BERKELEY -- With an abundance of walkers, runners and cyclists, well-used parks, health-conscious schools, breast-feeding moms and tobacco-free public spaces, the city looks healthy. And it is -- for most residents.

Nonetheless, Berkeley has significant health inequities that the 2013 City of Berkeley Health Status Report calls "avoidable," "unjust" and "predictable by race/ethnicity ... income, housing, and education."

Dr. Janet Berreman, who heads the city's Public Health Division, shared data from the report at an Oct. 29 City Council work session: while many in Berkeley's white community -- 55 percent of the population -- enjoy homeownership, post-high school education and access to health care, life for many of the city's African Americans -- 10 percent -- is less rosy.

African Americans living in Berkeley are twice as likely as whites to live in poverty (a family of four living on less than $23,550 per year), and twice as likely to bear a premature baby. Blacks are hospitalized 14 times more for diabetes and five times more for hypertension.

The report focuses on the stark gap dividing white and black health outcomes, covering to a lesser degree Latino and Asian-American communities where the disparities are less pronounced.

Berkeley has multiple programs targeting the health divide, including health and mental health clinics serving mostly lower-income people, clinics at Berkeley High School and Berkeley Technology Academy, teen parenting programs and a community-based project in South Berkeley focused on hypertension.

Budget cuts, however, have hampered these efforts.

"As a result of the economic downturn ... the Public Health Division is about 50 percent of the size it was (in 2007)," Berreman told the council. "We have diminished resources to do this work." In a separate interview, Berreman declined to discuss how the consequences of cuts impact efforts to eliminate disparities.

Councilwoman Susan Wengraf asked Berreman to go beyond statistics. "I want to know the why," she said.

Berreman pointed to "racial inequities ... rooted in the long history of racial inequality in our country," and said solutions are beyond the capacity of a single agency or city.

Still, there has been progress, Berreman said, singling out the Black Infant Health program's role in reducing the rate of low-birth-weight (under 5.5 pounds) African American babies from four times that of white babies in 1991, to 2.5 times today. Still, she said, "That level of disparity is not acceptable."

BIH founder, Dr. Vicki Alexander, retired director of Berkeley's Maternal, Child and Adolescent Health explained in a phone interview that the BIH program worked because it was sensitive to participants' needs.

She described the program's core, sessions educating expectant and new African American mothers, and program elements that she likened to sunflower petals. The "petals" are support that participants receive when literally taken by the hand to navigate the maze of public services, including "getting past a welfare interview without getting pissed off by the way you're treated," she said.

The support includes building trust among participants facing "the constant assault society puts on you, between the job, education, the way people look at a black person as you walk down the street," Alexander said.

Budget cuts, however, eliminated 2.5 of the four BIH staff, one of whom was a mental health professional. "'Petals' are what the program had before we were cut back," Alexander said.

Interviewed in the Public Health Division offices, Berreman underscored the importance of looking ahead, noting her department recently added tobacco prevention staff -- 25 percent of adult African Americans in Berkeley smoke -- and staff for emergency preparedness focusing on vulnerable communities.

A school-based mobile asthma clinic is expanding.

"There have been reductions in the six-year period (2007-13) we're talking about," she said. "The reductions aren't my primary focus at this point. The reductions had an enormous impact a few years ago. Where we are now, is really a new normal. We have a strong (Public Health) Division. We are focused on moving forward."

While the council did not discuss health policy at the work session, Councilwoman Wengraf suggested it might be "appropriate to re-evaluate how our resources are being used in light of this information."

On Nov. 12, the council will look at NAACP and Health Commission proposals to reduce disparities.

The Health Status Report is at http://www.ci.berkeley.ca.us/publichealth/

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