by Camalot Todd, Nevada Current
Systemic racism, lack of affordable housing, limited access to healthy food, and hard-to-get medical services are some of the biggest barriers for Nevadans to be healthy, according to a report released this month by the Nevada Division of Public and Behavioral Health (DPBH).
The State Health Assessment notes that as Nevada’s population becomes increasingly diverse “systems of oppression, such as racism and classism” impact access to resources, in turn compromising people’s health.
The Nevada report mirrors many findings from the Centers for Disease Control and Prevention, which has declared racism a “serious threat to the public’s health.”
Both interpersonal and structural racism negatively affects people’s mental and physical health, with a breadth of research noting people who are not white experience higher rates of illness including diabetes, hypertension, obesity, asthma, and heart disease when compared to white people, and the COVID-19 pandemic exacerbated those disparities, according to the CDC.
In 2020, Gov. Steve Sisolak and the Nevada Legislature declared racism a public health crisis, following in the footsteps of dozens of other states and municipalities that have issued similar proclamations or statements.
The State Health Assessment released this month is a comprehensive overview of the health of Nevadans done every three to five years that aims to quantify its top health challenges and compare the health of the state to that of the nation.
Since DPBH last released the report in 2019, the state’s overall health ranking fell — from 35th in the nation in 2019 to 42nd in 2022. Health measurements like obesity, diabetes, opioid-related deaths, and childhood immunization all worsened, as have educational outcomes and the availability of affordable housing.
More children (19%) and adults (13%) in Nevada live at or below the federal poverty line than the national average (17% of children and 11.6% of adults). Black Nevadans experience poverty at twice the rate of their white counterparts, according to the report.
Black Nevadans are also disproportionately impacted by the lack of affordable housing in the state, according to the report. Low-income renters are more likely to sacrifice healthy food and health care to pay rent, according to the assessment..
The state not only struggles with affordable housing but also safe housing that reduces exposure to lead, fire risk, and has proper heating and cooling.
The assessment found that from 2015 to 2019, 18.5% of Nevada households either lacked complete kitchen facilities, plumbing facilities, were overcrowded, or had occupants who were severely cost-burdened.
Native American residents are disproportionately affected, with .67% of Native American households in Nevada lacking indoor plumbing in contrast 0.4% of Native Americans nationally.
Systemic impacts on health are compounded by the shortage of physicians in nearly every part of Nevada, leading to extended wait times and difficulties getting necessary health care.
For years, Nevada ranked at or near the bottom of all states in access to mental health care, while also having among the nation’s highest prevalence of mental illness and youth mental health, according to the nonprofit Mental Health America’s annual rankings, and every county in the state is a designated mental health professional desert and many professionals have waitlists for months or years.
Rates of depressive episodes were highest among Native Americans, Native Hawaiians/Pacific Islanders, and Hispanic/Latino youth, according to the report.
Cultural competency and language barriers not only inhibit access to mental health care but also social services and physical health care.
Spanish, Tagalog, and Chinese are the most commonly spoken languages after English in the state, and 48.6% of foreign-born Nevadans live in houses where no one over the age of 5 speaks English very well.
Linguistically isolated households are less likely to seek social services and health care, and are less likely to receive important health information provided to them, according to the State Health Assessment.
The bulk of adults living in the U.S. are not adequately literate in how to navigate the health care system. The challenges of navigating the system are even more daunting for populations who don’t speak English as their primary language, are less educated, lower-income, and live in medically underserved communities.
The report explains that ensuring a culturally competent health care workforce can help minimize the impact of systemic disparities. As of 2019, Nevada requires all licensed health facilities to provide cultural competency training annually and at the time of hire.
Nevada will develop a State Health Improvement Plan to address issues highlighted in the report and provide guidance over the next five years. The assessment notes that addressing the systemic and structural roles racism and poverty play in health care disparities will take coordinated efforts from multiple segments of Nevada’s political, social and economic environment, including legislators, tribal officials, social services nonprofits, and the private sector.
DPBH did not provide additional comments about its State Health Assessment by the time of this story’s publication.
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