Race & Health Outcomes:
How Poverty Drives Health Disparities
Income is a driving force behind the significant disparities in health outcomes facing communities of color. It’s estimated that income explains over 50 percent of the differences in life expectancy between Whites and Blacks. Other research has found that differences in health outcomes between Whites and communities of color are smaller than the disparities found among high and low-income populations within racial and ethnic groups. This is also true in Colorado: health disparities are greatest among low- and high- income groups within the same racial or ethnic groups.
Communities of color are disproportionately low-income and we know that low-income families are at greater risk for poor health outcomes. Understanding this intersection between race/ethnicity and income is important because while we know that health disparities exist by race and ethnicity, the elimination of those disparities is not possible without addressing the income disparities.
The various environmental, economic and social conditions that place low-income families at greater risk for poor health compared to higher income Coloradans, must be addressed to eliminate both race-based and income-based health disparities.
Disparity in Poverty Rates by Race and Ethnicity
The poverty rate among Latino and Black Coloradans is more than two times higher than non-Hispanic Whites in Colorado.
Defining poverty as those with incomes under twice the federal poverty level (FPL) provides a more complete picture of the share of Coloradans experiencing economic hardship. The Self-Sufficiency Standard for Colorado—the level at which families can meet basic needs without public or private support—generally requires an income above 200 percent of FPL. Using this measure, nearly half of all Latinos and Blacks in Colorado in 2014 were living in or near poverty.
Fig. 9: Poverty rates are consistently higher for people of color in Colorado
Poverty Rates by Race/Ethnicity, 2014
Poverty is now widely viewed as one of the most significant threats to child health—so harmful, in fact, that doctors are calling for classifying childhood poverty as a disease. Living in poverty puts children at risk of developing conditions with lifelong consequences, including premature birth, low birthweight, asthma, obesity, diabetes and mental illness.
Latino and Black children are considerably more likely to live in poverty than White and Asian children in Colorado. Over half of all Latino and Black children in Colorado live in or near poverty, compared to 24 percent of White or Asian children.
Physical and Mental Health by Race/Ethnicity and Income
Disparities in health outcomes and access to quality health care by race and ethnicity are well documented. The health disparities of low-income people have also been studied extensively. Most research looks at these important contributors to health separately making it difficult to understand the distinct effects of income and race on health outcomes. Recent research examining health status by both income and race has found that that some of the largest health disparities exist between high and low-income people within the same racial and ethnic group.
The graphs below support this small but growing body of evidence. These graphs still show differences between White, Black and Latino Coloradans. They also show that differences within racial/ethnic groups by income are more dramatic than differences between racial/ethnic groups. Low-income White, Latino and Black Coloradans are nearly twice as likely to report poor or fair physical health compared to higher income Coloradans within the same racial or ethnic group.
The same is true for mental health. The share of Coloradans reporting poor mental health is substantially higher among lower-income people across racial and ethnic groups. In fact, when broken out by income, differences in physical and mental health between White, Black and Latino Coloradans narrow.
Fig. 10: Larger health disparities between high and low income people within racial and ethnic groups
Self-Reported Health Status, by Race/Ethnicity and Income, 2015
Source: Colorado Health Access Survey 2015