Analysis: Poverty shortens lives in Fresno, Calif. (and elsewhere)

Many of Fresno's poorest neighborhoods rank highest for a wide range of health risks, a fact public health experts say is no accident


The Fresno Bee
By Tim Sheehan

FRESNO, Calif. — Neighborhoods with higher poverty rates face many challenges, including lower educational attainment, greater reliance on public assistance, and higher rates of people who are uninsured.

It turns out that residents in those areas in Fresno may live shorter lives, too.

An analysis of Fresno County census tract-level data on life expectancy from the National Association for Public Health Statistics and Information Systems and poverty information from the U.S. Census Bureau shows a general correlation between the two — and not in a good way.

Some of the census tracts with the highest rates of poverty in the county also have the lowest overall average life expectancy compared with more affluent neighborhoods.

The life-expectancy information, released by the U.S. Centers for Disease Control and Prevention and updated this fall, indicates that life expectancy for a person in one census tract can vary considerably from that for a person in another tract in the same community, whether across town or across the street.

"It is truly unsettling to see how small differences in geography yield vast differences in health and longevity," said Donald F. Schwarz, senior vice president of programs for the New Jersey-based Robert Wood Johnson Foundation, which was involved last year in producing the nation's first analysis of life expectancy down to the census tract level.

"In some places, access to healthy food, stable jobs, housing that is safe and affordable, quality education, and smoke-free environments are plentiful. In others, they are severely limited."

The foundation collaborated with the National Association for Public Health Statistics and Information Systems and the National Center for Health Statistics at the Centers for Disease Control and Prevention to compile and issue the life-expectancy data. It then created a searchable database in which people can type in their address to see what the average life expectancy is in their neighborhood.

For example, almost 56% of residents in Fresno's Census Tract No. 6 — a one-square-mile area that includes the aging Lowell Elementary School neighborhood north of downtown Fresno — are considered to be in poverty under federal income guidelines. That's one of the five most poverty-stricken tracts in the city. It also has the shortest average life expectancy of any census tract in the county, at 70.4 years.

By contrast, the average life expectancy is 85.5 years in northeast Fresno's Census Tract 55.17, which includes the neighborhoods around the Fort Washington Country Club and Liberty Elementary School. There, only about 4.3% of residents are in poverty.

But a look at other data at the census tract level shows that there are plenty of other health concerns that correlate to poverty — exposure to pollution, incidents of asthma, cardiovascular disease and low birth weights. And that correlation is not necessarily just a coincidence.

"Wealth and income generally provide greater access to physical conditions that promote good health, such as safe homes and neighborhoods, healthy food, and places to exercise," state the authors of "Wealth Matters for Health Equity," a report published by the Robert Wood Johnson Foundation. (Full report can be accessed below.)

"Families with more economic resources are better able to rent or buy homes that are free of lead ... and free of mold and cockroaches, which can trigger asthma attacks."

The findings don't come as a surprise to advocates for low-income neighborhoods in Fresno, including the Leadership Counsel for Justice and Accountability. The organization has long lobbied for more equitable policies and gone to court over land-use issues that they say perpetuate divisions between poor and affluent neighborhoods.

"Unfortunately, we see the reality of economic and health disparities during our work with low-income residents in Fresno and across California every day," said Ashley Werner, a senior attorney with Leadership Counsel.

"Low-income communities have always received lower levels of public and private investment and have borne the brunt of industrial and hazardous land uses."

The California Office of Health Hazard Assessment, in its CalEnviroScreen data for 2018, assesses a wide range of health risks by census tract and ranks each tract in comparison with every other tract in the state. By those measures, many of Fresno's poorest neighborhoods rank highest for prevalence of those health concerns.

The Fresno tract with the highest poverty rate, at 70%, is Census Tract 25.02, straddling Highway 180 in southeast Fresno and bounded by First Street, Olive, Cedar and Belmont avenues. The average life expectancy there is about 76 years, and it ranks:

  • Higher than 87% of all California census tracts for the burden of pollution faced by its residents.
  • Higher than almost 96% of all California census tracts for instances of asthma among residents.
  • Higher than 99% of all California census tracts for instances of cardiovascular disease among residents.
  • Higher than 92% of all California census tracts for instances of low-birth-weight babies born to mothers living there.

The census tract with the lowest poverty rate in Fresno is Tract 43.01, in the affluent Lake Van Ness area of northwest Fresno. The life expectancy is 85.3 years -- about nine years longer than the poorest tract -- and it ranks:

  • Lower than all but 6.4% California census tracts for low-birth-weight babies.
  • Lower than all but 30.1% of California census tracts for instances of cardiovascular disease.
  • Lower than all but 46% of California census tracts for instances of asthma.
  • Higher than 77% of census tracts for the pollution burden for residents -- possibly due to its proximity to traffic along busy Herndon Avenue and its location between Highways 99 and 41.

Werner cited a local life expectancy study in reacting to the various differences between different parts of Fresno. "It's no accident that, according to a Fresno State study, West Fresno residents' life expectancy is 20 years less than residents of Woodward Park in northeast Fresno," she said. "Elected leaders must commit to tackling these inequities directly and comprehensively."

The authors of the Robert Wood Johnson Foundation report said that, not surprisingly, wealth and income align with conditions for better health and well-being. "Wealthier families can live in neighborhoods with less air pollution and other toxic hazards, less crime, fewer fast-food outlets and liquor stores, and more parks and green spaces to exercise," the report stated.

Lower-income families, in comparison, lack the same protection from health consequences from homelessness or housing insecurity, food insecurity, and reduced ability to afford necessities such as heat and transportation that can affect health.

"While those at the bottom of the economic ladder typically experience the worst health outcomes, people in the middle of the ladder also tend to be less healthy than the most affluent individuals," the report stated.

The authors added that "children in more economically disadvantaged families typically have more limited educational and social opportunities, in turn limiting their chances for economic advantage -- and good health -- as adults."

(c)2019 The Fresno Bee (Fresno, Calif.)

Learn more about the connection between health and affluence:

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