Much of public health focuses on individual behavior and its impact on health. Rather than looking at a person’s health over the course of their life as disconnected stages unrelated to each other, the Life Course Perspective considers it an integrated continuum where a complex interplay of biological, behavioral, psychological, social, and environmental factors contribute to various health outcomes. The Nebraska Department of Health and Human Services received technical assistance from the Association of Maternal and Child Health Programs (AMCHP) to develop a communications piece about life course indicators. We chose concentrated disadvantage, which captures the synergistic effects of economic and social factors that cluster geographically. Neighborhoods with high concentrated disadvantage can have limited access to resources, social networks, and expose people to negative social conditions and poor health outcomes. Our goal was to develop informational material to help communities understand how neighborhoods impact an individual’s health, how concentrated disadvantage impacts outcomes like teen birth, and to encourage community partnerships.
METHODS:
Concentrated disadvantage was calculated from five census variables: percent of individuals below the poverty line, percent on public assistance, percent of female-headed households, percent of adults unemployed, and percent under the age of 18. 2009-2013 data were obtained from the American Community Survey for Nebraska census tracts. Z-scores were calculated for each variable, summed for each census tract to create a tract-specific concentrated disadvantage score, then split into low, medium low, medium high, and high quartiles. These quartiles were mapped. Next we calculated census tract level teen birth rates from 2009-2013, and geocoded them with the concentrated disadvantage scores. We developed a four page, consumer-oriented brochure designed to be a resource for conversations about how neighborhoods impact health, how concentrated disadvantage impacts teen birth, and to encourage community partnerships to address concentrated disadvantage.
RESULTS:
Areas of high concentrated disadvantage were identified mostly in urban metro areas, Native American reservations, and a few rural farming communities. The teen birth rate in areas of high concentrated disadvantage is twice that of areas of low concentrated disadvantage.
CONCLUSIONS:
Understanding the life course perspective helps communities go beyond focusing on individual behaviors to recognizing the biological, behavioral, psychological, and environmental factors that impact health. Mapping concentrated disadvantage ties individuals and their health outcomes to their neighborhoods. Community leaders, agencies, and local health departments can use the communications piece to strengthen communities and start addressing the health outcomes of people living in neighborhoods with high concentrated disadvantage.