Health Equity Concerns

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Learn more about the health equity concerns for the following health focus areas:



Age and Gender - Percent of Washington adults reporting diabetes increased with age. About 6% of adults under age 65 reported having diabetes; of those 65 years old and older, 23% of men and 17% of women reported having diabetes. This is similar to national patterns.

Socioeconomic Status - Adults reporting diabetes increased with decreasing income and levels of education. Adults with incomes less than $25,000 were more than twice as likely to have diagnosed diabetes as those with incomes of $75,000 or more.  Adults with a high school education or less were almost twice as likely as those with a college degree or more.

Race and Hispanic Origin - White adults reported lower age-adjusted percent of diabetes (than all other groups except Asian adults). Wide margins of error make it difficult to compare percentages between other groups. The high age-adjusted prevalence among Hispanic (14% ±2%), American Indians and Alaska Native (13% ±4%), and black adults (13% ±3%) is consistent with national data. National data are not available for Native Hawaiian and other Pacific Islanders.



Socioeconomic Status

Obesity rates are highest among people with adjusted incomes less than $25,000 per year (34%); and lowest among those who make $75,000 or more per year (23%). Similarly, people with some college (31%) and high school or less (34%) had higher rates of obesity than college graduates (21%).

Race and Hispanic Origin

BRFSS data for 2012–2014 combined showed Asians having the lowest rate of obesity followed by non-Hispanic whites. Residents with Hispanic origin, American Indian and Alaska Native (AIAN), and black Washington residents reported higher levels of obesity than those for Asian and white residents. The rate for Native Hawaiians and other Pacific Islanders is hard to interpret due to the wide margin of error. Compared with whites, black residents had higher obesity rates and Asian residents had lower obesity rates after accounting for gender, income, education and age. National BRFSS data show similar patterns.



One-in-four adults with an annual household income less than $35,000 smoke cigarettes, while only about one-in-12 adults in households making $75,000 or more smoke. Lower income households also have a higher prevalence of secondhand smoke exposure, may have less access to resources to help them quit, and may have more tobacco marketing in their neighborhood than higher income households.

American Indians / Alaska Natives, Pacific Islanders, people who identify as lesbian, gay, or bisexual also have a higher prevalence of smoking than other Washington residents. These populations also have higher rates of exposure to secondhand smoke, may have less access to resources, and experience more targeted marketing by the tobacco industry.

Prevalence of smoking among youth in Washington State has decreased but higher prevalence of smoking and exposure to secondhand smoke exists among students with lower grades (C’s, D’s, and F’s), students who experienced harassment (in general or because of their perceived sexual orientation), and students who speak Russian or Ukrainian at home.


Well-Child Visits

A primary concern is access to care.  Lack of access is impacted by barriers such as lack of time, transportation, workplace flexibility and language or literacy levels. It has been noted that cultural differences can affect perceptions around the value of well child visits, as with some immigrant populations.  Multi-sector partners will need to collaborate on efforts to address access, remove barriers, and increase awareness among our most vulnerable populations.


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