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 RatesColorectal 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 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. 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, HP 2010 Goal: 4.5 HP 2000 Goal: 7.0

NYC Avg.: 6.1 HP2010 Goal: 4.5 HP2000 Goal: 7.0

Teen Pregnancy in NYC, 2000 (by UHF Neighborhood)

NYC Teen Pregnancy Rates , by Year & Borough of Residence

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 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 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