“Islands of Disadvantage:” Prince William neighborhoods rated poorly in regional health study

PRINCE WILLIAM COUNTY — Areas in Prince William County — including the area near Manassas, Dale City, Woodbridge, and Dumfries — are implicated as having a lower life expectancy in the metropolitan Washington region, according to a new report produced for the Metropolitan Washington Council of Governments (COG).

The report, “Uneven Opportunity: How conditions for wellness vary across the metropolitan Washington region,” was conducted by the Virginia Commonwealth University (VCU) Center on Society and Health.

“The residents of the Virginia suburbs of Washington, D.C. are among the most affluent in the United States,” the report noted. Despite this, life expectancy in the region can vary by as much as 27 years in some areas.

“[C]loser examination reveals clusters of census tracts where residents live in more difficult conditions,” and in many cases, these adverse areas are “separated by only a few miles or blocks” from more affluent ones.

“The health status of the local population is not uniform across the region,” according to the report.

Census tracts are small subdivisions of counties defined for the purpose of gathering information about the members of a given population. The metropolitan Washington region has 1,223 census tracts. By examining these, the study found “striking geographic differences in… health measures such as infant mortality, obesity, heart disease, and diabetes.”

Two prior studies by the VCU Center on Society and Health have documented Northern Virginia’s “uneven opportunity landscape” and identified 15 “islands of disadvantage,” which are “clusters of census tracts with adverse living conditions.”

Included in those 15 “islands” were Bull Run-Manassas, Dale City-Woodbridge, Dumfries and Centreville.

What is causing the disparity? VCU researchers developed a Healthy Places Index (HPI) to find out more details. The HPI was created using census tract data, indicators and life expectancy computation, and used to rate communities on health conditions.

The HPI provides a score, ranging from zero (lowest opportunity for health) to 100 (most opportunity for health), and researchers used it to rank all census tracts in the metropolitan Washington area. Included in that overall score is six “domain” scores: air quality, education, economic/other household resources, health care access, housing, and transportation.

A higher HPI placement often correlates with a higher life expectancy.

Distant suburbs of Northern Virginia, including areas of Woodbridge and Dumfries, “where life expectancy was as low as 75-79 years,” scored the lowest in the HPI. Contrastingly, areas of Washington, D.C. with high HPI score have an average life expectancy of 87 years.

Ultimately, the HPI found that individual health — often interpreted as a personal choice — is shaped by a variety of factors. These include, but are not limited to, economic resources, housing and transportation. Simply having access to quality health care nearby is not enough to raise an area’s HPI score.

“Health is about more than health care,” the report reads. “Doctors cannot solve the socioeconomic challenges or improve neighborhood conditions. Impacted areas have large populations that lack health insurance and localized areas have an inadequate number of primary care physicians, mental health professionals, and other clinical services.”

The report also found a great disparity in the racial population. “[P]eople of color and immigrants were more likely to live in neighborhoods with fewer resources,” or islands of disadvantage, “which lack the conditions for good health.”

In tracts with the highest HPI scores, 64 percent of the population was white and the proportion of black and Hispanic residents was 6 percent and 10 percent, respectively. In tracts with the lowest HPI scores, 63 percent of residents were black, 13 percent were Hispanic, and 19 percent were white.

“Black-white health disparities persist even after adjusting for other factors that affect health such as education, household resources, and housing,” the report said.

Jennifer Schitter, a principal health planner for COG, told Potomac Local that the COG Health Officials Committee “will be engaging various sectors to champion this report in 2019. Sectors may include housing, education, planning directors, and county and city governments.”

“It is important to be aware of where the neighborhoods with fewer resources are in their respective jurisdictions,” said Schitter. “Once identified, elected officials could work with these communities to identify holistic solutions to addressing each community’s unique needs.”

In addition to COG, organizations who funded the report include Kaiser Permanente, Healthcare Initiative Foundation, Northern Virginia Health Foundation, and the Potomac Health Foundation.

“[C]reating healthy communities and closing the region’s 27-year gap in life expectancy require more fundamental social and economic solutions beyond the world of health care,” the report suggested.

“Real solutions require targeted investments in marginalized neighborhoods to improve access to affordable, healthy housing as well as affordable transportation, child care, and health care.