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1 Keeping Brooklyn Healthy by Assessing Population Health and Driving Innovation 11234, 11236, 11239

2 Neighborhood at a glance Population: 195,027 TBHC Service Areas: Outside the Service Area for The Brooklyn Hospital Center Age Group 85 yrs and older , yrs , yrs ,202 1, yrs 1,101 1,003 1,315 1, yrs 1,677 1,161 1,360 2, yrs 355 2,491 1,744 1,977 3, yrs 405 3,185 1,709 1,941 4, yrs ,718 1,794 1,878 5, yrs 482 3,716 1,472 1,560 5, yrs 499 3,274 1,248 1,337 5, yrs 484 3,209 1,287 1,276 4, yrs 527 3,285 1,195 1,209 4, yrs 516 3,724 1,203 1,175 4, yrs 627 4,514 1,287 1,187 4, yrs 1, , yrs 429 2, , yrs 393 2, , yrs 261 1, , yrs 602 3,782 1,287 1,226 3, yrs 528 2,819 1, , Younger than 1 yr ,000 6,000 5,000 4,000 3,000 2,000 1, ,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 Male Female Population pyramid with panes showing gender/age groups, color shows details about race. The marks are labeled by population counts for males and females across age groups in year 2010 Source: New York City Department of Health and Mental Hygiene. Epiquery: NYC Interactive Health Data System - NYC 2010 Census.

3 Socioeconomic Conditions Economic Conditions Percentage of population in each zip code representing the various economic indicators Source: U.S. Census Bureau American Community Survey 5-year estimates Median income ranges from $24,640 to $68,177 across the three zip codes Zip code has a higher proportion of people living in poverty at 31.4% compared to 9.6% in zip code 11234

4 Nativity and Language Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, % of the population in zip code is foreign born Over 53% of the population in every zip code speaks only English in the household, making English the most common primary spoken language in the neighborhood Percentage of foreign born population and primary language spoken in each zip code Source: U.S. Census Bureau American Community Survey 5-year estimates Educational Attainment Nearly 41% of the population in zip code has completed some college Highest level of education attained by population 18 years and over Source: U.S. Census Bureau American Community Survey 5-year estimates

5 Health Insurance Status: Trends in health insurance types from , by percentage of population within each category Source: Community Health Survey New York City Department of Health & Mental Hygiene Each year, private insurance has comprised at least 48% of the neighborhood s coverage

6 Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, Health Conditions Self-reported Health Status: Trends in self-reported health from , by percentage of population within each category Source: Community Health Survey, New York City Department of Health & Mental Hygiene Since 2002, all subsequent years had a lower proportion of persons reporting fair or poor health

7 Prevalence of Diabetes Body Weight: Trends in self-reported medical conditions based on diagnosis through lab results or having been told by a physician from Source: Community Health Survey New York City Department of Health & Mental Hygiene In 2012, 17.1% of the population reported having diabetes compared to 11.8% of Brooklyn s overall population In 2012, 59.4% of the residents reported being overweight or obese Burden of Illness: Trends in self-reported medical conditions based on diagnosis through lab results or having been told by a physician from Source: Community Health Survey New York City Department of Health & Mental Hygiene Between , the prevalence of hypertension increased to 31.4%

8 Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, People living with HIV/AIDS by Race/Ethnicity: People living with HIV/AIDS per 100,000 from , by race/ethnicity Source: HIV/AIDS Surveillance Data, New York City Department of Health & Mental Hygiene Hispanic residents have the highest prevalence of HIV/AIDS in the neighborhood, however, the overall prevalence across all racial/ ethnic groups increased between

9 Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, All-Cause Mortality: Trend in all-cause mortality (age-adjusted per 1,000) from Source: Deaths Epiquery, NYC Vital Statistics. New York City Department of Health & Mental Hygiene Since 2000, the all-cause age-adjusted mortality rate declined by nearly 17% (p<0.0001) to 6 per 1,000 residents in 2011

10 Cigarette Smoking Status: Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, Trends in self-reported cigarette smoking status from , by percentage of population within each category Source: Community Health Survey, New York City Department of Health & Mental Hygiene Although 70% of residents identified as never smokers in 2012, there was a 15.6% increase in current smokers between Cancer Screening: Trends in self-reported breast and colon cancer screening from Source: Community Health Survey New York City Department of Health & Mental Hygiene In 2012, 94.2% of women had screening mammograms and 70% of residents had colon cancer screening

11 Access to Healthcare Services: Trends in self-reported HIV testing and having a personal doctor from Source: Community Health Survey New York City Department of Health & Mental Hygiene In 2012, 81.4% of the population reported having a personal doctor and 64.6% of the population underwent HIV testing

12 Technical Notes Data Sources: The data presented in these Brooklyn Neighborhood Health Profiles (BNHP) is public use data, made available from the New York City Department of Health and Mental Hygiene as well as U.S. Census Bureau via the American Community Survey (ACS) estimates. The Community Health Survey (CHS) is a telephone survey conducted annually by the New York City Department of Health and Mental Hygiene since It is a cross-sectional survey providing self-reported data from an annual sample of approximately 8,500 randomly selected adults aged 18 years and older from New York City. For the purpose of these profiles, data for indicators related to vital statistics, health outcomes, health services, health behaviors, built environment, education and insurance were obtained from CHS. The U.S. Census Bureau s ACS is an ongoing survey that provides data every year related to age, sex, race, family and relationships, income, health insurance, education, veteran status, disabilities, commute and housing. Most of the socioeconomic and demographic data is obtained with zip codes as statistical areas from the ACS. Geographic area definitions: For the purpose of Phase 1 of BNHP, we have used United Hospital Fund definitions (UHF) to define the eleven neighborhoods throughout Brooklyn. The CHS uses stratified random sampling according to UHF neighborhood descriptions to collect data. We have also used the zip code statistical areas to retrieve data from ACS. These two different geographic areas are combined to present data in UHF neighborhood definitions with the aid of an equivalency table. Domains and Indicators: A total of thirty-eight indicators are included in BNHP and categorized within eight domains, each describing the social environment of an individual (Table 1). To develop the Health Needs Index using the social indicators approach and for ranking the neighborhoods based on unmet needs, we shortlisted fourteen indicators across seven domains using a correlation matrix to eliminate skewing from highly correlated indicators (Table 2). Data for indicators obtained from CHS is age-adjusted.

13 Table 1: Domains and Indicators: Domain Subdomain Indicator Year/Period 1. Demographics Population Population 2010 Veterans Birth Birth data Fertility data Mortality Age adjusted mortality rate Migration Foreign born Socioeconomic Economic Median household income Unemployment status Below poverty level (individuals) Below poverty level (families) Education Educational attainment Language Language spoken at home Insurance Health insurance type Health outcomes Morbidity Prevalence of diabetes Prevalence of asthma Prevalence of obesity Prevalence of hypertension Disability status Serious psychological distress Health services Preventive services Flu vaccination Colon cancer screening Breast cancer screening Treatment related services Mental health counseling or treatment Personal doctor HIV testing

14 Table 1: Domains and Indicators (cont): Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, Domain Subdomain Indicator Year/Period 5. Health behaviors Health awareness Rode bicycle in past year Last routine health check up Exercise Condom use Nutrition Healthy diet Consumption of fruits and vegetables Economic Heavy drinking Binge drinking Smoking Smoking status Quit smoking attempts Quality of life Health related quality of life Self-reported health status Indicators used to develop thehealth Needs Index 7. Environmental health Air quality Secondhand smoke Transport Walk/bike for transport Table 2: Indicators used to develop Health Needs Index: Domain Subdomain Indicator Year 1. Demographics Migration Foreign born Socioeconomic Economic Below poverty level (individuals) 2011 Education High school graduates 2012 Insurance Health insurance - Medicaid Health Outcomes Morbidity Prevalence of diabetes 2012 Prevalence of asthma 2012 Prevalence of hypertension Health services Treatment related services HIV testing Health behaviors (Healthy) 5. Health behaviors (Unhealthy) Health awareness Condom use 2012 Nutrition Consumption of fruits and vegetables 2012 Economic Heavy drinking 2012 Smoking Quit smoking attempts Quality of life Health related quality of life Self-reported health status 2012

15 Table 3: Neighborhood Ranks based on Health Needs Index (from highest need to lowest need) Neighborhood Rank Williamsburg/Bushwick 1 East New York/New Lots 2 Greenpoint 3 Sunset Park 4 Borough Park 5 Canarsie and Flatlands 6 Bedford Stuyvesant/Crown Heights 7 Coney Island 8 Flatbush 9 Bay Ridge/Bensonhurst 10 Downtown Brooklyn/Heights/Slope

16 Acknowledgments We are grateful to the Young Leadership Council of The Brooklyn Hospital Center, for providing seed funding for development of the Brooklyn Neighborhood Health Profiles. The Profiles would not have been feasible without grant funding from the New York State Vital Access Program and the Everest Foundation. We are indebted to the Prevention Steering Committee for providing guidance and feedback throughout development of the Profiles. Above all, we are grateful to each person who will use the Profiles toward keeping Brooklyn healthy

17 HSR TEAM Jean Ford, MD Founding Director Carlos Castillo-Salgado, MD, JD, DrPH Director of the Global Public Health Observatory, The Johns Hopkins Bloomberg School of Public Health, Consultant Manuel Vidaurre, MCSc Principal Information Technology Consultant Sam Amirfar, MD, MS Director of Medical Informatics Heather Mavronicolas, PhD, MPH Director of Research Training Tanyka Sam, MD, MPH Director of Research in Community-Oriented Primary Care Tejal Shah, MBBS, MPH Data Analyst Allyson Ho, MPH Education Manager Deeba Zivari, MS Communications Strategist and Research Coordinator Aracelis Torres, MPH, PhD Candidate Research Assistant Karina Christiansen, MPP, PhD Candidate Research Assistant Suggested Citation: Health Situation Room, The Brooklyn Hospital Center: Brooklyn,. Brooklyn, New York, USA Principal Investigator: Jean Ford Design by: Manuel Vidaurre Graphs by: Tejal Shah Text by: Tejal Shah, Aracelis Torres, Deeby Zivari, Rebecca Schwarz and Tanyka Sam Health Needs Index by: Carlos Castillo-Salgado Photographs by: Deeba Zivari, Allyson Ho, & Rebecca Schwarz Some pictures are from the Wikimedia Commons, the free media repositor. For author attribution please check our website Health Situation Room The Brooklyn Hospital Center 121 Dekalb Avenue Maynard Building, Suite 14D Brooklyn, NY

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