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There are clear links between race, ethnicity, geography and drivers of health outcomes in the U.S., a special report from U.S. News & World Report finds.

In one of the largest assessments of social determinants of health to date, U.S. News found that communities with a greater share of white residents generally score better, differing from the negative link between communities’ scores and their share of black residents. Larger Hispanic and Native American populations also are linked to worse Healthiest Communities outcomes.

Released today, this report analyzed social determinants of health across nearly 3,000 U.S. counties that were part of the initial Healthiest Communities rankings. The report identifies factors that influence overall well-being such as economy, housing and access to health care, and highlights diverse areas outperforming the norm.

Key Findings include:

  • Nearly 700 communities have a black population share larger than the national average of about 13 percent. Yet just 26 of those communities rank among the top 500 Healthiest Communities overall, with many of those in the Washington, D.C., and Atlanta areas.
  • Some of the strongest predictors of community performance in the U.S. News assessment are also areas in which communities with large black populations generally struggle. These factors include homicide rates, low birth weight and, in particular, access to healthy and affordable food.
  • Low segregation is one of the top 15 drivers of community performance for places with larger than average Hispanic populations. Proximity to jobs and good child care quality reveal some of the largest gaps in social determinants of health between communities with both a Hispanic population share above the national average of about 17 percent and communities with smaller Hispanic populations.

“Your ZIP code can influence your health more than your genetic code. However, even within the varying health outcomes that we see across different geographies, we also see inequality across racial and ethnic groups,” said Dr. Garth Graham, president of the Aetna Foundation and vice president of Community Health for Aetna Inc. “In order to improve health equity in our country, we need to truly understand where these problems exist so that we can help support local solutions that address these unique needs.”

The analysis relies on U.S. Census five-year population estimates of race and ethnicity paired with the U.S. News Healthiest Communities dataset. The rankings encompass 80 metrics drawn from sources such as the Centers for Disease Control and Prevention, the Institute for Health Metrics and Evaluation, the U.S. Census Bureau, the Dartmouth Atlas of Health Care and the U.S. Environmental Protection Agency.

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