The Health of The Bronx and New York City by yurtgc548

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									The Health of The Bronx
  and New York City



  Thomas R. Frieden, M.D., M.P.H.
      Commissioner, New York City
 Department of Health and Mental Hygiene
              April 24, 2003
    Community Health Survey
• First ever NYC health survey
   – 10,000 New Yorkers interviewed on health status
     and lifestyle
   – Largest survey of its kind ever in NYC
• Data reported and broken down into many
  different categories
   – More than just traditional demographic information
     (sex, age, ethnicity)
• Detail will allow us to target services at the
  community level on a neighborhood-by-
  neighborhood basis, as needed
   Neighborhoods Most in Need:
Harlem, So. Bronx, Central Brooklyn
Smoking Prevalence in The Bronx
            (by UHF Neighborhood)

    Healthy People 2010 Goal: 12%
         Annual Deaths from Smoking
         Compared with Other Causes
                                    NYC, 2001




* Total includes smoking-related deaths
# Total includes 265 AA587 deaths
+ Total does not include 2,743 WTC deaths
Cancer Screening in
The Bronx vs. NYC
                 HP 2010: 90%
       Colon Cancer
   Detection & Cure Rates




Early-Stage Detection Rates   Colorectal Cancer Cure Rates
    HIV & AIDS Cases in The Bronx
                         Calendar Year 2001




Figures as of 12/31/01
 Rates of People Living w/HIV &
AIDS in The Bronx vs. NYC vs. US
     Calendar Year 2001 – Rates per 1,000 Pop.




Figures as of 12/31/01
   Rates of New HIV Diagnoses in
     The Bronx vs. NYC vs. US
     Calendar Year 2001 – Rates per 1,000 Pop.




Figures as of 12/31/01
 There Has Been a Resurgence of
      Risky Sexual Behavior
• Syphilis cases more    Reported Primary and Secondary
                         Syphilis Case Rates, NYC, 2000-2002
  than doubled
  between 2000 and
  2001, increased
  another 50% in 2002
• Syphilis increase
  almost entirely
  among men,
  especially MSM
• Foreshadowing future
  rise in HIV rates?
Diabetes Prevalence Has More than
Doubled in NYC in the Past 8 Years
Adults with Self-Reported Diabetes, NYC, 1994-2002
  Percent of Overweight NYC
Residents (BMI > 25), by Borough




A woman 5’4” tall is considered overweight at 146 lbs.
A man 5’10” tall is considered overweight at 174 lbs.
   Percent of Overweight Bronx
Residents (BMI > 25), by UHF District




 A woman 5’4” tall is considered overweight at 146 lbs.
 A man 5’10” tall is considered overweight at 174 lbs.
 Percent of Obese NYC Residents
     (BMI > 30), by Borough




A woman 5’4” tall is considered obese at 175 lbs.
A man 5’10” tall is considered obese at 209 lbs.
Percent of Obese Bronx Residents
    (BMI > 30), by UHF District




A woman 5’4” tall is considered obese at 175 lbs.
A man 5’10” tall is considered obese at 209 lbs.
Diabetes Prevalence in NYC
           By Borough, 2002

  Healthy People 2010 Goal: 2.5%
Diabetes Prevalence in NYC
        By Ethnicity, 2002
   Healthy People 2010 Goal: 2.5%
   Percent of Bronx Residents w/
Diagnosed Diabetes, by UHF District
 Good Diabetes Management
• Patient education and participation
  – “Know your ABCs”
     • A1c level below 7%
     • Blood pressure less than 130/80
     • Cholesterol (“bad” LDL cholesterol) less than 100
• Clinical best practices
• Systematic monitoring of and accountability
  for HbA1C, retinal, foot care
• Cardiovascular disease prevention:
  – Smoking, blood pressure, lipid control
   On ABCs, USA Gets an “F”

• People with diabetes who have adequately
  controlled blood sugar – 11%
• People with hypertension who have
  adequately controlled blood pressure – 27%
• People with high cholesterol who have
  adequately controlled hyperlipidemia – 27%

       Despite spending 1 out of
     every 7 dollars on health care!
 Percent of NYC Adults Who Report
One or More Binge Drinking Episodes
  >5 drinks at one time within past month (by Borough)

       Healthy People 2010 Goal: 6%
Percent of All Bronx Adults Who Report
 One or More Binge Drinking Episodes
   >5 Drinks per Month (by UHF District)
       Hospital Admissions
    Related to Mental Disorders
  Age adjusted rates per 10,000 population, excluding
alcohol-related, by Bronx UHF Neighborhood, NYC 2000
Trends in Infant Mortality
       NYC, 1991-2001



     HP 2000 Goal: 7.0


                         HP 2010 Goal: 4.5
 HP2000 Goal: 7.0
NYC Avg.: 6.1


 HP2010 Goal: 4.5
Teen Pregnancy in NYC, 2000
    (by UHF Neighborhood)
    NYC Teen Pregnancy Rates
1996-2000, by Year & Borough of Residence
Trends in NYC Asthma Hospitalization
  Rates per 1,000 persons, 1990-2000, All Ages
        Asthma Hospitalizations
            Are Decreasing
But Still More Prevalent Among Low-Income Neighborhoods
Asthma Hospitalizations in The Bronx
     Hospitalization rate of children under age 15,
   per 1,000 population, by UHF neighborhood, 2000
        Too Few People are
         Getting Flu Shots
NYC, 2001 Influenza Immunization Data
     Healthy People 2010 Goal: 90%
Gender and Racial Disparities
      in Vaccinations
NYC, 2001 Influenza Immunization Data
      Healthy People 2010 Goal: 90%
   Gender and Racial Disparities
         in Vaccinations
NYC, 2001 Pneumococcus Immunization Data
        Healthy People 2010 Goal: 90%
       Flu Vaccinations
    by Bronx Neighborhood
NYC, 2001 Influenza Immunization Data
    10 Things Everyone Should Do
           to Stay Healthy
•   Have a regular doctor or nurse practitioner
•   Don’t smoke and don’t accept smoking around
    you or your children
•   Know your vital signs and keep them healthy
    (blood pressure, cholesterol, weight)
•   Know your HIV status and use condoms to
    protect against HIV and other STDs
•   Don’t live with depression – seek help
  10 Things Everyone Should Do
         to Stay Healthy
6. Know the warning signs of drug/alcohol abuse –
    ask your doctor to help
7. Get screened for cancer, especially colon,
    cervical and breast
8. Get your shots – everyone needs immunizations
9. Live in a home free of violence
10. Be healthy before getting pregnant, plan your
    pregnancy, and get early and regular prenatal
    care

								
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