We must take action to improve health equity.
Where we live, our race and ethnicity, and our incomes all affect our health. This series of fact sheets lays out the health inequities facing different populations in Colorado and outlines concrete action steps we can take to improve the situation.
Learn the Facts
Health depends a lot on a person’s life circumstances. Find out about health disparities in Colorado.
There are lots of great resources available on this topic. See what else is out there.
Ready to take action? We have a number of suggestions for ways you can get involved to improve health equity.
Learn the Facts
Healthy Eating & Obesity
Healthy eating and maintaining a healthy weight while growing up are important for ensuring long term good health. In Colorado, there is a complex relationship between food insecurity, defined as lacking access to enough food to fully meet basic needs, and obesity, race, ethnicity, income, and location.
Insurance & Access to Care
Health insurance for children in Colorado varies by both family income and race and ethnicity. Overall, 7% of Colorado’s children do not have insurance. A lack of coverage impacts a child’s ability to get needed health care. One in four, or 28.1% of uninsured children did not seek an appointment because they were uninsured. Not having insurance impacts a child’s health beyond the ability to get appointments.
OPPORTUNITIES FOR ACTION
Children who experience inequities in health because of their race or ethnicity, income, or where they live, fail to reach their full potential. This is harmful not only for children themselves, their families, and their community—but to the whole state.
- Engage Parents & Families. Parents and families have important insights into making the future better for Colorado’s children. Performance standards for child health programs should include explicit measures of parent engagement in both design and implementation.
- Increase Data Collection. We should increase collection, availability, and analysis of detailed, population-specific data to inform our understanding of the experiences and challenges of diverse groups of children served by state programs.
- Support Vulnerable Children. A health care home is important for all kids, but especially for children in low-income families. New opportunities for this exist through the Medicaid Accountable Care Collaborative and the Affordable Care Act.
Many studies have demonstrated the relationship between higher incomes and the ability to maximize health. In 2012, over 210,000 Coloradans had incomes below $15,000. These Coloradans are nearly six times more likely to say that they are in poor or fair health compared to Coloradans with family incomes over $50,000.
Heart disease is the leading cause of death in Colorado. Income is a determinant in a person’s ability to manage prevention and reduce the risks and impacts of heart disease and stroke. Coloradans with lower incomes are more likely to experience heart disease, heart attacks, and strokes. Furthermore, Coloradans with lower incomes are less likely to access important screenings and preventive care, such as blood pressure and cholesterol checks.
OPPORTUNITIES FOR ACTION
There is room for improvement in the health of Coloradans at every income level. However, Coloradans with lower incomes face significant challenges to maximize their health due to a lack of affordable quality housing, safe neighborhoods, healthy food choices and the inability to afford health insurance coverage and needed health care.
- Enable Education & Job Creation. Local, regional, and state efforts need to ensure quality education and support the creation of stable jobs that offer a family-sustaining wage, health care and retirement benefits, training, paths for advancement, and a voice in the workplace.
- Increase Health Coverage. In 2013, 70% of uninsured Coloradans lived in families with incomes at or below 200% of the federal poverty level. Evaluations of the impacts of new opportunities for health insurance should include analysis of the impact on coverage for low-income Coloradans.
- Support Clinics & Providers. Local health clinics and providers across the state provide care that accounts for the complex needs of patients and recognizes the additional hardships of difficult life circumstances. We must ensure these institutions remain economically viable.
Racial & Ethnic Minorities
Factors That Impact Health
A person’s health is influenced by powerful social factors such as income, educational attainment, and employment. Compared to all Coloradans, racially and ethnically diverse Coloradans experience living in poverty, lower educational attainment, and higher levels of unemployment. These life circumstances have a significant impact on the health of communities of color in Colorado.
Illness & Chronic Disease
Cancer and cardiovascular disease are the leading causes of death for Colorado adults 45 years and older. Research shows that racially and ethnically diverse Coloradans are more likely to have risk factors that lead to these diseases, less likely to get recommended screenings, and less likely to have access to needed treatments.
OPPORTUNITIES FOR ACTION
Research in Colorado clearly demonstrates that racially and ethnically diverse Coloradans experience a high burden of health inequities. For Colorado to become the healthiest state in the nation, we need to address this issue.
- Advance Economic Opportunity. A good education, adequate employment, and access to other economic securities creates a foundation for short and long-term well being. All Coloradans benefit from a strong economy.
- Secure Health Insurance. Health insurance provides security and peace of mind and creates access to primary and preventive care services. Engaging communities of color in new opportunities for health insurance will be critical to reduce the number of uninsured Coloradans.
- Improve Care Experiences. Racially and ethnically diverse Coloradans are at a higher risk for some chronic diseases and may not have access to all needed health services, so performance metrics for health initiatives should include the impacts on and experiences of communities of color.
Geography & Transportation
Transportation is necessary to access and secure basic needs, adequate employment, and health care services. Rural Coloradans face challenges with transportation, mainly with the availability of transit services and the ability to access needed health care.
Health Care Workforce
Access to both providers and care facilities are necessary to meet a person’s health care needs. In rural Colorado, there are fewer providers per capita than in urban areas. There are also shortages of specialists, clinics, and 18 counties without a hospital. The data is reinforced by public perception. More than twice as many rural Coloradans as urban Coloradans felt that the shortage of health care providers in their community was a major problem.
OPPORTUNITIES FOR ACTION
Coloradans who live in rural communities are active contributors to agriculture, manufacturing, and tourism, which means rural areas are integral to the state’s economy and health. We must take action to ensure rural Coloradans have an equal opportunity to live a healthy life.
- Improve Transportation Options. Medicaid non-emergency transportation in Colorado is limited to nine counties, none of which are rural, and there are few options for uninsured or privately-insured residents. A transportation evaluation would allow us to better understand the gaps and develop solutions.
- Improve Understanding of Capacity. Current capacity analyses separate each component of the workforce and facilities—physicians, nurse practitioners, physician assistants, clinics, and hospitals. An inclusive analysis will improve our understanding of capacity.
- Support Community Innovations. Rural communities excel at innovating to maximize limited resources. Sometimes regulation is a barrier to success, though. There is great opportunity to aid these communities by helping them navigate and develop the right regulatory framework.
Health Status & Age
Colorado’s seniors are generally healthier as compared to seniors around the country, but less healthy than the rest of Colorado’s population. Further, seniors who live in poverty are more vulnerable to worse health and multiple co-occurring chronic conditions, such as diabetes, heart disease, and high blood pressure.
Access to Care
To adequately meet the health care needs of Colorado seniors, communities need a range of health care facilities and providers, including long-term care facilities, adequate primary care providers, and community-based support services. Long term care is often the source of care for seniors who need great assistance, but it is costly. Community-based services are still relatively new, but have proven to be much more affordable and highly preferred by seniors.
OPPORTUNITIES FOR ACTION
For Colorado to be the healthiest state we need to recognize and meet the unique social and health care needs of all Colorado seniors. To reach this goal, we must dedicate resources to meeting the needs of our growing senior population.
- Capitalize on Community Supports. Helping seniors live as they want to and ensuring that those environments are safe and supportive of their choices and basic needs is key. Examples of community supports include building age-appropriate apartments, creating volunteer opportunities, and virtually connecting home-bound seniors.
- Improve Care for Medicaid Seniors. An estimated 48,000 beneficiaries, many of whom are low-income seniors, are about to be enrolled into the Accountable Care Collaborative. We must ensure that it meets the needs of this population.
- Implement State Plan on Aging. Colorado has created a State Plan on Aging. As this plan is carried out, the state should engage stakeholders, and strive for coordination with all agencies that serve seniors.
There are countless additional resources documenting health disparities issues around the country and suggesting strategies for change.
- Listen to health stories – listen to Coloradans explain their experiences with health disparities, through Colorado HealthStory
- Learn how to talk about the Social Determinants of Health (PDF) – find out how you can talk about health disparities more effectively, from the Robert Wood Johnson Foundation
- Read recommendations for advancing health equity (PDF) – see what the Center for Disease Control has to say about community strategies
- Investigate more data – learn about health disparities around the US, from the Center for Disease Control
- Discover how health equity affects the economy (PDF) – find out about the economic burden of health inequities, from the Joint Center for Political and Economic Studies
Colorado needs thoughtful and decisive action to improve health equity, by both policymakers and committed citizens.
- Join our email listserv – stay up-to-date on the specific projects we’re undertaking to improve health equity
- Connect with your community – find ways to learn about and address the issues within your own community
- Contact your elected officials – share your thoughts and ideas on improving health equity in Colorado
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