What does this score mean?

A score of 100 represents racial equity, meaning there are no racial disparities in the outcomes between black and white populations. The lower the Equity Score, the greater the disparity.

For Chronic Disease Hospitalizations, a score of 100 – a score reflecting racial equity – would mean black and white residents are equally likely to be hospitalized for treatment of a chronic disease. It is important to note that for this indicator, equity is not our only goal; we also want to improve outcomes for all.

WHAT DOES THIS ANALYSIS MEAN?

Black residents are about 50% more likely than white residents to be hospitalized for chronic disease (45.4 per 1,000 black residents, compared to 30.6 per 1,000 white residents). The data reveal that in St. Charles County, black residents are not more likely than white residents to be hospitalized for chronic disease. Black residents are 95% more likely to experience this outcome in the City of St. Louis, 37% more likely to experience it in St. Louis County, and 16% more likely in St. Clair County.

If chronic disease hospitalizations were equitable, the number of hospitalizations to treat black residents of a chronic disease would have decreased by:

• 4,429 in the City of St. Louis,
• 276 in St. Clair County, and
• 3,128 in St. Louis County.

Why Do Chronic Disease Hospitalizations Matter?

Hospitalizations are tied to overall health outcomes. Chronic diseases, according to the Centers for Disease Control and Prevention, “are the most common, costly, and preventable of all health problems.” Many chronic diseases are linked with quality-of-life issues, including lack of walkable neighborhoods, limited access to fresh food, and high levels of stress. Not only is the rate of hospitalization related to health, it can also be related to financial outcomes and opportunities as well. Medical costs are one of the leading causes of bankruptcy in the United States, and disparities in health insurance coverage exacerbate this problem.

One particular issue within this indicator is the use of emergency rooms. Emergency room visits for chronic disease represent both our best estimates of chronic disease rates in the population, and the ability of people to manage their chronic disease. Emergency rooms are meant to serve as the healthcare of last resort, yet the data show that many residents are using them to treat chronic diseases because they lack access to more regular and preventative care. The Ferguson Commission highlighted that emergency room use is tied to people having to delay or forgo needed care because of a lack of health insurance.

Which Calls to Action from the Ferguson Commission’s report are linked with this indicator?

The Ferguson Commission’s calls to action intended to reduce reliance upon emergency rooms as sources of primary care, including:

• Build Safe Neighborhoods
• Build Healthy, Affordable Housing
• Increase Health Insurance Coverage and Access
• Expand Medicaid Eligibility
• Provide Gap Coverage
• Increase ACA Marketplace Enrollment

Questions for Further Investigation:

• Why is there a racial disparity in Chronic Disease Hospitalizations?
• What can St. Louis do to reduce racial disparities in Chronic Disease Hospitalizations?
• What initiatives are currently underway to reduce racial disparities in Chronic Disease Hospitalizations?

Chronic Disease Hospitalizations Data