Health is not the same for everyone in Howard County | COMMENTARY

Howard County is a growing county with a good hospital, but racial inequalities still exist when it comes to health.

The Horizon Foundation in 2018 added a key priority to our list of initiatives — equity.

For 22 years, we have focused our work on ensuring everyone in Howard County can live a long, healthy life. That sweeping goal has led us to serve groups across racial and socioeconomic spectrums, advocating for priorities that include reducing sugary drink consumption, supporting mental health and building safe places to bike and walk.


But it had become glaringly apparent that these efforts would ultimately fall short if we didn’t address one underlying truth: the benefits of our wealthy and fast-growing county are not equally shared. Persistent racial disparities negatively affect health outcomes for a significant number of our residents.

Last month, the Horizon Foundation released a report, “The 2020 Vision for Health in Howard County,” providing the data — taken from publicly available sources — to underscore this point. The themes highlighted in the report serve as examples of alarming health issues that affect residents across the county, from cradle to grave.


They include:

  • Black infants in Howard County die at double the rate of white infants and black and Latina pregnant women are twice as likely as white women to receive late, or no, prenatal care.
  • Black patients are four times as likely as white patients to be seen in the emergency department for diabetes; additionally, heart disease kills black residents at a rate higher than for any other race.
  • Surveys show Latina youth in Howard County are most at risk of depression and planning a suicide, while white students are least likely.
  • Asian residents are least likely to have an advance directive outlining preferences for medical emergencies or end-of-life care, affecting the care they may receive at their most vulnerable moments.

In truth, most of us working to improve health in Howard County already implicitly understood these trends. But “implicit” isn’t good enough. We believe any real conversation about change must be informed by robust, reliable, disaggregated data, and our report aims to provide that.

So now what? Howard County has long served as a national example of how people of diverse backgrounds can create a thriving community. With some of Maryland’s best schools, a crime rate below the state average and a standout medical facility in Howard County General Hospital, it’s not hard to see why so many are drawn to our neighborhoods.

We have directly witnessed how passionate local leaders, strong community organizations and steadfast advocates can bring about meaningful changes that improve lives. As our community continues to grow, we must find new ways to leverage these assets, assembling and motivating the talent, commitment and experience necessary to face our collective health challenges head on. Having clearly seen the consequences of systems that don’t serve everyone equally — particularly our neighbors of color — we can’t now look away.

These systems include policies, practices and programs that are persistent legacies of an earlier time, and it will take unusually stalwart efforts to unwind them and their devastating impacts. And, of course, injustice isn’t merely a historical construct; new inequities emerge far too regularly in our current systems and policy debates, and we need to ensure that voices from communities of color steer and inform those debates and the responses they inspire.

When the Horizon Foundation expanded its equity focus, we identified a guiding precept: our success depended on our ability to get comfortable being uncomfortable. It’s not easy to admit that your zip code, skin color, income or other demographic factors may determine your health outcomes or length of your life. But acknowledging that truth — in our country, state and local community — is necessary to our efforts to develop policies that address key issues, advocate persuasively and effect lasting change.

We know many others are wrestling with this reality — in Baltimore and beyond. We welcome the chance to learn and work together. We expect our uncomfortable report will be part of broader conversations about all social determinants of health — including economic stability, housing, transportation and education. And we look forward to working with partners and existing organizations on the front lines — including the African American Community Roundtable of Howard County, Association of Community Services of Howard County, Equity4HC, HopeWorks of Howard County and Howard County Chinese School — to dismantle longstanding barriers and arrive at more equitable health outcomes for all.

Now is the time to prioritize addressing racial disparities in health. By building on our strengths and taking collective action, we can create a community where everyone truly has an opportunity to thrive.


Nikki Highsmith Vernick ( is president and CEO of Horizon Foundation, an independent health philanthropy focused on improving health and wellness in Howard County.