Health Disparities in
the Bronx and New York City
A.H. Strelnick, MD
Department of Family & Social Medicine
Albert Einstein College of Medicine
(These slides were provided by Dr. Jane Bedell, Assistant
Commissioner, South Bronx District Health Office,
New York City Department of Health & Mental Hygiene)
What is health?
Health
is a state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity.
Preamble to the Constitution of the World Health Organization, 1948
(the Definition has not been amended since 1948)
What is Public Health?
Public health is the science and art of
preventing diseases, prolonging
life, and promoting health through
the organized efforts of society.
Smoking Prevalence in the Bronx, 2002
35
Healthy People 2010 Goal: 12%
29
30
25
25
25
25
22
20
20
17
15
10
5
NY
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0
NYC Smoking Reduction 2002-2004
6.2%
10.0%
5.0%
-10.0%
-5.1%
-15.0%
-20.0%
-25.0%
-18.7%
-18.9%
-23.1%
Staten
Island
Queens
Manhattan
Brooklyn
-5.0%
Bronx
0.0%
2002-2004 decline
Cancer Screening in
the Bronx vs. NYC, 2002
Bronx
100
NYC
Healthy People 2010 Goal: 90%
80
85
80
78
77
60
50
49
40
20
0
Colon Screening
Mammogram
PAP Smear
HIV & AIDS Cases in the Bronx, 2003
25000
20000
19504
15000
10000
5000
774
0
# Living w/HIV & AIDS
Figures as of 9/30/2003
# New HIV Diagnoses
Rates of People Living w/HIV & AIDS
in the Bronx vs. NYC vs. US, 2001
18
17.0
15.6
16
Rates per 1,000 Population
17.0
14
12
11.1
10.7
9.2
10
7.9
8
6
5.1
3.9
4
3.2
2
Figures as of 12/31/01
S
U
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Rates of New HIV Diagnoses in
The Bronx vs. NYC vs. US, 2001
2.5
2.3
Rates per 1,000 Population
2.1
1.9
2.0
1.5
1.3
1.2
1.0
0.8
0.8
0.6
0.5
0.3
0.1
0.0
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Figures as of 12/31/01
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U
S
Obesity Prevalence in NYC
2002, by UHF District
Percent of Overweight NYC Residents
(BMI > 25), by Borough, 2003
% Overweight (BMI > 25)
70
64
57
60
50
52
53
Queens
Staten
Island
53
44
40
30
20
10
0
Manhattan
Brooklyn
Bronx
NYC
Percent of Obese NYC Residents
(BMI > 30), by Borough, 2003
% Obese (BMI > 30)
30
25
23
20
15
18
24
19
19
14
10
5
0
Manhattan
Queens
Staten
Island
Brooklyn
Bronx
NYC
Percent of Overweight Bronx Residents
(BMI > 25), by UHF District, 2003
% Overweight (BMI > 25)
80
68
70
62
62
63
64
60
53
49
50
40
30
20
10
0
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Percent of Obese Bronx Residents
(BMI > 30), by UHF District, 2003
30
27.0
25.0
23.0
24.0
23.0
19.0
20
15.0
15
10
5
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% Obese (BMI > 30)
25
Prevalence of
Diagnosed Diabetes in NYC
2002, by UHF District
Percent of NYC Residents with Diagnosed
Diabetes, by Borough, 2003
14
12.0
% w/Diagnosed Diabetes
12
10
8.5
9.1
9.7
9.0
8
6
5.6
4
2
0
Manhattan
Staten
Island
Queens
Brooklyn
Bronx
NYC
Percent of Bronx Residents w/ Diagnosed
Diabetes, by UHF District, 2003
20
18.0
16
14
12
11.0
10.0
12.0
11.0
9.0
10
8
5.0
6
4
2
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% w/Diagnosed Diabetes
18
Percent of All Bronx Adults Who Report One
or More Binge Drinking Episodes, 2003
>5 Drinks per Month (by UHF District)
16
14.0
14
12
11.0
9.9
9.4
10
11.0
9.7
8
6
5.0
4
2
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0
Hospital Admissions
Related to Mental Disorders
Age adjusted rates per 10,000 population, excluding
alcohol-related, by UHF Neighborhood, 2000
Hospitalization Rate per 10,000 Population
120
99.3
100
87.5
99.5
90.5
80
69.4
66.5
62.5
60
55.8
52.9
40
20
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Teen Pregnancy in NYC, 2000
(by UHF Neighborhood)
NYC Teen Pregnancy Rates
1996-2000, by Year & Borough of Residence
per 1,000 females age 15-19
200
150
100
50
1996
Manhattan
1997
Bronx
1998
1999
2000
Brooklyn
Queens
Staten Isl.
Adolescent Pregnancy Rates in the
Bronx, U.S., and Europe
150
137.2
79.8
100
50
20.2
16.1
8.7
France
Germany
Netherlands
0
Bronx
United
States
Rate of pregnancy per 1,000 w om en ages 15 to 19
Too Few People are
Getting Flu Shots, 2003
Influenza Immunizations in Past 12 Months
*only people aged 50 and over
Healthy People 2010 Goal: 90%
100
60
56
53
48
46
56
52
48
40
20
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N
% Immunized
80
Flu and Pneumonia Vaccinations
by Bronx Neighborhood, 2003
% Immunized
*only people aged 50 and over
100
Flu vaccinations in past 12
months
80
Pneumonia vaccinations in
lifetime
56
60
56
53
46
42
40
52
48
40
39
35
48
37
32
30
20
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0
Gender and Racial Disparities in
Vaccinations, Bronx, 2003
Influenza Immunizations in Past 12 Months
*only people aged 50 and over
100
Healthy People 2010 Goal: 90%
% Immunized
80
59
60
53
55
49
42
37
40
20
0
Male
Female
White
Hispanic
Black
Asian
Gender and Racial Disparities
in Vaccinations, Bronx, 2003
Pneumococcus Immunizations in Lifetime
*only people aged 50 and over
100
Healthy People 2010 Goal: 90%
% Immunized
80
60
44
40
39
35
38
31
24
20
0
Male
Female
White
Hispanic
Black
Asian
Trends in NYC Asthma Hospitalizations
Rates per 1,000 persons, 1990-2000, All Ages
Rate per 1,000 Persons
6
5.1
5
4.6
4.6
4.6
4.7
4
3
4.0
4.3
4.3
3.7
4.0
3.4
2
1
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Asthma Hospitalizations in The Bronx
Hospitalization rate of children under age 15,
per 1,000 population, by UHF neighborhood, 2002
14
11.7
12
10.0
10
9.0
8.8
10.1
9.7
9.4
8
6.0
6
4.8
4
2
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11.69
12
10.05
10
8.98
8
6.02
6
4
3.08
1.72
2
Hunts
Point-Mott
Haven
High
BridgeMorrisania
CrotonaTremont
(excluding NYC)
NYC
NYS
0
US
Rate per 1,000 Population
Asthma Hospitalization Rates in Children
Aged 0-14 in NYC, US, and South Bronx
(2002)
Hospitalization rates for children
in South Bronx (ages 0-14) have
gone down over the past 5 years
rate per 1000 children
25
22.49
18.53
20
16.16
15
11.69
10.05
10
8.98
9.43
6.02
5
0
CrotonaTremont
27.2% decrease
High Bridge- Hunts PointMorrisania Mott Haven
45.7% decrease
60.1% decrease
NYC
36.2% decrease
1997
2002