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The Journal Gazette

  • GiaQuinta

Sunday, September 16, 2018 1:00 am

ZIP code big determinant in kids' outcomes

Dr. Sarah E. GiaQuinta

When it comes to health, a child's ZIP code is as important as his or her genetic code, and the data prove that Fort Wayne's children are not an exception. Unfortunately, the health disparities tied to the social determinants of health in adults are reflected in our children.

Early experiences affect brain development and build the foundation for a child's future behavior, educational achievement and health. It is the combination of a child's genes and experiences that shape his or her brain, and between birth and age 5, the brain develops more than at any other time in life.

Childhood health and development are directly affected by the homes and neighborhoods the children grow up in. This is illustrated in the disparity in infant mortality rates among Fort Wayne ZIP codes and racial groups. Infant mortality, the death of a child within the first year of life, is an important public health issue for Allen County. According to Indiana State Department of Health data, the 46806 ZIP code ranks among the highest of all Indiana counties for infant mortality, and within those neighborhoods, the rate of death for African-American infants is three times as high as the overall rate for Allen County.

Not only are African-American infants dying at unacceptable rates across the city, the infant mortality rate is an important indicator of the overall health of these communities, influenced by rates of poverty, the baseline health of women and mothers living in the community, and the ability to access healthy food and affordable, high-quality health care.

Using City Health Dashboard data to better understand the health of Fort Wayne's children, consistent disparities appear across neighborhoods. According to the American Academy of Pediatrics, poverty early in life can lead to chronic illness, developmental delay, poor social relationships and behavioral issues. Poverty makes parenting harder, and families living in poverty are exposed to higher levels of toxic stress, which increases a child's risk of chronic disease, mental health issues or a shortened life expectancy.

In Fort Wayne, about 28 percent of children are living in poverty, a number that is higher than the average of the 500 cities in the Dashboard study. However, a deeper dive shows significant variation with poverty rates ranging between less than 15 percent for much of southwest and northwest Fort Wayne to greater than 60 percent for many of southeast Fort Wayne's neighborhoods. The everyday struggles resulting from low household income make it difficult to lead healthy lives, both for adults and children.

Many of these same households also have limited access to healthy foods. According to County Health Rankings and Roadmaps, 14 percent of Allen County's families don't know where their next meal is coming from. Perhaps counterintuitive, hunger and obesity co-exist, and food insecurity is associated with weight gain and premature death. As illustrated by the City Health Dashboard data, the highest rates of adult obesity mirror the highest rates of poverty across Fort Wayne.

The City Health Dashboard data also show an increased lead exposure risk index score for Fort Wayne compared with the 500-city average. The Centers for Disease Control and Prevention reports no safe level of lead exposure, and high blood lead levels can diminish a child's ability to succeed in school. A child's risk of lead poisoning – a known neurotoxin – is dependent on where he or she lives or spends time, and the risk significantly increases for impoverished families living in homes built prior to the 1978 lead paint ban. Unfortunately, the effects and costs of lead poisoning last a lifetime.

Fort Wayne's children are this community's future. Yet according to national trends and statistics, we are raising a generation that is destined to earn less money than their parents and live fewer years. Our city can do better.

Frederick Douglass said, “It is easier to build strong children than to repair broken men.” All children – and their parents and grandparents, too – should have the same opportunity to thrive. But it isn't enough to focus on health care. It will take policy changes and upstream investments in housing, neighborhoods and the creation of measurable economic opportunities to change the course for our children, our future and our commonwealth.

Dr. Sarah E. GiaQuinta is director of the Children's Health Collaborative of Allen County.