only indicators that had sufficient data for breakdowns by race/ethnicity were included.

Time-frame for Data Shown

In all cases, the most recent data for each indicator are incorporated. For some topics (e.g. hospitalizations for various causes), only older data are available by race/ethnicity. However, the goal of this dashboard is to capture the current experiences of this priority population. As such, the years of data presented are different for each chart; we opted for the most recent data available over using the same (older) year across all indicators in the report

Race/Ethnicity Group Definition and Data Collection

This report presents race/ethnicity data as it is collected and defined by each source. DPH complies with the the Federal Office of Management and Budget (OMB) Standards and have adapted the recommendations to capture this information. We acknowledge that the race/ethnicity breakdowns presented here may not reflect each group's preferred terms. We recognize that race groups are not monolithic. Grouping into larger categories (e.g. Asian) and grouping Hispanic separately (e.g. Black and Hispanic is not a category in this report) is problematic and may not fully capture the experiences specific groups have. Data on language and disability status are not reflected in this version of the report but we plan to include these in future versions. Detailed information on the specific race/ethnicity group definitions and data collection practices can be found using the links to data sources provided for each chart. The DPH Race/Ethnicity/Language Data Standards Guide provides information on current department wide minimum compliance for collecting, defining, and reporting this information.

Data Suppression

For some charts, race/ethnicity groups may not be shown. This varies by data source and reflects insufficient sample size to support reliable estimates or suppression to protect residents privacy. For more information on the DPH suppression guidelines, please see the Department of Public Health Confidentiality Procedures.

Current Analysis

Unless otherwise noted, the differences between race/ethnicity groups in this report are based on descriptive observations (i.e. estimates are higher or lower than others) and key findings for the data shown in charts do not represent statistically significant differences. Any language that indicates statistical significance is taken directly from reports that have performed these analyses separately from this dashboard. For more information on how analyses were performed and definitions for significance, please see the data source notes provided for each chart.

CI refers to Confidence Interval (if available), which describes the certainty of a value. The Department of Public Health uses a 95% confidence interval.

Future Plans

This initial report focuses on communities of color. Additional dashboards on the other priority populations will be created. We also plan to expand dashboard contents including adding more indicators, updating data currently included, and incorporating intersectionality of populations (e.g. data by race/ethnicity and sexual orientation/gender identity).

Visual representations of statistical significance and additional analytics to compare differences between groups will also be incorporated.