Last year, protests in Baltimore shone a spotlight on the poverty, isolation and trauma many African-American communities continue to face across the country. In fact, recent reports show that Maryland’s largest city is noted for having some of the worst health outcomes in the United States, and that, once again, racial disparities are largely to blame for this problem, The Baltimore Sun reports.

The latest city data show that up to 19 percent of Baltimore residents have asthma, 30 percent of children are obese and 30 percent of city kids have suffered at least two traumatic childhood experiences in their lives. Today, about 12 percent of Baltimore babies are born with low birth weight, and up to a quarter of Baltimore residents are smokers. All these numbers are nearly more than twice the national average.

Baltimore health officials said race is a major driver of many of the city’s health disparities. In this seaport city, 62 percent of residents are African American, and more than a quarter of families live below the poverty line. While race and poverty are often to blame for health disparities, researchers noted that even middle-class African Americans in the city currently suffer higher rates of disease than normal.

A recent review of statistics comparing the health of Baltimore’s black population with that of population groups nationally paints an even starker picture of the city’s medical crisis. Black infants in the city die at more than twice the national rate, as do African Americans living with diabetes. Black folks in Baltimore are also diagnosed with HIV at a rate of almost eight times the national average. Recent studies show that the city’s black residents are also far more likely to be hospitalized for chronic disease, drug or alcohol use, sexually transmitted infections or mental health issues than Baltimore’s white residents.

“The drivers are historical things, the way we’ve structured systems and policies that perpetuated or created the disparities,” said LaMar Hasbrouck, MD, MPH, executive director of the National Association of County and City Health Officials, which released these data in a recent presentation at the national Big Cities Health Coalition forum.

Hasbrouck also noted that health disparities in Baltimore are also the result of social factors, such as unsafe neighborhoods that make it impossible for people to exercise outdoors; lack of employment opportunities, stable housing or transportation; and high rates of stress and trauma.

Click here to learn more about how unhealthy spaces, segregation and poverty lead to poorer health among U.S. minority communities.