Life or Death Could Depend on Your Zipcode

What is your zip code?

That could be a determining factor of your life expectancy and what kind of healthcare you receive, says Dr. Asha Shajahan, a family medicine specialist and medical director of the Community Health Program for Beaumont Hospital, Grosse Pointe.


Some zip codes show a life expectancy of 76 years of age while another anticipates life expectancy of 86 years of age. Some of the contributing factors according to Shajahan could be poor housing, poor education, violence-filled neighborhoods, and more. “Grosse Pointe’s average life expectancy is 83 years of age. Detroit’s different zip codes have a different life expectancy. One particular life expectancy drops to 63 years of age.”


Many are well aware that high poverty and disparity rates in healthcare have resulted in the tragic deaths of many Black Detroiters particularly during the COVID-19 pandemic. As of January 28, the U.S. had surpassed more than 25.6 million total cases and 429,000 deaths due to the pandemic, according to a report from the non-profit organization Kaiser Family Foundation.


According to a Centers for Disease Control and Prevention study, Blacks, Latinos, and Native Americans are dying from COVID-19 nearly three times the rate of white people.

Shajahan has published work on how implicit bias training done correctly can improve healthcare.


“It appears in general with the COVID-119 pandemic we did see a lot of the disparities really focusing on the African American community,” Shajahan said. “Having worked in this space we know structural racism plays a big part in the African American communities (and how they perceive healthcare systems).”


She added that a deeper look into social determinants of health, like where a person lives, their transportation situation and beyond, “plays a role in determining if you get good healthcare.”


She added that based on a report (from the President Lyndon B. Johnson era) after the 1968 Detroit rebellion, Johnson wanted to find out what started it all. The Kerner Commission identified three things that were the root of the cause: injustice in the criminal justice system, housing and education.


”That all has to do with social determinants of health and we were living in (the Kerner Commission) quoted, ‘Separate but unequal societies.’ Fifty years later this is still happening with COVID-19.”


She added that some people might push back and say, why don’t some Detroiters move out. It’s not always that easy.

“In the past housing loans were denied for people of color. Even though that may not be happening today it was happening so recently that it’s going to affect people generationally because housing equity is how you can build wealth. So, it is like a domino effect; that is the thing people miss. These social circumstances affect your health,” she said. “If we don’t fix the social circumstances in an equitable fashion, communities for people of color will continue to have bad health.”


Many times, unconscious bias can impact residents looking for care, too.


“Everyone has unconscious bias. Some medical schools are beginning to touch upon this during training but that’s rare. The need for this training is now being designed by health systems across the nation and it’s about time,” stated Dr. Maria Hernandez, president and COO of Impact4Health, a multidisciplinary team of psychologists, public health researchers, physicians, and health educators who promote health equity.


To help diminish unconscious bias, Impact4Health tools help train healthcare boards, administrators, physicians, nurses and other healthcare workers. This approach has been demonstrated in a variety of healthcare settings and can be implemented in stages.


The first step is identifying where problems exist in a healthcare system. The best way to identify “pain points” is to collect and analyze data.


Data reveals disparity, according to Impact4Health. Tracking healthcare metrics in the context of race, ethnicity, languages and other factors produce actionable intelligence to improve outcomes. That’s why Impact4Health developed the Inclusion Scorecard for Population Health, a free, customizable assessment that helps break the cycle of unconscious bias while meeting the goals of healthcare providers.


Then comes changing perspectives regarding cultural education to teach C-suite administrators the direct link between inclusion and better outcomes.


“Achieving health equity is tremendously hard work, but it can be done. It needs to be a priority on the frontlines, at the doctor’s office and in the boardroom. Those leaders who want to improve healthcare outcomes, augment their staff and improve productivity by embracing inclusion and health equity have to be committed to the work, and it requires a sea change in our healthcare culture to get there,” Hernandez said.


How can Healthcare systems increase healthcare equity, improving patient outcomes?

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