Community Empowerment Association, Inc. (CEA) in partnership with the University of Pittsburgh's Center for Health Equity used USALEEP data to provide initial evidence of disparities in life expectancy within its communities of Homewood, PA and McKeesport, PA, linking health inequities to social and environmental determinants. Using life expectancy and mortality data, the project included a series of neighborhood roundtable conversations to encourage the communities to think broadly about various factors influencing health (e.g. air quality, food/nutrition, safety, housing, violence, racism, sexism).

HOW THEY USED USALEEP DATA

When the project Live Longer: Empowering and Engaging Pittsburgh Communities was launched, the overarching goal was to use USALEEP data, community-based participatory research and problem solving to demonstrate the relationship between life expectancy (LE)-related disparities and various social and environmental determinants of health. Utilizing USALEEP Data, the Pitt Public Health life expectancy computation of 63 Pittsburgh area neighborhoods, determined longevity (life expectancy differentials) ranged from 62-84 years - a 22 year differential.

As mentioned, the first step was to use the USALEEP data to determine the life expectancies (LE) for Pittsburgh area neighborhoods and municipalities. The project used the USALEEP data to provide initial evidence of LE-related disparities within our targeted neighborhoods, and then went on to discuss how inequalities in health are socially and environmentally determined, and hence, avoidable. The life expectancy data was valuable in that it likely captured the overall health impacts of a multitude of factors. In addition to the USALEEP data, the Pitt Health and CEA Team also acquired and analyzed neighborhood specific mortality data to determine top causes of death and top causes of years of life lost. This information was used as a way to further engage community members on the contributors to lower life expectancy in their neighborhoods.

A "perceptions" tool was also developed and distributed at various outreach events. The tool was designed to engage community members on issues regarding health and wellness, and also concerns and strengths about their neighborhood. The results from these perceptions tools were integrated into the neighborhood roundtable conversations which were held in Homewood, East Liberty, Penn Hills, and Wilkinsburg.

WHAT THEY LEARNED

The USALEEP data was extremely helpful during the beginning of the project as stated above, however a major challenge to the project was the outbreak of the Covid-19 pandemic which, because of the shut-down in early March, severely limited the ability to move forward with the project as it was designed.

After adjusting the deliverables due to the pandemic to include food and survival insecurity, the Community Empowerment Association conducted a survey on the impact of COVID-19 on Homewood and McKeesport and did a follow up assessment to understand health practices of community members surveyed. CEA found out that over sixty percent of those surveyed had not been tested for COVID-19, 45% said that the pandemic has adversely impacted their ability to feed their families, 43% did not know the warning signs of heart disease and 36% reported increased levels of anxiety, isolation and stress during the COVID-19 pandemic. These findings were elevated to highlight the relevance of extreme disparities of life expectancy in these communities.

WHAT THEY RECOMMEND FOR SIMILAR PROJECTS

Community Empowerment Association has identified a few recommendations for organizations interested in conducting similar projects centering in the USALEEP data, outlined below:

• For equitable longevity to occur for the neighborhoods that were targeted in this project in particular and the low USALEEP life expectancy data neighborhoods in general, social determinants of health interventions are key. Neighborhoods are the units of change; the role of place in people's lives (culture of health) is monumental.
• A determinant that is overlooked that is integral to effectively operationalizing the social determinants of health - are the determinants of decision making. For example it is known that inequality kills; it doesn't appear as a cause of death, nor does food insecurity or racism, but the decisions (policies) that are responsible for the inequity - injustice - premature death does. If life expectancy is used as a barometer for human development (i.e. an investment in human flourishing) then a requirement removing the poverty of empathy and racial animus in decision making must occur.

To learn more, follow Community Empowerment Association on Facebook. If you are interested in learning more about this team’s project approach or have specific questions regarding replicating their work in your community, please feel free to contact the Principal Investigator of this project, T. Rashad Byrdsong.