In Cincinnati, as in other cities around the United States, the top causes of death are heart disease, stroke, cancer, diabetes and chronic lower respiratory (lung) disease. Death rates in Cincinnati tend to be higher than Ohio, overall, and much higher when compared to the rest of the United States.

While these data are startling, what is even more surprising is how health can differ even within Cincinnati. Data from 2001-2009, released by the Cincinnati Health Department, highlighted differences in average life expectancy in Cincinnati. The average life expectancy for the city is 76.7 years; if you live in Mt. Lookout/Columbia Tusculum, average life expectancy is 87.8 years. If you live in South Fairmount, average life expectancy is only 66.4 years. This means that, depending on where you live in Cincinnati, your life expectancy could vary by 20 years or more! In fact, 29 of the 47 neighborhoods in Cincinnati have a life expectancy that is less than the average for the entire city.

How does where one lives impact health? Availability of health-related resources and opportunities to engage in healthy behaviors, like eating fresh fruits, are key to improved health. Communities lacking resources have poorer health and more disease than communities with more resources. In addition, low or under employment, high poverty and high stress can contribute to crime rates and unhealthy coping behaviors like alcoholism and drug use.

Health disparities is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affect[ing] groups of people who have systematically experienced greater social and/or economic obstacles to health and/or a clean environment based on [personal characteristics].” Historically, systematic discrimination has been related to outward personal characteristics, primarily race and ethnicity, and overt and institutionalized racism has systematically limited opportunities for non-white citizens, including opportunities for optimal health.

Since 2004, The Center for Closing the Health Gap (The Health Gap) has been working toward a mission of eliminating racial and ethnic health disparities in Greater Cincinnati through the use of our grassroots model where we engage, empower and advocate creating a culture of health.

We do our work in and with communities. We work alongside community members to understand the factors that make it difficult to maintain healthy behaviors given the available resources in the community. Community members also work with us to identify effective strategies that can improve factors that influence health, like income and socioeconomic status and living conditions.

Some of our signature programs have provided opportunities for mass access to health screenings through the annual Health Expo, educational classes such as the Mt. Auburn Do Right! program, and environmental improvements through our healthy corner store initiative.

The Health Gap is fighting not for equality, but for equity in health. Health equity means people in equal need deserve equal access to health care. Dr. Martin Luther King Jr. once said “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” The Center will continue to strive for health equity by directly addressing factors, like racism, that have systematically restricted access to optimal health. It may require allowing what could be perceived as special treatment to allow those with the fewest resources opportunities to access health care and resources so that, in the end, we can all benefit. n

Dwight Tillery grew up in Cincinnati’s West End has held a number of distinguished professional positions throughout his career. In 1991, he became the first African American popularly elected mayor of Cincinnati. He also served as a member of city council; where he sponsored many pieces of legislation that benefited the poor and minorities. He is founder, president and CEO of The Center for Closing the Health Gap in Greater Cincinnati whose mission is “to lead the efforts in eliminating racial and ethnic health disparities in Greater Cincinnati through Advocacy, Education, and Community Outreach.”