the health of manhattan and new york city
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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 - PowerPoint PPT PresentationTRANSCRIPT
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 HygieneApril 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)
14.6
20.5 21.2 22.1 22.324.4
27.1
31.0
21.7 21.7
0
5
10
15
20
25
30
35HP 2010 Goal: 12%
Annual Deaths from Smoking Compared with Other Causes
NYC, 2001
0
2000
4000
6000
8000
10000
* Total includes smoking-related deaths# Total includes 265 AA587 deaths+ Total does not include 2,743 WTC deaths
Cancer Screening in Manhattan vs. NYC
56
80 81
50
7781
0
20
40
60
80
100
Colon Screening Mammogram PAP Smear
Manhattan NYCHP 2010: 90%
Colon CancerDetection & Cure Rates
0
20
40
60
80
Colorectal Cancer Breast Cancer Prostate Cancer
Early-Stage Detection Rates Colorectal Cancer Cure Rates
0
20
40
60
80
100
Early stage Late-stage
HIV & AIDS Cases in ManhattanCalendar Year 2001
1736
21033
0
5000
10000
15000
20000
25000
# Living w/HIV & AIDS # New HIV Diagnoses
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.
9.1 9.111.6 12.6 12.8
18.419.6 20.0
32.3
13.8
9.2
3.24.8
0
5
10
15
20
25
30
35
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.
0.80 0.88 0.89 0.901.00
1.09
1.81
2.35 2.39
1.14
0.84
0.140.30
0.0
0.5
1.0
1.5
2.0
2.5
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?
0.51 0.51 0.66
10.75
7.50
3.07
02
468
1012
2000 2001 2002
Rat
e per
100,0
00
Females Males
Reported Primary and Secondary Syphilis Case Rates, NYC, 2000-2002
Diabetes Prevalence Has More than Doubled in NYC in the Past 8 Years Adults with Self-Reported Diabetes, NYC, 1994-2002
7.9
6.3
6.7
4.73.7
0
1
2
3
4
5
6
7
8
9
1994-95 1996-97 1998-99 2000-01 2002
% R
epo
rtin
g D
iab
etes
Percent of Overweight NYC Residents (BMI > 25), by Borough
43
52 5357
62
53
0
10
20
30
40
50
60
70
Manhattan Queens Brooklyn Staten Island Bronx NYC
% O
ve
rwe
igh
t (B
MI
> 2
5)
A woman 5’4” tall is considered overweight at 146 lbs. or moreA man 5’10” tall is considered overweight at 175 lbs. or more
Percent of Overweight Manhattan Residents
BMI > 25, by UHF Neighborhood
3136 38 40 41
5158
65
43
53
010203040506070
% O
verw
eig
ht
(BM
I > 2
5)
A woman 5’4” tall is considered overweight at 146 lbs. or moreA man 5’10” tall is considered overweight at 175 lbs. or more
Percent of Obese NYC Residents(BMI > 30), by Borough
11.9
15.416.8
18.8
21.8
16.6
0
5
10
15
20
25
Manhattan Queens StatenIsland
Brooklyn Bronx NYC
% O
bese (
BM
I >
30)
A woman 5’4” tall is considered obese at 175 lbs. or moreA man 5’10” tall is considered obese at 209 lbs. or more
Percent of Obese Manhattan Residents
BMI > 30, by UHF Neighborhood
7.3 9.1 9.2 10.512.4
18.4
31.3
11.9
18.2
25.1
05
101520253035
% O
bes
e (B
MI
> 3
0)
A woman 5’4” tall is considered obese at 175 lbs. or moreA man 5’10” tall is considered obese at 209 lbs. or more
Diabetes Prevalence in NYCBy Borough, 2002
4.6
6.07.0
9.0
11.5
7.9
0
2
4
6
8
10
12
14
Staten Isl Manhattan Queens Brooklyn Bronx NYC
Healthy People 2010 Goal: 2.5%
Diabetes Prevalence in NYCBy Ethnicity, 2002
5.0
6.8
10.8
12.2
7.9
0
2
4
6
8
10
12
14
White Asian Black Hispanic NYC
Healthy People 2010 Goal: 2.5%
Diabetes Prevalence in NYCBy UHF Neighborhood, 2002
2.13.1 3.2 3.7
5.7
8.6
11.3
13.6
6.0
7.9
0
2
4
6
8
10
12
14
16
% R
epor
ting
Dia
gnos
ed D
iabe
tes 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)
12.8 13.0
14.916.2
18.6
15.2
0
2
4
6
8
10
12
14
16
18
20
Brooklyn Bronx Staten Isl Queens Manhattan NYC
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)
12.7
15.516.6 16.8
19.8 20.5 21.323.2
18.6
15.2
0
5
10
15
20
25 Healthy People 2010 Goal: 6%
Trends in Infant MortalityNYC, 1991-2001
11.4
6.1
10.2 10.2
9.08.8
7.87.1 6.8 6.9 6.7
0.0
2.0
4.0
6.0
8.0
10.0
12.0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Per
1,0
00 L
ive
Bir
ths
HP 2010 Goal: 4.5
HP 2000 Goal: 7.0
Infant Mortality Rate in Manhattan by HCD, 2001
1.43.6 3.7
5.1 5.5
13.1
7.8
0.0
4.0
8.0
12.0
16.0
20.0
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 HospitalizationRates per 1,000 persons, 1990-2000, All Ages
3.44.03.7
4.3
4.64.64.65.1
4.74.34.0
0
1
2
3
4
5
6
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Rat
e pe
r 1,0
00 P
erso
ns
Asthma HospitalizationsAre Decreasing
But Still More Prevalent Among Low-Income NeighborhoodsTrends in Asthma Hospitalization Rates, High- and Low-
Income ZIP Codes, Children Aged 0-4, NYC 1988-2000
0
5
10
15
20
25
30
Ra
te p
er
1,0
00
Po
pu
lati
on
Low-IncomeHigh-Income
Asthma Hospitalizations in ManhattanHospitalization rate of children under age 15,per 1,000 population, by UHF neighborhood
1.7 1.8
3.5 3.84.4 4.9
7.2
12.7
17.2
6.96.1
3.5
0
5
10
15
20
Too Few People are GettingFlu Shots
NYC, 2001 Influenza Immunization Data
31
63
0
20
40
60
80
100
Ages 50-64 Ages 65+
% I
mm
un
ize
d
Healthy People 2010 Goal: 90%
Gender and Racial Disparities in Vaccinations
NYC, 2001 Influenza Immunization Data
59
6763
53 52
69
0
20
40
60
80
100
Male Female White Hispanic Black Asian
% I
mm
un
ized
(o
ver
ag
e 6
5) Healthy People 2010 Goal: 90%
Gender and RacialDisparities in Vaccinations
NYC, 2001 Pneumococcus Immunization Data
4956
4642
31
53
0
20
40
60
80
100
Male Female White Hispanic Black Asian
% I
mm
un
ized
(o
ver
ag
e 6
5) Healthy People 2010 Goal: 90%
Flu Immunizations in Manhattan vs. NYC vs. US
NYC, 2001 Influenza Immunization Databy UHF Neighborhood
5460
64
77 77 78 80
6863 65
49
0
20
40
60
80
100
% Im
mu
niz
ed (
ove
r ag
e 65
) 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 immunizations9. Live in a home free of violence10. Be healthy before getting pregnant, plan your
pregnancy, and get early and regular prenatal care