Montgomery County was recently ranked as the healthiest county in Maryland and among the healthiest in the country, outranking other jurisdictions in life expectancy, vaccination rates and more. Despite this, a recent county report shows that health disparities persist between white residents and Black and Hispanic county residents.
The Health in Montgomery County 2013-2022 report, released publicly on Friday, highlights the ways the county performs better in health outcomes than many parts of the state and country, including low rates of premature death and fewer visits to the emergency room for substance use.
But the report also illustrates that health outcomes are more disparate for the county’s marginalized demographics, particularly for the Black and Hispanic communities. The report also found the county’s white population is decreasing as minority community populations increase. In 2018, white residents made up 43% of the county’s population, but accounted for 40% in 2022.
For example, the incidence of heart disease among county residents has decreased over time despite a spike in 2020 during the COVID-19 pandemic. Emergency room visit rates for heart disease have also dropped over the time covered in the report, with the county consistently reporting lower rates than the state. However, the report also notes that Black residents had the highest heart disease mortality and emergency room visit rates among all racial groups in the county.
“The data also indicates troubling trends in access to and utilization of care services, as well as disparities in areas like infant mortality and chronic disease management,” county health officer Dr. Kisha Davis wrote in a press release Friday announcing the report. “Our goal is to use this data to strengthen our current health programs and develop new, innovative and accessible programs that directly address the public health needs of our residents.”
The surveillance report was created using county health data from a variety of sources, including county health equity reports, U.S. Centers for Disease Control and Prevention, the Behavioral Risk Factor Surveillance System and the U.S. Census American Community Survey. It was produced by the county’s Department of Health and Human Services.
According to the press release, the report aims to serve as a “centralized resource for County health statistics across a broad spectrum of health conditions.” It also aims to provide “valuable insights, identify both successes and challenges and encourage further analysis by stakeholders to inform the development of targeted health interventions.”
More than 80% of county residents were fully vaccinated for COVID-19 between 2020 and 2022, in comparison to just over 60% nationwide. The county also reported high rates of vaccination for influenza and the human papilloma virus (HPV). The county also reported an average life expectancy of 83.2 years, a six year difference from the state and national average of 77 years.
County focuses on Black residents’ maternal health
The maternal health of Black women has been a key area of focus for the county health department programming and intervention in recent years, with infant and maternal mortality rates for Black county residents being consistently higher than other racial groups. According to the report, this continues to be a trend, with Black infants having the highest rates of mortality and low birth weight among all racial groups. Black infants had a 9.7% low birth rate in comparison to 2.4% statewide for Black infants between 2018-2022, and Black infant mortality peaked at 12.2 deaths per 1,000 live births in 2021. However, the county continues to have lower rates of low birth weight (7.3% of all infants born in 2022) and infant mortality (3.6 deaths per 1,000 live births in 2022) in comparison to the rest of the state.
The leading causes of death in the county from 2020-2022 were heart disease (24.9%), cancer (19.5%), COVID-19 (9.4%), cerebrovascular disease (5.4%) and accidents (4.4%). The COVID-19 pandemic had a disparate racial impact, with the virus identified as the leading cause of death among Hispanic residents, followed by cancer and heart disease.
Heart disease, injuries and mental health were the top three leading causes of hospitalization among white and Black residents, while cancer was the third leading cause among the county’s Asian and Pacific Islander residents. While heart disease and cancer were the top two leading causes of death for males and females of all races, COVID-19 emerged as the third leading cause since the beginning of the pandemic in 2020.
County Executive Marc Elrich (D) highlighted the report’s “good news” that the county continues to outperform the state regarding health outcomes, but noted it needs to take steps to reduce disparities impacting Black and Hispanic residents.
“We can’t ignore that,” he said in the press release. “Our job is to use this information to guide better decisions that lead to better outcomes for everyone. That means making services easier to access, expanding community-based programs and continuing to focus on equity as we invest in public health.”
