Among District residents, the average black man has a life expectancy of 68.8 years, almost 15 years shorter than the average white man; the average black woman, meanwhile, has a life expectancy of 76.2 years, nine less than her white peer, according to a new report out this week from the School of Nursing and Health Studies at Georgetown University.

That’s just one of the stark disparities in measures of health contained in the report, which examined what experts call “social determinants,” such as economic and environmental factors. Although the Affordable Care Act has helped more residents access healthcare since 2010 than in previous years, and, overall, HIV infections, deaths from coronary heart disease, and infant mortality have gone down, the report finds that African Americans in the District have not benefited to the same degree as other racial groups have. For example, the authors note, black males are the most likely subset in D.C. to be victims of homicide, while many long-term residents are struggling to meet basic needs like housing and savings.The report is being submitted to Mayor Muriel Bowser and the D.C. Commission on African-American Affairs.

“Historically, we’ve placed more emphasis on the health care system as a means of addressing the problem and less emphasis on complex social factors,” said NHS Assistant Professor and report author Christopher King in a release. “We can have the best health care in the world, but if we don’t live in communities that make it easy to make healthy choices, we’re less likely to see an improvement in health.”

The authors relied on data from the U.S. Census Bureau, federal and local health agencies, and the National Cancer Institute, among other sources, to compile the report. They explicitly discuss gentrification and displacement as drivers of disparate health outcomes for black residents, pointing out that in the past 30 years, the District’s African-American population has shrunk by roughly one-fifth. “Destabilized housing and housing cost burden can lead to homelessness, food insecurity, job loss, and social disconnection,” the report explains. “Chronic or survival stress associated with meeting day-to-day needs increase[s] risks for chronic disease conditions and mental dysfunction.”

On a brighter note, the report says more than 90 percent of black adults and children in D.C. are insured, and approximately “85 percent of black residents receive routine medical checkups—the highest percentage of all racial and ethnic groups” in the District.

Among other racial disparities highlighted in the report:

• Infant mortality rates in 2013: 9.9 per 1,000 among black residents versus 1.7 per 1,000 among white residents
• “African Americans are 10 times more likely than whites to be victims of homicides”
• Black residents are twice as likely to die from coronary heart disease and have high blood pressure than their white peers
• Nearly 15 percent of black residents suffer from diabetes as compared with three percent of whites
• African-American residents are “more than two times more likely to report 15-30 days of poor mental health.”
• Black adult residents have the highest rates of obesity in D.C., at 34 percent
• African Americans represent almost three-quarters of all diagnosed HIV cases in the District

“As the city continues to experience rapid growth and economic progress, proactive efforts are needed to address policies, practices, and norms that perpetuate segregation and inequitable distribution of resources—disproportionately burdening African American residents,” the authors conclude. Major disparities are shown below:

You can read the report here. On Wednesday, D.C.’s Department of Health released its 2020 health goals for the city.