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7 Social Determinants of Health 1) Social Determinants of Health, 2) Mental Health & Substance Abuse and 3) Physical Activity & Nutrition are Orange County’s three chosen priority areas for 2015-2019. Access and poverty were the highest ranked social determinants and will be the focus of this section. You may find other social determinants in the Social Determinants of Health section. v According to income inequality measures, wealth in Orange County is not evenly distributed across resident populations, and health inequities persist due to differences in educational and economic opportunities. While the county’s median household income ($57,261) is above the state ($46,693) and national average ($53,482), this number hides pockets of poverty. The current 2014 poverty rate in Orange County is 16.8%—down from 17.4% in 2012, with child poverty at 15.7%. Adult poverty rates differ by ethnic group with Black (26.7%) and Hispanic (34.1%) residents being more likely to live in poverty than their White (14.8%) or Asian (11.7%) counterparts. Poverty guidelines are identified based on family size and income to determine various purposes such as financial eligibility for federal programs. Programs that use poverty guidelines (or percentage multiples of the guidelines —125%, 150%, or 185% of the guidelines) in determining eligibility include but not limited to: Head Start, the Food Stamp Program, the National School Lunch Program, the Low-Income Home Energy Assistance Program, the Children’s Health Insurance Program, and Community and Migrant Health Centers. hldhdv In January 2014, the Orange County Health Department (OCHD) responded to a question about the state of child poverty in Orange County. 17% of Orange County children are estimated to be below the federal poverty level as of 2013, representing a 7% increase from 2001. In particular, children who have adverse childhood experiences (ACEs) that are more common among families experiencing poverty are at higher risk of health outcomes like obesity, depression, and substance abuse. Few publicly available sources exist to map poverty estimates at the neighborhood level, and many sources of poverty-related data are imperfect when taken individually. Therefore, OCHD staff identified pockets of low-income populations (see figure 4) using four different data sources that suggest low-income: (1) residential structure type from the Land Records/GIS, (2) active housing choice vouchers from Housing, (3) children on Medicaid Fg4:OagAaf cadv