Bronx Community Health Dashboard: Smoking

Transcription

1 Bronx Community Health Dashboard: Smoking Created: 6/12/217 Last Updated: 1/23/217 See last slide for more information about this project. 1

2 Percent Daily Smoking Prevalence, USA Daily smoking prevalence in the United States has declined since 199 but rose to the leading risk factor for mortality amongst both sexes and all ages in 215 Despite increasing in rank, smoking mortality rates in the United States have fallen 13.85% 2 Data source: Global Burden of Disease Tobacco Viz, 215 Data is age-adjusted.

3 3 Smoking Status

4 Percent of New York City Current Smokers The percent of current adult smokers across New York City has fallen since 22 but remains highest for Staten Island 35 Bronx Brooklyn Manhattan Queens Staten Island Data source: Community Health Survey, Analysis by Montefiore OCPH. Staten Island 21 data is likely an underestimate of the true prevalence of smoking due to random sampling variation.

5 Fewer Bronx adults are current smokers and more Bronx adults report having never smoked in 215, compared to Never Smoked Current Smoker 18% 16% 14% increase 11% decrease 25% 57% Never Smoked Current Smoker Former Smoker 14% Never Smoked Current Smoker Former Smoker 7% 5 Data source: Community Health Survey, 22, 215. Analysis by Montefiore OCPH. Data is age-adjusted.

6 Reported Age When Respondent Began Regularly Smoking (%) Among Bronx adults there is a trend towards current smokers starting later in life, suggesting that tobacco prevention among youth is paying off Results restricted to those who reported being a current or former smoker years and under years 18-2 years 21 years and over 6 Data source: Community Health Survey, 22, 215. Analysis by Montefiore OCPH. Regularly smoking cigarettes not explicitly defined.

7 Age-Adjusted Percent of Current Smokers, 215 The Bronx has the third highest percent of current smokers of all New York City 25 Bronx only Data source: Community Health Survey, 215. Analysis by Montefiore OCPH. Age results not age-adjusted.

8 Age-Adjusted Percent of Current Smokers In the Bronx, the unemployed, least educated, and most impoverished individuals are most likely to smoke * 5 8 Data source: Community Health Survey, 215. Analysis by Montefiore OCPH. * Lowest Poverty data point is unstable.

9 Racial and ethnic disparities in current smokers have grown by.7 points in the previous 15 years 35 Non-Hispanic White Non-Hispanic Black Hispanic Data source: Community Health Survey, Analysis by Montefiore OCPH. Non-Hispanic white 21, data should be interpreted with caution. All Bronx Asian smoking data unstable.

10 Percent of Adult Current Smokers 3 of 1 community districts with highest percentages of current smokers are in the Bronx Bronx 16 NYC Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights 26 Belmont & East Tremont 27 Kingsbridge Heights & Bedford 28 Riverdale & Fieldston 29 Parkchester & Soundview 21 Throgs Neck & Co-op City 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester Data source: NYC Community Health Profiles.

11 Age-Adjusted Type of Smoker, Bronx Respondents (%) The primary driver of the declining adult smoking rates in the Bronx is heavy smoking, which has fallen 3 fold since Non-daily Smoker Light daily smoker Heavy daily smoker Heavy smokers: more than 1 cigarettes a day Light smokers: between 1 and 1 cigarettes a day Data source: Community Health Survey, Analysis by Montefiore OCPH. Data restricted to those that indicated they are current smokers.

12 Percent of Bronx Residents Purchasing Cigarettes, 215 Bronx residents are increasingly purchasing cigarettes in New York City stores 1 Purchased in NYC Store Not Purchased in NYC Store Data source: Community Health Survey, Analysis by Montefiore OCPH. Results restricted to current smokers whose most recent cigarette smoked was from a carton, pack or single/loosie.

13 Percent of Respondents Reporting Quit Attempts Quit Attempts were consistent across all five boroughs between 22 and Bronx Brooklyn Manhattan Queens Staten Island Quit attempts defined as an attempt to quit smoking for 24 hours or longer during the past year Data source: Community Health Survey, Analysis by Montefiore OCPH. Data not collected after 213.

14 Tobacco Retailer Rate per 1, 3 of 1 community districts with highest tobacco retailer rates are in the Bronx Bronx 11 Highest: Midtown 8 NYC Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights Belmont & East Tremont Kingsbridge Heights & Bedford 28 Riverdale & Fieldston 29 Parkchester & Soundview 1 Note graph is depicted on log scale 21 Throgs Neck & Co-op City 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester Data source: NYC Community Health Profiles.

15 15 Youth Smoking

16 Age-Adjusted Percent of Current Youth Smokers The percent of current youth smokers across New York City has fallen since 23 but remains highest for Staten Island and lowest for the Bronx Bronx Brooklyn Manhattan Queens Staten Island Bronx Staten Island % decrease 15.4% decrease Data source: Youth Risk Behavior Survey, Analysis by Montefiore OCPH. Current smoker is defined as smoking at least one or more times in the previous 3 days.

17 Age-Adjusted Percent of Youth Current Smokers, 215 Fewer youth are currently smoking in the Bronx, but those that do smoke are primarily male, non-hispanic white, and 18 years or older 12 1 Bronx only Data source: Youth Risk Behavior Survey, 215. Analysis by Montefiore OCPH. Age results not age-adjusted.

18 Age-Adjusted Percent of Youth Current Smokers, Bronx Youth smoking in the Bronx used to be higher for female youth but now is higher amongst male youth Male Female Data source: Youth Risk Behavior Survey, Analysis by Montefiore OCPH. Current smoker is defined as smoking at least one or more times in the previous 3 days.

19 Percent of Youth Current Smokers Despite a decrease in the percentage of Bronx youth reporting being current smokers, an increasing percentage of youth that smoke are heavy smokers Heavy smokers: more than 1 cigarettes a day 16 Current Smokers, Light Current Smokers, Heavy Bronx Current Youth Smokers Heavy Smokers Current Smokers % increase 26% decrease Data source: Youth Risk Behavior Survey, Analysis by Montefiore OCPH. Data is age-adjusted. Heavy Smoker results restricted to students who smoked in the past 3 days.

20 Youth in the Bronx are less likely to get their cigarettes from someone else in 215 and more likely to get them by other means Purchased from a Store From Someone Other Purchased from a Store From Someone Other Data source: Youth Risk Behavior Survey, 23, 215. Analysis by Montefiore OCPH. Data is age-adjusted. Results restricted to students who smoked in the past 3 days.

21 21 Health Consequences of Tobacco Use

22 22 Lung Cancer

23 Lung Cancer rates are highest for males in all boroughs, Bronx males have the second highest lung cancer incidence rate Age-Adjusted Lung Cancer Incidence Rate per 1, Males Females Bronx Brooklyn Manhattan Queens Staten Island 23 Data source: New York State Cancer Registry, Analysis by Montefiore OCPH. Data is age-adjusted.

24 Bronx males have higher lung cancer incidence rates, though Bronx female lung cancer rates have risen nearly 16 points in the last 37 years Age-Adjusted Lung Cancer Incidence Rate per 1, 12 Male Female Data source: New York State Cancer Registry, Analysis by Montefiore OCPH. Data is age-adjusted.

25 Age-Adjusted Rate of Lung Cancer Mortality per 1, The Bronx have the second highest rate of lung cancer mortality of all New York City boroughs 7 Bronx Brooklyn Manhattan Queens Staten Island Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

26 Age-Adjusted Rate of Lung Cancer Mortality per 1, Males in the Bronx consistently have higher lung cancer mortality rates than females, but rates have fallen 22 points 8 Female Male Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

27 Rate of Lung Cancer Mortality per 1, Lung cancer mortality rates are highest in the Bronx amongst males, those 75 years and older, and in non-hispanic white populations Female Male Non- Hispanic Black Data source: Underlying Cause of Death, 215. Analysis by Montefiore OCPH. Age grouped data is not age-adjusted. Non- Hispanic White Hispanic

28 Age-Adjusted Rate of Lung Cancer Mortality per 1, Racial and ethnic disparities in lung cancer mortality have fallen 1 points in the previous 15 years 7 Non-Hispanic Black Non-Hispanic White Hispanic Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

29 29 Chronic Lower Respiratory Disease

30 Chronic obstructive pulmonary disease (COPD) is the largest contributor to chronic lower respiratory disease mortality in the Bronx Chronic obstructive pulmonary disease Bronchitis and Bronchiectasis Emphysema Asthma (including Status Asthmaticus) Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Bronchitis sub-categories grouped due to unstable data.

31 Age- Adjusted Rate of Chronic Lower Respiratory Disease Related Mortality per 1, The Bronx now has the highest chronic lower respiratory related mortality rates of all NYC boroughs 45 Bronx Brooklyn Manhattan Queens Staten Island Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

32 Age- Adjusted Rate of Chronic Lower Respiratory Disease Related Mortality per 1, Men in the Bronx have higher rates of chronic lower respiratory disease related mortality 45 Female Male Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

33 Chronic lower respiratory disease mortality rates are highest in the Bronx amongst males, those 75 years and older, and in non-hispanic white populations Chronic Lower Respiratory Disease Related Mortality per 1, Female Male Non- Hispanic Black Non- Hispanic White Hispanic 33 Data source: Underlying Cause of Death, 215. Analysis by Montefiore OCPH. Age group data is not age-adjusted.

34 Age-Adjusted Rate of Chronic Lower Respiratory Disease Mortality per 1, Racial and ethnic disparities in chronic lower respiratory disease mortality have fallen nearly 4 points in the previous 15 years 45 Non-Hispanic Black Non-Hispanic White Hispanic Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

35 Avoidable Child Asthma Hospitalization Rate per 1, 6 of 1 community districts with highest avoidable child asthma hospitalization rates are in the Bronx Bronx Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights 26 Belmont & East Tremont 27 Kingsbridge Heights & Bedford 28 Riverdale & Fieldston 29 Parkchester & Soundview 21 Throgs Neck & Co-op City 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester NYC Data source: NYC Community Health Profiles.

36 Age-Adjusted Avoidable Asthma Hospitalizations per 1, 6 of 1 community districts with highest asthma hospitalization rates are in the Bronx Bronx Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights NYC Belmont & East Tremont 27 Kingsbridge Heights & Bedford Riverdale & Fieldston 29 Parkchester & Soundview 21 Throgs Neck & Co-op City 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester Data source: NYC Community Health Profiles.

37 Cardiovascular Disease Chronic Heart Disease Includes: Stroke/Cerebrovascular disease Heart attack/myocardial infarction 37

38 Age-Adjusted Cardiovascular Disease Mortality Rate per 1, Cardiovascular Disease Mortality Rates are highest in the Bronx compared to all other New York City boroughs 35 Bronx Brooklyn Manhattan Queens Staten Island Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

39 Age-Adjusted Cardiovascular Disease Mortality Rate per 1, Males in the Bronx consistently have higher chronic heart disease mortality rates than females 4 Female Male Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

40 Chronic heart disease mortality rates are highest in the Bronx amongst males, those 75 years and older, and in non- Hispanic black populations Cardiovascular Disease Mortality Rate per 1, Female Male Non- Hispanic Black Non- Hispanic White Hispanic 4 Data source: Underlying Cause of Death, 215. Analysis by Montefiore OCPH. Age grouped data is not age-adjusted.

41 Age-Adjusted Rate of Cardiovascular Disease Mortality per 1, Racial and ethnic disparities in chronic heart disease mortality have fallen 6.6 points in the previous 15 years 4 Non-Hispanic Black Non-Hispanic White Hispanic Data source: Underlying Cause of Death, Analysis by Montefiore OCPH. Data is age-adjusted.

42 42 Diabetes

43 Bronx Brooklyn Queens Manhattan Staten Island Miami-Dade San Bernadino Bexar (San Antonio) Dallas Los Angeles Age-adjusted prevalence Age-adjusted prevalence The Bronx has a higher prevalence of diabetes than all other NYC boroughs and peer counties Bronx Miami-Dade San Bernardino Bexar (TX) Dallas Los Angeles Bronx: +4% Peer Counties Average: +31% Data source: United States Diabetes Surveillance System, Division of Diabetes Translation, CDC. Data not comparable to NYC CHS data presented elsewhere.

44 Male Female Hispanic NHB NHW <HS HS Some college College Age-Adjusted Percent with Diagnosed Diabetes Those 65 years and older, Females, and Hispanics have highest rates of diabetes in the Bronx in Not age-adjusted 44 Data source: New York City Community Health Survey, Analysis by Montefiore OCPH.

45 Age- Adjusted Mortality Rate per 1, Diabetes Mortality Rate has fallen by 1 percentage points over the last 15 years in the Bronx Bronx NYC Excluding Bronx Bronx NYC Excluding Bronx Miami-Dade San Bernadino Bexar (TX) Dallas Los Angeles Data source: Underlying Cause of Death, Analysis by Montefiore OCPH.

46 Age-Adjusted Mortality Rate per 1, 5 Males have a higher diabetes mortality rate, adjusting for age in the Bronx Male Female Bronx Diabetes Mortality Rates from for Females are divergent from national trends Data source: Underlying Cause of Death, Analysis by Montefiore OCPH.

47 About the Community Health Dashboard Project The goal of the project is to provide Bronx-specific data on risk factors and health outcomes with an emphasis on presenting data on trends, socio-demographic differences (e.g., by age, sex, race/ethnicity, etc.) and sub-county/neighborhood level data Data will be periodically updated as new data becomes available. Produced by Montefiore s Office of Community & Population Health using publicly-available data sources For more information please contact Colin Rehm, PhD, Manager of Research & Evaluation (crehm@montefiore.org). 47