The Health of Manhattan and New York City Thomas R. Frieden, M.D., M.P.H. Commissioner, New York City Department of Health and Mental Hygiene April 24, 2002

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 Manhattan (by UHF Neighborhood) HP 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 Manhattan vs. NYC HP 2010: 90%

Colon Cancer Detection & Cure Rates Early-Stage Detection RatesColorectal Cancer Cure Rates

HIV & AIDS Cases in Manhattan Calendar Year 2001 Figures as of 12/31/01

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

Rates of New HIV Diagnoses in Manhattan 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 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? Reported Primary and Secondary Syphilis Case Rates, NYC,

Diabetes Prevalence Has More than Doubled in NYC in the Past 8 Years Adults with Self-Reported Diabetes, NYC,

Percent of Overweight NYC Residents (BMI > 25), by Borough A woman 5’4” tall is considered overweight at 146 lbs. or more A man 5’10” tall is considered overweight at 175 lbs. or more

Percent of Overweight Manhattan Residents BMI > 25, by UHF Neighborhood A woman 5’4” tall is considered overweight at 146 lbs. or more A man 5’10” tall is considered overweight at 175 lbs. or more

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

Percent of Obese Manhattan Residents BMI > 30, by UHF Neighborhood A woman 5’4” tall is considered obese at 175 lbs. or more A man 5’10” tall is considered obese at 209 lbs. or more

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%

Diabetes Prevalence in NYC By UHF Neighborhood, 2002 Healthy People 2010 Goal: 2.5%

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 Manhattan Adults Who Report One or More Binge Drinking Episodes >5 drinks at one time in past month (by UHF Neighborhood) Healthy People 2010 Goal: 6%

Trends in Infant Mortality NYC, HP 2010 Goal: 4.5 HP 2000 Goal: 7.0

Infant Mortality Rate in Manhattan by HCD, 2001 IMR and 95% Conf. Interval, and Citywide IMR by Health Center District, NYC, 2001 NYC average IMR: 6.1 HP 2010 Goal: 4.5

Trends in NYC Asthma Hospitalization Rates per 1,000 persons, , All Ages

Asthma Hospitalizations Are Decreasing But Still More Prevalent Among Low-Income Neighborhoods

Asthma Hospitalizations in Manhattan Hospitalization rate of children under age 15, per 1,000 population, by UHF neighborhood

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 Immunizations in Manhattan vs. NYC vs. US NYC, 2001 Influenza Immunization Data by UHF Neighborhood Healthy People 2010 Goal: 90%

10 Things Everyone Should Do to Stay Healthy 1.Have a regular doctor or nurse practitioner 2.Don’t smoke and don’t accept smoking around you or your children 3.Know your vital signs and keep them healthy (blood pressure, cholesterol, weight) 4.Know your HIV status and use condoms to protect against HIV and other STDs 5.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