Measures to Advance Health and Opportunity

The HOPE Initiative

The HOPE Initiative provides an interactive data tool designed to help our nation and states move beyond measuring disparities to spur action toward achieving health equity. HOPE tracks 24 social determinants of health and health outcomes by race, ethnicity, and socioeconomic status. Our unique analyses use an opportunity framework to set aspirational but achievable goals to improve peoples’ lives—especially those most affected by racism, oppression, and other forms of discrimination.

The HOPE Initiative shows where the nation and states are doing well and where they can do better on reaching health equity goals. In doing so, HOPE helps state and federal leaders, advocates, and other stakeholders know three things to inform action and policy change: 1) where the gaps in opportunity are among people of different races and ethnicities; 2) what goals for achieving equity look like; and 3) how far they need to move the dial to make these goals a reality.

In light of the COVID-19 pandemic, we are releasing this preliminary site to examine how inequity plays a role in the virus’ disproportionate effects on poor, marginalized, and communities of color. Our full site with all 24 measures for the nation, 50 states, and D.C. will go live in late summer 2020. For more information on how COVID-19’s impact highlights an urgent opportunity for change, check our our Health Affairs’ blog here.

What Does HOPE Measure?

HOPE measures how different racial and ethnic populations are faring on 24 indicators of health and well-being, and examines the disparities that need to be addressed to achieve health equity. Specifically, HOPE sets aspirational, yet achievable goals based on the best outcomes some communities are already experiencing, and measures what it will take for everyone to achieve those goals.

Health Equity

HOPE is about health equity. Health equity means that everyone has a fair and just opportunity to be as healthy as possible. For the purposes of measurement, health equity means reducing and ultimately eliminating disparities in health and its determinants.

Domains

HOPE tracks indicators across five topic areas, referred to as domains: health outcomes, social and economic factors, community and safety factors, the physical environment, and access to health care.

HOPE Goal

HOPE Goals are national benchmarks set for each indicator based on best outcomes achieved in the top five states. These aspirational benchmarks are possible because some people are already achieving them.

Indicators

HOPE’s 24 indicators span the life course, and measure the outcomes, opportunities, and resources people need to achieve optimal health and well-being. These measures reflect the systems and policies that affect health equity.

Distance to Goal

Distance to Goal (DTG) shows how much progress the nation and each state must make to achieve the HOPE Goal on a particular indicator, overall and by race and ethnicity.

HOPE for COVID-19

It is no accident that communities of color have been hit the hardest by the devastation of COVID-19. Across the country, these are the same groups facing steep systemic barriers to basic opportunities—from a livable income, affordable housing, and food security to access to neighborhoods that are safe and thriving. Left unchecked, disasters like the pandemic only make existing disparities worse. Below, we pair COVID-19 data with HOPE indicators to reveal the connections among the pandemic’s inequitable outcomes and critical measures of health and opportunity.

Alabama
Arizona
Colorado
Maryland
Mississippi
Wisconsin

What HOPE Tells Us About COVID-19 Inequities in Alabama

In Alabama, Blacks and Hispanics are suffering the worst health outcomes from COVID-19, mirroring the deep systemic inequities they face in their daily lives. For instance, Blacks comprise almost twice as many COVID-19 cases (50%) and deaths (48%) than their share of the state’s population (26%).

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
66%
43%
50%
White
26%
50%
48%
Black
4%
13%
3%
Hispanic
1%
1%
1%
Asian/PI
1%
0%
0%
AI/AN
1%
0%
0%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Alabama

HOPE shows that Blacks in Alabama are disenfranchised from a range of basic opportunities. They are least likely to live in areas with low rates of concentrated poverty and least likely to have access to affordable housing, food security, and a livable income.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data show that to improve Black lives in Alabama—including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Poverty Concentration: Nearly 730,000 Black people (a number equivalent to Alaska’s entire population) need to see improvements in economic opportunity and neighborhood conditions to lift them out of areas with concentrated poverty. Doing so would provide a critical pathway to stable jobs, quality schools, safe environments, food security, and other resources.
  • Livable Income: Over 386,000 Black people must be given fair opportunities to earn livable wages to sustainably support their households.
  • Food Security: Nearly 300,000 Black people need adequate access to food.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.

What HOPE Tells Us About COVID-19 Inequities in Arizona

In Arizona, American Indians are suffering by far the worst health outcomes from COVID-19, mirroring the deep inequities they face in their daily lives. American Indians have four times the rate of COVID-19 cases (18%) and five times the rate of COVID-19 deaths (20%) as their share of the state population (4%).

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
56%
29%
50%
White
4%
5%
3%
Black
31%
43%
23%
Hispanic
3%
1%
1%
Asian/PI
4%
18%
20%
AI/AN
2%
0%
0%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Arizona

HOPE shows that American Indians in Arizona are disenfranchised from a range of basic opportunities. Only one in four American Indians lives in areas with low rates of concentrated poverty, about one in three (34%) earns a livable income, and just half (51%) have food security. They also face the lowest rate of health insurance coverage in the state.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data show that to improve conditions for American Indians in Arizona—including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Poverty Concentration: Over 200,000 American Indians of the total 265,000 in Arizona need to see improvements in economic opportunity and neighborhood conditions to lift them out of areas with concentrated poverty. Doing so would provide a critical pathway to stable jobs, quality schools, safe environments, food security, and other resources.
  • Food Security: Over 121,000 American Indians need adequate access to food which is near equivalent to the entire population of Cochise County.
  • Livable Income: Nearly 87,000 American Indians must be given fair opportunities to earn livable wages to sustainably support their households.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.

What HOPE Tells Us About COVID-19 Inequities in Colorado

In Colorado, Blacks and Hispanics are suffering the worst outcomes from COVID-19, mirroring the deep inequities they face in their daily lives. For instance, Hispanics (46%) comprise twice as many cases as their share of Colorado’s population (21%).

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
69%
41%
65%
White
4%
7%
7%
Black
21%
46%
22%
Hispanic
3%
4%
4%
Asian/PI
1%
1%
1%
AI/AN
2%
1%
1%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Colorado

HOPE shows that Hispanics in Colorado are disenfranchised from a range of basic opportunities. Hispanics are less likely to live in low poverty concentration areas, earn a livable income, have affordable housing, and health insurance coverage than most other groups.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data shows that to improve conditions for Hispanics in Colorado including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Poverty Concentration: Nearly 434,000 Hispanics (a population the size of Minneapolis) need to see improvements in economic opportunity and neighborhood conditions to lift them out of areas with concentrated poverty. Doing so would provide a critical pathway to stable jobs, quality schools, safe environments, food security, and other resources.
  • Livable Income: Nearly 255,000 Hispanics also need to be provided with fair opportunities to earn livable wages to sustainably support their households.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.

What HOPE Tells Us About COVID-19 Inequities in Maryland

In Maryland, Blacks and Hispanics are suffering the worst outcomes from COVID-19, mirroring the deep inequities they face in their daily lives. For instance, Hispanics have three times the rate of COVID-19 cases than expected.

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
52%
24%
43%
White
30%
35%
41%
Black
10%
33%
11%
Hispanic
6%
2%
4%
Asian/PI
0%
0%
0%
AI/AN
2%
0%
0%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Maryland

HOPE shows that Hispanics in Maryland are disenfranchised from a host of basic opportunities. They have the lowest rates of having a livable income, affordable housing, health insurance coverage and food security, as compared to all other racial and ethnic groups in the state.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data show that to improve conditions for Hispanics in Maryland—including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Health insurance coverage: Over 126,000 Hispanics (more than the entire population of Frederick, MD) need to be covered by health insurance, providing them with critical access to health care services.
  • Livable income: Over 102,000 Hispanics need to be provided with fair opportunities to earn livable wages to sustainably support their households.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.

What HOPE Tells Us About COVID-19 Inequities in Mississippi

In Mississippi, Blacks and Hispanics are suffering the worst outcomes from COVID-19, mirroring the inequities they face in their daily lives. For example, Blacks have 1.5 times the rate of COVID-19 cases (55%) and deaths (51%) as compared to their share of the population (37%).

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
57%
28%
42%
White
37%
55%
51%
Black
3%
7%
2%
Hispanic
1%
0%
0%
Asian/PI
0%
5%
6%
AI/AN
1%
0%
0%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Mississippi

HOPE shows that Blacks in Mississippi are largely disenfranchised from basic opportunities. They are least likely to live in low poverty concentration neighborhoods (31%), and also face low rates of having a livable income (34%), affordable housing (61%) and food security (69%) in the state.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data show that to improve Black lives in Mississippi—including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Poverty concentration: Over 758,000 Black people (more than the population of Seattle) need to see improvements in economic opportunity and neighborhood conditions to lift them out of areas with concentrated poverty. Doing so would provide a critical pathway to stable jobs, quality schools, safe environments, food security, and other resources.
  • Livable income: Nearly 365,000 Black people also need to be provided with fair opportunities to earn livable wages to sustainably support their households.
  • Food Security: Over 314,000 Black people need adequate access to food.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.

What HOPE Tells Us About COVID-19 Inequities in Wisconsin

In Wisconsin, Blacks and Hispanics are suffering the worst outcomes from COVID-19, reflecting the deep inequities they face in their daily lives. For example, Blacks have three times (21%) the rate of cases and four times (25%) the rate of deaths as their share of the population (6%).

Portion of the Population
% of COVID-19 Cases
% of All COVID-19 Deaths
82%
60%
70%
White
6%
21%
25%
Black
7%
37%
11%
Hispanic
3%
4%
3%
Asian/PI
1%
1%
1%
AI/AN
2%
0%
0%
Multiracial

Key HOPE Indicators by Race and Ethnicity in Wisconsin

HOPE shows that Blacks in Wisconsin are largely disenfranchised from basic opportunities. They (43%) are half as likely to live in areas with low poverty concentration as Whites (92%). Blacks also have among the lowest rates of having a livable income and affordable housing in the state.

This chart is interactive. Explore data by clicking the dots to select and compare different race and ethnicity groups.

White
Black
Hispanic
Asian/PI
AI/AN
Multiracial
HOPE Goal

High Health Status

73%

Livable Income

88%

Low Poverty Concentration

100%

Affordable Housing

87%

Food Security

97%

Health Insurance Coverage

98%
0%
20%
40%
60%
80%
100%
Further from HOPE Goal
Closer to HOPE Goal

HOPE’s Distance to Goal data shows that to improve Black lives in Wisconsin including the disproportionate effects of COVID-19—decision-makers must prioritize policies and programs that address:

  • Poverty concentration: More than 205,000 Black people need to see improvements in economic opportunity and neighborhood conditions to lift them out of areas with concentrated poverty. Doing so would provide a critical pathway to stable jobs, quality schools, safe environments, food security, and other resources.
  • Livable income: Nearly 107,000 Black people also need to be provided with fair opportunities to earn livable wages to sustainably support their households.

Source: The COVID Racial Data Tracker, data downloaded on June 18, 2020, 10:00 AM CDT.

Note: Six states were selected based on available data (no more than 20% missing data) on COVID-19 cases by race/ethnicity and corresponding number of deaths; complete race/ethnicity data on select HOPE indicators; their wide disparities for HOPE and COVID-19 indicators; to capture a mix of Democratic and Republican governed states; and for geographic diversity. Read more about our methods here.