the health of queens and new york city
DESCRIPTION
The Health of Queens 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 - PowerPoint PPT PresentationTRANSCRIPT
The Health of Queensand New York City
Thomas R. Frieden, M.D., M.P.H.Commissioner, New York City
Department of Health and Mental HygieneApril 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 Queens (by UHF Neighborhood)
16.3 16.718.4 18.9
24.2
27.3
20.8 21.7
0
5
10
15
20
25
30 Healthy People 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 Queens vs. NYC
7676
49
8077
50
0
20
40
60
80
100
Colon Screening Mammogram PAP Smear
Queens 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 QueensCalendar Year 2001
845
8309
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
# Living w/HIV & AIDS # New HIV Diagnoses
Figures as of 12/31/01
Rates of People Living w/HIV & AIDS in Queens vs. NYC vs. US
Calendar Year 2001 – Rates per 1,000 Pop.
1.7 1.92.7
3.3 3.4
4.8 5.05.8 6.0
4.3
9.2
3.2
1.0
0
2
4
6
8
10
Baysi
de
Fresh
Mea
dows
Flush
ing
Ridge
wood
SW Q
ueen
s
SE Quee
ns
Astor
ia-LI
C
Rocka
way
Wes
t Quee
ns
Jam
aica
Queen
sNYC US
Figures as of 12/31/01
Rates of New HIV Diagnoses in Queens vs. NYC vs. US
Calendar Year 2001 – Rates per 1,000 Pop.
0.13 0.14
0.28 0.290.33
0.380.47
0.660.70
0.43
0.84
0.140.08
0.0
0.2
0.4
0.6
0.8
1.0
Baysi
de
Fresh
Mea
dows
Flush
ing
SE Quee
ns
Ridge
wood
SW Q
ueen
s
Astor
ia-LI
C
Wes
t Quee
ns
Rocka
way
Jam
aica
Queen
sNYC US
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 StatenIsland
Bronx NYC
% O
ve
rwe
igh
t (B
MI
> 2
5)
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 Queens Residents
(BMI > 25), by UHF District
45 47 48 5055 55
6068
52 53
0
1020
30
40
5060
70
80
% O
verw
eig
ht
(BM
I >
25)
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
11.9
15.416.8
18.8
21.8
16.6
0
5
10
15
20
25
% O
bese (
BM
I >
30)
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 Queens Residents BMI > 30, by UHF District
11.9 12.1
15.116.9
18.919.9
21.2 22.1
15.416.6
0
5
10
15
20
25
Flushin
g
Ridge
wood
Astoria
-LIC
Baysid
e
Jam
aica
SE Que
ens
SW Q
ueen
s
Rocka
way
Queen
sNYC
% O
bes
e (B
MI
> 3
0)
A woman 5’4” tall is considered obese at 175 lbs.A man 5’10” tall is considered obese at 209 lbs.
Percent of NYC Residents with Diagnosed Diabetes, by Borough
4.66.2
7.0
8.8
11.8
7.9
0
2
4
6
8
10
12
14
State
n Isl
and
Man
hatta
n
Queen
s
Brook
lyn
Bronx
NYC
% w
/Dia
gn
ose
d D
iab
etes
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%
Percent of Queens Residentswith Diagnosed Diabetes
by UHF District
2.2
5.56.3
7.6 7.88.5
9.710.3
7.07.9
0
2
4
6
8
10
12
% w
ith
Dia
gn
ose
ed D
iab
etes
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!
Hospital Admissions in Queens Related to Mental Disorders
Age adjusted rates per 10,000 population, excluding alcohol-related, by UHF Neighborhood, 2000
21.531.0 31.8 32.4
39.9 43.2 44.4 45.853.7
136.6
45.1
66.5
0
20
40
60
80
100
120
140
Ho
sp
ita
liza
tio
n R
ate
pe
r 1
0,0
00
Po
pu
lati
on
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 All Queens Adults Reporting One or More Binge Drinking Episodes
>5 Drinks per Month (by UHF District)
10.1 10.512.6 13.5 13.6 13.9
18.7
21.2
16.215.2
0
5
10
15
20
25
% B
ing
e D
rin
kin
g
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 by Queens HCD, 2001
3.0
6.9 7.0
4.9
3.4 3.5
4.6
0
1
2
3
4
5
6
7
8A
sto
ria
-LIC
Flu
shin
g
Ma
spe
th-F
.H
ills
Co
ron
a
Jam
aic
aE
ast
Jam
aic
aW
est
Qu
ee
ns
IMR
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 Hospitalization Is DecreasingBut Still More Prevalent Among Low-Income Neighborhoods
Trends 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-Income
High-Income
Asthma Hospitalizations in Queens Hospitalization rate of children under age 15,per 1,000 population, by UHF neighborhood
1.9
3.53.8
4.4 4.7 4.7 4.8
6.7
7.5
4.8
6.1
4.2
0
2
4
6
8
Too Few People are Getting Flu 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
% Im
mu
niz
ed (
ove
r ag
e 65
)
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
% 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