Community Context and Challenges

  • Renewal efforts in the 1960s pushed many low-income black residents to areas with concentrated poverty and a shrinking business base, and left them them unable to move due to housing policies that restricted development of subsidized housing.

  • Due to disparities in educational attainment, many black residents are ill prepared to meet local employers’ needs; they are thus more likely to hold lower paying jobs and experience unemployment.

  • At 13%, unemployment among black residents is higher than for Hispanic (10%) and white (5%) residents.

  • Cigarette smoking prevalence in Louisville and the state are among the highest in the nation; more than 27% of Kentucky adults are cigarette smokers, compared to 17% nationwide.

  • Nearly 13% of Louisville residents suffer from asthma, compared to the national average of 8%; it is the leading cause of emergency room visits among children.

Community Actions: A First Look

Today, Louisville is focused on health in all policies and setting its sights on better preparing the region’s workforce for high-demand jobs.

Recognizing the need to narrow health disparities and to improve its competitiveness and quality of life, Louisville has adopted a “health-in-all-policies” approach to improving population health and engaging broad sectors of the community.


These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

Going Forward: Questions for Consideration

Responding to decades-old challenges in a proactive manner, Louisville’s business, community, and public health sectors have worked collaboratively to narrow the social, economic, and educational disparities that have long plagued the city and hampered progress toward health equity. Comprehensive initiatives to improve educational attainment, expand health insurance, and address long-standing health disparities have gained the cooperation of diverse stakeholders and influential partners across the community. Additional surveillance, data and information gathering, analysis, and reporting will examine the impact of these and other initiatives on Louisville’s residents, especially members of its underserved low-income, black community.

The following questions will be addressed in future reports:

  • To what extent will the proposed Medicaid waiver influence future access to health insurance coverage among the city’s low-income population? How will changes to the current “one-stop shopping” eligibility system affect access to insurance coverage?

  • In what ways are stakeholders in the business, health, and public health sectors coordinating their initiatives to ensure that all residents are served and can attain the maximum possible benefit?

  • What has been the success of workplace initiatives in Louisville to reduce unemployment and underemployment among racial minorities?

  • In what ways will Louisville continue to use or expand its use of civic data to drive decision making?

  • To what extent is the “health-in-all-policies” philosophy being adopted across initiatives, included in Healthy Louisville 2020, and what lessons can be learned from how is this philosophy being applied?

  • To what extent is input from diverse resident groups reflected in the initiatives championed by Louisville’s leaders?