Identifying Target Areas for Built Environment Interventions Aimed at Improving Health by Eric Lucas

IDENTIFYING TARGET AREAS FOR BUILT ENVIRONMENT INTERVENTIONS AIMED AT IMPROVING HEALTH

Health Issues, Disparities, and Distribution in Marion County

Prepared by: Eric Lucas Prepared for: LA 690-001, Martha Hunt Date of Submission: May 4, 2012

Table of Contents

Introduction ��1 Targeting Health Issues ��3 Health Issues �� 3 Health Disparities �� 4 Health Policy �� 5 Challenges to Healthier Lifestyles �� 6

High Risk Areas based on Hispanic or Latino �� 26 High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino �� 27 High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino + Food Deserts �� 28 High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino + Food Deserts �� 29

Conclusions ��31

Marion County Analysis ��9 Methodology �� 9

References ��33

Parks and Open Space �� 10 Trail Systems �� 11 USDA Food Deserts �� 12 Age �� 13 Race - Non-Hispanic Black �� 14 Race - Hispanic or Latino �� 15 Household Income �� 16 Education Attainment �� 17 Household Income + Age �� 18 Education Attainment + Age �� 19 Household Income + Non-Hispanic Black �� 20 Education Attainment + Non-Hispanic Black �� 21 Household Income + Hispanic or Latino �� 22 Education Attainment + Hispanic or Latino �� 23 High Risk Areas based on Age �� 24 High Risk Areas based on Non-Hispanic Black �� 25

Introduction

Current health statistics for weight and chronic disease indicate that we must take dramatic steps to improve our well-being. Many federal, state, and local agencies have advocated for healthier lifestyles that reduce risk for weight and chronic disease illness, and a host of initiatives are seen throughout our communities. Given costs associated with treating these illnesses, more and more of these strategies focus on prevention. Alongside medical strategies, our built environment can have a profound impact on promoting healthier lifestyles. The design community is beginning to recognize the role that we can, and should, play in promoting healthier lifestyles, but research is needed to inform the who, what, where, when, why, and how of built environment strategies aimed at improving health. This paper provides an overview of the why: the chronic disease health issues facing our society, the disparities affecting certain populations, the changing focus of our nationâ&#x20AC;&#x2122;s healthcare industry, and the challenges that our communities face in promoting healthy lifestyles. A methodology, based on health data mapping is proposed to inform where healthy lifestyle initiatives can be targeted.

Targeting Health Issues

Health Issues In 2010, the Indiana State Department of Health published In-

State Department of Health and the Indiana Healthy Weight Ini-

dianaâ&#x20AC;&#x2122;s Comprehensive Nutrition & Physical Activity Plan 2010-

tiative Task Force, 2010, p. Executive Summary). Despite in-

2020, a report that spells out a strategy for combating poor

creased awareness and targeted programs, the prevalence of

nutrition, sedentary behaviors, and obesity.

Within the docu-

overweight and obesity has increased sharply for both adults

ment, the State issues a stark warning: â&#x20AC;&#x153;with the majority of

and children over the past 30 years (Centers for Disease Con-

our population either overweight or obese and those who are

trol and Prevention, 2008).

not struggling to maintain a healthy weight, we are at risk of becoming a state with a burden so great that it will cripple our

The State is also struggling to control diabetes, a family of dis-

productivity, severely impact our economy, and completely

eases that can lead to diminished quality of life, disability, or

change our way of lifeâ&#x20AC;? (Indiana State Department of Health and

death (Thomaskutty & Dwivedi, 2011, p. 1). In fact, in 2005,

the Indiana Healthy Weight Initiative Task Force, 2010, p. 4).

diabetes was the sixth leading cause of death in the U.S. (Cen-

This dire statement is based upon recent statistics from 2009

ters for Disease Control and Prevention, 2008). In 2009, diag-

that indicate almost one-third of Indiana adolescents and almost

nosed cases of diabetes plagued Hoosiers at a 12% greater

two-thirds of Indiana adults are overweight and obese (Indiana

rate than the national average (Thomaskutty & Dwivedi, 2011,

overweight + obesity among chldren 2-17

1:3 overweight + obesity among adults

2:3 3

diabetes among adults

1:10 indiana’s cost related to diabetes

$4B

p. 4). Beyond personal and family-related health impacts, there

period (Indiana Business Research Center, IU Kelley School of

is a considerable economic cost associated with treatment of

Business, 2012). It is estimated that nationwide, $1 out of every

diabetes- and obesity-related illnesses. In 2007, an estimated

$6 spend on healthcare is related to treatment of heart disease

$218 billion economic cost, $58 billion of which was attributed

(Centers for Disease Control and Prevention, 2011). As an il-

to reduced national productivity, was associated with diabe-

lustration of the local impact of these costs, Indiana’s estimated

tes, and the average annual healthcare cost for a person with

2007 Medicaid treatment costs for cardiovascular diseases

diabetes in the United States is almost four times the cost for

alone was over $450 million (National Conference of State Leg-

a person without diabetes (Thomaskutty & Dwivedi, 2011, p.

islatures, 2012). At present, using Marion County’s population

2). Diabetes-associated costs for the Hoosier state alone ap-

to approximate Medicaid cost, the local share is $63 million.

proach $4 billion (Thomaskutty & Dwivedi, 2011, p. 2). This is a significant burden on the private and public sectors. At present, Marion County represents 14% of the State’s population. Using population percentage to approximate cost, Marion County’s share is $560 million, a significant figure especially given that half of the county’s population is either reliant on public insurance or has no coverage at all (U.S. Census Bureau, 2010). Though Indiana residents face enormous weight and diabetes challenges, the most significant health burden is cardiovascular disease. In 2005, heart disease accounted for 26% of all deaths in Indiana (Centers for Disease Control and Prevention, 2008). In 2003, the total cost of treating heart disease in Indiana was estimated at over $4 billion and is projected to increase by an additional 250% to over $10 billion by 2023 (Indiana State

Health Disparities According to CDC data, higher incidences of diabetes in Indiana can be associated with lower education, lower income level, and race (Thomaskutty & Dwivedi, 2011, p. 12). Similarly, cardiovascular disease has a higher rate of incidence for those among certain ethnic groups, such as African Americans, and groups with a low socioeconomic status (Centers for Disease Control and Prevention, 2011). Understanding chronic health disparities is important on two fronts. First, lower socioeconomic groups are more likely to depend on government-assisted healthcare programs. As the na-

Department of Health, 2010), even though the state’s population is projected to increase by only 8% during that same time

indiana’s 2023 growth projections

8% 255%

population

costs of treating heart disease 4

amount spent on treatment of heart disease of all healthcare dollars

adolecents not meeting daily levels of exercise

3:5 adults not meeting daily levels of exercise

2:5 adolescents consuming the recommended servings of fruits/vegetables

less than

1:5

adults consuming the recommended servings of fruits/vegetables

1:5 tion’s new healthcare law, the Affordable Care Act, is implement-

cording to the CDC, chronic diseases such as heart disease,

ed an estimated additional 20 million people, mostly adults, will

stroke, and diabetes “are among the most prevalent, costly, and

be eligible to enroll in Medicaid by 2014 (Bachrach, November

preventable of all health problems.” (Centers for Disease Con-

2010). This additional burden on resources represents a clear

trol and Prevention, 2008).

need to control healthcare costs through focused prevention

that include eating well and being physically active greatly re-

in order to ease the burden facing our federal, state, and local

duces a person’s risk for developing chronic disease (Centers

governments, particularly in a time of economic uncertainty and

for Disease Control and Prevention, 2008). In fact, even if you

decreased resources. Second, understanding the connection

have no other conditions or habits that increase your risk, the

between chronic health incidences to race and socioeconomic

chances of developing heart disease are twice as likely among

status allows us to understand where to geographically focus

inactive people compared to those who are more active (Na-

efforts that seek to prevent, not just treat.

tional Institutes of Health, 2006). Unfortunately, at present, the

Making healthy lifestyle choices

State’s population does not measure up well: less than 1/5 of adolescents and just over 1/5 of adults eat recommended daily

Health Policy It is widely recognized through Federal and State policies that poor diet and physical inactivity are key contributors to overweight and obesity, cardiovascular disease, and diabetes. Ac-

servings of fruits and vegetables, and just over 2/5 adolescents and 3/5 adults meet the recommended levels of physical activity. (Indiana State Department of Health and the Indiana Healthy Weight Initiative Task Force, 2010, p. Executive Summary). 5

In strong support of healthier lifestyles, Healthy People 2020,

alone, 24 census tracts are classified as food deserts (U.S.

the nationâ&#x20AC;&#x2122;s published health objectives, lists eleven objectives

Department of Agriculture Economic Research Service, 2011).

for improving health through diet and physical activity (Healthy

The Healthy Food Financing Initiative Working Group defines a

People 2020). Of those, four directly address the need for im-

food desert as a low-income census tract where a substantial

proved food security and access to fresh fruits and vegetables,

number or share of residents has low access to a supermarket

and seven relate to increased levels of physical activity. Interest-

or large grocery store (U.S. Department of Agriculture). Most of

ingly, this recent version of Healthy People also includes three

these tracts, home to over 90,000 residents (U.S. Department

developmental objectives that seek to increase the proportion

of Agriculture Economic Research Service, 2011), or about 10

of bicycling and walking trips, and promote legislative policies

percent of all Marion County residents, also have the some of

for the built environment that enhance access to and availability

the Cityâ&#x20AC;&#x2122;s highest percentages of low-income and poorly-edu-

of physical activity opportunities.

cated populations (U.S. Census Bureau, 2010). Despite encouragement from advocacy groups and governments, grocery

Surprisingly, just a brisk 30-minute walk each day of the week

store and supermarket chains, which left the inner-cities in the

can reduced your risk of heart disease, stroke, cancer, high

latter part of the 20th century, have failed to return in substantial

marion county residents living in food deserts

1:10 blood pressure, and diabetes (National Institutes of Health,

numbers (Food and Water Watch, March 2011). This strategy

2006). In addition to walking, the simplest of activities are en-

has left vast areas of the inner-city without convenient access to

couraged for achieving daily levels of physical activity: light gar-

fresh fruits and vegetables, which is especially critical in these

dening/yardwork, bicycling, and running/jogging (National Insti-

communities due to the underlying transportation challenges

tutes of Health, 2006). These are activities that can and should

and eroded family structure (single-parent households), both of

be planned for and built into each neighborhood, so that healthy

which complicate the ability to make frequent trips to a far-away

lifestyle choices are free, accessible, and convenient.

grocery store or supermarket. A possible barrier to increasing physical activity is the low pro-

Challenges to Healthier Lifestyles Representing a major challenge to achieving Federal and State objectives for increased fruit and vegetable consumption is the lack of access to these types of foods in high-risk, urban populations. In support of health policies, studies indicate that neighborhood residents with better access to supermarkets and other retail stores that provide access to healthful food products and limited access to convenience stores, which oftentimes do not stock fresh produce, tend to have healthier diets and lower levels of obesity (Larson, Story, & Nelson, 2009, p. 75). This is a critical distinction to draw, and one that may explain why prevalence of certain conditions, like diabetes, is found to be higher in lower-income, less-educated areas. In Marion County 6

portion of outdoor recreation opportunities in Marion County. According to the 2011 American Fitness Index, relative to the top 50 metropolitan statistical areas in the U.S., Marion County falls woefully short in the present amount of parkland. Key comparisons: 55% less parkland (as a percentage of land area), 26% less acres of parkland (per 1,000 residents), 65% fewer ball diamonds (per 10,000 residents), and 45% fewer recreational centers (per 20,000 residents) (American College of Sports Medicine, 2011). Economically, the City spends $46 per resident for parks; well below national average of $102 (Indy Parks & Recreation, 2009). Walk Score, whose mission is to promote walkable neighborhoods, ranks the top 50 cities based upon â&#x20AC;&#x153;walking routes and distances to amenities, road connectivity metrics such as intersection density and block length, and

50 largest msaâ&#x20AC;&#x2122;s - fitness index (acsm) 1 minneapolis 14 cincinnati 17 pittsburgh 21 milwaukee 22 kansas city 24 raleigh 25 cleveland 28 chicago 36 charlotte 37 nashville 38 columbus

amount spent on parks in indianapolis msa compared to average of top 50 msaâ&#x20AC;&#x2122;s

45%

45 indianapolis scores for individual amenity categoriesâ&#x20AC;? (Walk Score, 2011). In their current rankings, Indianapolis ranks 45th, matching the American Fitness Index ranking.

Marion County Analysis

Methodology This analysis maps health data that ties diabetes prevalence to

Black high school populations have a higher rate of prev-

race, age, and socioeconomic status, and overweight/obesity

alence.

prevalence to age and race. »» The basis for mapping is Marion County GIS (Imagis).

»» The basis of obesity disparity data is the Indiana Healthy Weight Initiative, which indicates that Hispanic or Latino populations have a higher rate of prevalence in ages 2-5

»» The basis for socioeconomic data is the 2010 U.S. Cen-

and in high school ages, Non-Hispanic Black populations

sus American Community Survey, mapped by census

have a higher rate of prevalence in ages 10-17 and in

tract.

high school ages.

»» The basis of diabetes disparity data is the 2010 Burden

The result of this analysis is a map illustrating higher-risk areas

of Diabetes by the Indiana State Department of Health

within the City. For the purposes of this analysis, higher-risk

which indicates the following: 9.3% prevalence rate for All

populations are defined as populations within a census tract

Adults, 13.9% prevalence rate for Non-Hispanic Blacks,

exceeding 150% of the county’s average for the given factor.

17.9% prevalence rate for Adults Age 55-64, 23.3%

The following factors were mapped to determine at-risk areas:

prevalence rate for Adults Age 65+, 11.5% prevalence rate for Education of High School Diploma or GED Educational Attainment, 13.7% prevalence rate for Less than High School Diploma Educational Attainment, 15.3% prevalence rate for Annual Household Income Less than $15,000, 13.2% prevalence rate for Annual Household

»» Age – more than 16% aged 55-64, more than 16% aged 65+ »» Race – more than 40% Non-Hispanic African-American, more than 14% Hispanic/Latino

Income between $15,000 and $24,999, and 12.8%

»» Household Income – more than 21% earning less than

prevalence rate for Annual Household Income between

$15,000, more than 19% earning $15,000-$24,999,

$25,000 and $34,999.

more than 19% earning $25,000-$35,000

»» The basis of overweight disparity data is the Indiana

»» Educational Attainment – more than 24% with less than

Healthy Weight Initiative, which indicates that Hispanic or

high school diploma, more than 45% with a high school

Latino populations have a higher rate of prevalence in

diploma or equivalent

ages 2-5, 10-17, and high school ages. Non-Hispanic 9

Parks and Open Space Included as reference

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Trail Systems Included as reference

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

USDA Food Deserts Food Deserts

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Age 55-64, Greater than 16% 65+, Greater than 16% 55-64 and 65+, Each Greater than 16%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Race - Non-Hispanic Black Non-Hispanic Black, Greater than 40%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Race - Hispanic or Latino Hispanic or Latino, Greater than 14%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Household Income $25,000 - $35,000, Greater than 19% $15,000 - $24,999, Greater than 19% Less than $15,000, Greater than 21% Less than $15,000, Greater than 21% and $15,000 - $24,999 Less than $15,000, Greater than 21% and $15,000 - $35,000, Greater than 19%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Education Attainment Attainment High School Diploma or Equivalent, Greater than 45% Attainment Less than High School Diploma, Greater than 24% Attainment Less than H.S. Diploma, Greater than 24% and Attainment H.S. Diploma or Equivalent, Greater than 45%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Household Income + Age $25,000 - $35,000, Greater than 19% $15,000 - $24,999, Greater than 19% Less than $15,000, Greater than 21% Less than $15,000, Greater than 21% and $15,000 - $24,999 Less than $15,000, Greater than 21% and $15,000 - $35,000, Greater than 19% 55-64, Greater than 16% 65+, Greater than 16% 55-64 and 65+, Each Greater than 16%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Education Attainment + Age Attainment High School Diploma or Equivalent, Greater than 45% Attainment Less than High School Diploma, Greater than 24% Attainment Less than H.S. Diploma, Greater than 24% and Attainment H.S. Diploma or Equivalent, Greater than 45% 55-64, Greater than 16% 65+, Greater than 16% 55-64 and 65+, Each Greater than 16%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Household Income + Non-Hispanic Black $25,000 - $35,000, Greater than 19% $15,000 - $24,999, Greater than 19% Less than $15,000, Greater than 21% Less than $15,000, Greater than 21% and $15,000 - $24,999 Less than $15,000, Greater than 21% and $15,000 - $35,000, Greater than 19% Non-Hispanic Black, Greater than 40%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Education Attainment + Non-Hispanic Black Attainment High School Diploma or Equivalent, Greater than 45% Attainment Less than High School Diploma, Greater than 24% Attainment Less than H.S. Diploma, Greater than 24% and Attainment H.S. Diploma or Equivalent, Greater than 45% Non-Hispanic Black, Greater than 40%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Household Income + Hispanic or Latino $25,000 - $35,000, Greater than 19% $15,000 - $24,999, Greater than 19% Less than $15,000, Greater than 21% Less than $15,000, Greater than 21% and $15,000 - $24,999 Less than $15,000, Greater than 21% and $15,000 - $35,000, Greater than 19% Hispanic or Latino, Greater than 14%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

Education Attainment + Hispanic or Latino Attainment High School Diploma or Equivalent, Greater than 45% Attainment Less than High School Diploma, Greater than 24% Attainment Less than H.S. Diploma, Greater than 24% and Attainment H.S. Diploma or Equivalent, Greater than 45% Hispanic or Latino, Greater than 14%

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

High Risk Areas based on Age Intersection of Age, Household Income, and Education Attainment Factors

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

High Risk Areas based on Non-Hispanic Black Intersection of Non-Hispanic Black, Household Income, and Education Attainment Factors

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

High Risk Areas based on Hispanic or Latino Intersection of Hispanic or Latino, Household Income, and Education Attainment Factors

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino Intersection of Age, Household Income, and Education Attainment Factors Intersection of Non-Hispanic Black, Household Income, and Education Attainment Factors Intersection of Hispanic or Latino, Household Income, and Education Attainment Factors

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino + Food Deserts Intersection of Age, Household Income, and Education Attainment Factors Intersection of Non-Hispanic Black, Household Income, and Education Attainment Factors Intersection of Hispanic or Latino, Household Income, and Education Attainment Factors Food Deserts

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

381001 390405 381203 381205

381201 381204

390403

390300

High Risk Areas based on Age + Non-Hispanic Black + Hispanic or Latino + Food Deserts High Risk for Two Groups and/or Food Deserts High Risk for Three Groups and/or Food Deserts

320203 320107

320106

320105

310104

330103

320204

330109

320303

310106

310105

320202

330206

330106

320304

330105

320301

320902

310201

330203

320109

320108

320800 310103

330108

330208 330107

320901 320600 320903

310204

310203

320700

320500

320400

330209

330204 330401

321300 310310

321200

321001

310308

310309

321400

390600

321700

321100 321800 310110

321600

310312

310305

321002

330202

322000

350900

350800

340901

353600

340902 341000

351900

353500

341700

390700

360402

360404

360101

360302

360301

360401

360405

391000

360800

352500

354900 354800 354700 354200 354400354500 355000 355100

360602

355300

361000

355400

361100

342600

360502

360501

360700

355600

355500

361200

355900 357200

342101

356900

357000

357100

342200

357300 358100

342400

360601

361300 355700

356200

342000

360202

360900

352700

356400

342500

360201

352400 352600

390900

353300

341600

341903

360102

352300 352100

351700

341200

341100

341904 341902

350600

352800

340113

330806

351600

340600

340800

340111

330805

330900

350700

351500

351200 340202

340102

350500

351000

340700

331000

330803

350400

390500

340500

340300

340114

340101

330804 322700

322600

322100

350300

350100 340400

340201 340109 340108

330700

322200 322500

340110 340112

330600

321900

310306

310111

330500

322400

322300 310311

310108

361600 357400 361400

357800 358000

342300

357900

380200

357600

380300

357500

380404

380403 390102

370202 390800

370201

390101

390200

380502 380600

380402

380501

380700

380800 390404

370302 380100

381101

381002

380901 380902 390402

381102 370301

390403

390300

381001 390405 381203 381205

381201 381204

Conclusions

Mapping prevalence-based health to geographically indicate possible areas of greater disparity that can inform where health interventions may be prioritized. As a next step, those areas deemed at greatest risk may be further analyzed based upon built environment characteristics that support active lifestyles, including: »» Street connectivity and character »» Sidewalk connectivity and walkability »» Access to park space »» Park space distribution »» Park space quality and type »» Trail access »» Transit availability, routes, and stops »» Food access, including restaurants, markets, stores The built environment analysis will indicate which areas are more likely to support healthier, active lifestyles and which are not. Combining that data with disparity mapping can further inform prioritization of interventions at the neighborhood scale.

References

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