How ZIP Codes Can Predict Health Destiny Better Than Genomes

Study after study shows COVID-19 is far more likely to infect residents in non-white, low-income, and densely populated neighborhoods. A recent analysis of cases in 8,500 U.S. ZIP codes found that infection rates in these locations were almost five times higher than in those that are more than 90 percent white.

These shocking statistics confirm what most health experts already know. Today, an individual's ZIP code often predicts their health destiny better than their genome. Forget the DNA -- it's the ZNA that counts.

When treating COVID-19, diabetes and other illnesses, the most advanced medical technologies in the world won't make a difference if individuals are unable to visit a doctor, afford their treatment or understand how to live a healthy lifestyle.

A study in New York's Finger Lakes region found that premature death measured in average "potential years of life lost" was as much as 50 percent worse in some poorer ZIP codes than the average for the region.

The correlation between higher income and longer life expectancy has been well documented. Average life expectancy for the richest 1 percent of American men at age 40 is nearly 90 years. For the poorest 1 percent, it isn’t even 73 years.

What’s shocking is that one in 10 seniors lives below the federal poverty line and 37 million people who are 50 or older are either in poverty or one life-event away from slipping into it. COVID-19 is that life-event for many – and that’s unconscionable.

It’s well known that older Americans are at significantly greater risk of death in this pandemic. CDC numbers through June show that 80.7% of U.S. COVID-related deaths were individuals 65 and older. These are horrifyingly grim numbers for our Baby Boomers and remaining members of the Greatest Generation.

One’s age being a risk factor for health outcomes is as old as human history, and modern medicine has greatly extended American’s average lifespan by 50 percent, from 53 in 1920 to 79 today. But if the wealthiest among us are living nearly two decades longer than the poorest, are we really making progress?

It's time for our nation to develop a holistic healthcare model that considers social determinants of health. The Root Cause Coalition, our organization, brings together more than 70 organizations from myriad sectors and industries – including healthcare, education, social service, faith-based, business and government – to achieve health equity by addressing the social determinants of health.

Earlier this spring, just before COVID shut down so much of our nation and unleashed its fury, we released the Status of Health Equity Report which highlighted front line primary care providers’ desire to fix our broken healthcare system, yet most feel they don’t have ability to be part of the solution. The global pandemic brought to the forefront serious deficiencies and inequities in a system meant to maintain public health. All this makes the call to achieve health equity more critical than ever.

The report also highlights the work of dozens of our members and programs they have implemented in their communities that have proven to be sustainable and effective and highlights the need for a new model of health care delivery. Most essential in that model is the inclusion of all sectors that play a role in an individual’s health and well-being.

As Randy Oostra, CEO of ProMedica, one of the Coalition’s two founding members, along with the AARP Foundation, recently noted, "comprising a broad cross-section of professionals from healthcare, business, social services, and federal officials -- is the best way to set national policies that will improve healthcare outcomes."

Our current healthcare delivery model is unsustainable. We need a bold, honest and coordinated national effort, while looking for inspiration and models of success at the local level. Members of The Root Cause Coalition can provide example upon example of such inspiration.

State-of-the-art treatments don't matter for those who face a choice between spending meager resources on their care and putting food on the table. They also don't matter for those who have no way of getting to a pharmacy, or put themselves at risk just by leaving their homes.

We must replace a healthcare hierarchy which neglects to address -- or sometimes even acknowledge -- the underlying social determinants impacting health outcomes for the less fortunate among us.

It’s unacceptable that where one lives determines one’s equal access to those needs.

It's time to close the ZIP code gap.

Barbara Petee is the executive director of The Root Cause Coalition.