OneCity Health PPS Community Profile

Transcription

1 OneCity Health PPS Community Profile Counties served: Bronx, Kings, New York, and Queens DEMOGRAPHICS 1 The four counties served by the OneCity Health PPS have a total 2014 population of 7,888,534. Age: Across all four counties, residents tend to be younger than the statewide average; 17.6% of the population is age 60 or older. Race/Ethnicity: Overall, the four counties have a population that is only 30.9% White. Foreign-born residents: 38.7% of residents are foreign-born. Approximately 180 cultures are represented in Queens County alone. Language: 49.9% of residents of these counties speak only English at home. Between 16.7% (Kings) and 46.9% (Bronx) of each county s residents speak Spanish at home. Poverty: Bronx County has the greatest percentage (30.5%) of residents living below Federal Poverty Guidelines (FPG), while Queens County (15.3%) has the lowest percentage. OneCity Health PPS Executive Summary page 1

2 HIV/AIDS 2 3 New HIV Diagnoses: In 2014, there were a total of 2,399 new HIV diagnoses in the PPS s four counties. Kings County had the largest number of new HIV cases 747 during that year. The HIV incidence for these four counties is significantly higher than New York State s overall rate of 19.1 new cases per 100,000 residents. PLWHA: As of December 31, 2014, there were 106,916 people living with HIV/AIDS in the PPS s region; each county s number of PLWHA ranged from 17,613 (Queens) to 31,776 (New York County). The HIV prevalence rates for these counties are significantly higher than New York State s overall PLWHA per 100,000 residents. Deaths: In 2014, a total 1,352 deaths occurred among PLWHA in these four counties. HIV/AIDS Hospitalization Costs: In 2014, HIV-related hospitalization costs across the PPS (4,025 patients and 41,613 hospital days) totaled $300,213,395; 44% of costs occurred in New York County. OneCity Health PPS Executive Summary page 2

3 HIV DISPARITIES 1 2 HIV and AIDS disproportionately impact non-white residents and especially residents identifying as Hispanic (of any race), Black (non-hispanic), and Multi-Race (non-hispanic) across all four of the PPS s counties. Despite Black individuals making up only 23.3% of the counties total population, this racial group represented 45.3% of all PLWHA in the region, as well as 44.5% of the region s new HIV diagnoses in Similarly, Hispanics accounted for 36.7% of new diagnoses and 33.6% of PLWHA in these four counties, while comprising only 29.5% of the total population. Of all PLWHA in the PPS region, 16.1% (17,265 individuals) indicated transmission by injection drug use (IDU) or MSM/IDU, and 37.7% (40,261) indicated transmission by MSM. OneCity Health PPS Executive Summary page 3

4 HIV RISK FACTORS Homelessness The OneCity Health PPS is represented by HUD Continuum of Care (CoC) region NY- 600, which is comprised of New York, Kings, Queens, Bronx, and Richmond Counties. o In the point of time HUD census in January 2015, a total of 75,323 individuals were homeless. Of these, 72,140 were sheltered and 3,183 were unsheltered. o Sixty-one percent 45,711 individuals were members of homeless families. o The number of homeless unaccompanied youth (under age 25) was 1,706. Parolees in the Region The OneCity Health PPS spans four state Department of Corrections regions: (1) Queens / Long Island, (2) Manhattan / Staten Island, (3) Brooklyn, and (4) Bronx. Counties included in these regions: Bronx, Kings, New York, Nassau, Queens, Suffolk, Richmond. As of December 2015, a total of 19,408 parolees reside in these four regions. Substance Use Only 14% of adults in the PPS region smoke cigarettes, a rate lower than the statewide rate of 15.9%. Bronx County has the highest rate of smokers (15.2% of adults). 15.8% of adults reported binge drinking in the last month, ranging from 12.5% of adults in Bronx County to 21.0% in Manhattan County. The statewide rate is 17.7%. The four counties in the OneCity Health PPS incurred total drug/alcohol-related hospitalization costs of over $614.2 million in 2014, serving 32,769 patients. o The largest share of costs (45%) is attributed to New York County, which served 13,840 patients for total cost of $277.9 million. o Kings County served 7,621 patients at a total cost of $129.4 million (21% of the region s total), and, similarly, Bronx County served 7,181 patients at a total cost of $121.9 million (20% of region s total). o Finally, Queens County incurred $85.1 million (14% of region s total) in total drug/alcohol-related hospitalization costs, with 4,127 patients. PPS-wide, the majority of costs were incurred by 11,397 patients admitted for Alcohol Abuse and Dependence, costing $262.4 million. OneCity Health PPS Executive Summary page 4

5 o o o o A total of 8,673 patients across these counties were treated for Opioid Abuse and Dependence, at a cost of $133.7 million. A total of 1,770 patients were admitted for Drug or Alcohol Dependence with Rehab or Detox Therapy, accounting for $78.0 million in hospitalization costs. Cocaine Abuse and Dependence and Other Drug Abuse and Dependence accounted for a combined total 4,463 patients and $72.1 million. In addition, $67.9 million in costs were incurred for 6,466 patients categorized as Drug or Alcohol Abuse or Dependence, Left Against Medical Advice. Mental Health Average Age-adjusted Percentage of Adults with Poor Mental Health for 14 days or more Days in the Past Month: 12.1%, higher than the state-wide rate of 11.1%. In Bronx County, only 12.5% of adults indicated poor mental health, while New York had the highest rate of self-reported poor mental health at 21.0%. Mental health-related hospitalization costs across all four counties totaled over $2.344 billion in 2014! The four counties served a combined 54,401 patients. o The majority of mental health-related hospitalization costs were incurred by New York County ($851.0 million, or 36% of the PPS s total mental health hospitalization costs), which served 18,674 patients in o Queens County served 12,007 patients at a total cost of $625.5 million, and Kings served 14,685 patients and spent $566.2 million. o Finally, 9,035 patients were treated in Bronx County, at a cost of $301.6 million. PPS-wide, the majority of mental health-related hospitalization costs were for 25,552 patients admitted for schizophrenia and other psychotic disorders, incurring total hospitalization costs of $1.272 billion. Mood disorders accounted for $867.6 million in cost for 22,730 patients, and 6,119 patients were admitted for other mental health disorders, incurring $204.4 million in hospitalization costs. OneCity Health PPS Executive Summary page 5

6 OneCity Health PPS Executive Summary page 6

7 SOURCES 1 U.S. Census Bureau, American Community Survey 5-Year Estimates. 2 New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at 3 New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). 4 U.S. Housing and Urban Development, Continuum of Care Homeless Assistance Program Homeless Population and Subpopulation Report, Point in Time (PIT) counts from January Published November Retrieved July 2016 from 5 New York State Department of Corrections, 2015 FOIA request on Community Supervision Offenders NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of Retrieved July 2016 from New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR MDC = Alcohol / Drug Use & Alcohol/Drug Induced Organic Mental Disorders. APR DRG = Alcohol & Drug Dependence w Rehab or Rehab/Detox Therapy (772); Alcohol Abuse & Dependence (775); Cocaine Abuse & Dependence (774); Drug & Alcohol Abuse or Dependence, Left Against Medical Advice (770); Opioid Abuse & Dependence (773); and Other Drug Abuse & Dependence (776). 8 New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. APR MDC = Mental Diseases and Disorders. CCS Diagnosis Categories = Mood Disorders (657); Schizophrenia and other psychotic disorders (659); and, sum of all other CCS Diagnoses under Mental Diseases and Disorders: Adjustment Disorders (650), Anxiety Disorders (651), Attention-Deficit (652), Delirium (653), Developmental Disorders (654), Miscellaneous Disorders (670), Other congenital abnormalities (217), Personality disorders (658), and Suicide and other intentional self-inflicted injury (662) NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of Retrieved July 2016 from OneCity Health PPS Executive Summary page 7

8 Community-Based Organizations funded by NYS Department of Health, AIDS Institute in the OneCity Health PPS Region Heights Hill Mental Health Services South Beach Psychiatric Center CAB, Inc. 25 Flatbush Ave, 3 rd Floor Brooklyn, NY Contact: Christian Huygen, Ph.D, Executive Director Phone: (718) christianhuygen@rainbowheights.org The After Hours Project, Inc Broadway Brooklyn, NY Contact: Fernando Soto, Executive Director Phone: (718) fsoto@afterhoursproject.org CAMBA, Inc Church Avenue,, 2 nd Floor Brooklyn, NY Contact: Joanne M. Oplustil, President / CEO Phone: (718 ) joanneo@camba.org Turning Point Brooklyn Inc th Avenue Brooklyn, NY Contact: Tata Traore-Rogers, Chief Program Officer Phone: (718) tata@tpbk.org Family Services Network of New York, Inc Bushwick Ave Brooklyn, NY Contact: Benjamin Igwe PhD, President / CEO Phone: (718) bigwe@fsnny.org Voices of Community Activists & Leaders 80-A 4th Ave Brooklyn, NY Contact: Jennifer Flynn, Executive Director Phone: (917) jennifer@vocal-ny.org Housing Works, Inc. 57 Willoughby Street, 2 nd floor Brooklyn, NY Contact: Charles King, President / CEO Phone: (347) king@housingworks.org African Services Committee, Inc. 429 West 127th St New York, NY Contact: Kim Nichols, Co-executive Director Phone: (212) kimn@africanservices.org START Treatment and Recovery Centers 22 Chapel St Brooklyn, NY Contact: Lawrence Brown Jr., MD, MPH, CEO Phone: (718) lbrown@startny.org Brightpoint Health (formerly HELP/PSI) 71 West 23rd Street New York, NY Contact: Carol Murphy, COO Phone: (718) cmurphy@brightpointhealth.org OneCity Health PPS Executive Summary page 8

9 Partnership for the Homeless 305 7th Ave New York, NY Contact: Arnold Cohen, President / CEO Phone: (212) acohen@pfth.org Betances Health Center 280 Henry Street New York, NY Contact: Santos Rivera, Jr., Executive Director Phone: (212) srivera@betances.org The Lesbian, Gay, Bisexual & Transgender Community Center 208 West 13th St New York, NY Contact: Glennda Testone, Executive Director Phone: (212) glennda@gaycenter.org Callen Lorde Community Health Project 356 W 18th St New York, NY Contact: Wendy Stark, Executive Director Phone: wstark@callen-lorde.org AIDS Service Center of Lower Manhattan, Inc. (& Lower Manhattan Harm Reduction Center) 64 West 35th St, 3 rd floor New York, NY Contact: Sharen I Duke, Executive Director Phone: (212) sharen@ascnyc.org Community Healthcare Network 60 Madison Avenue, 5 th Floor New York, NY Contact: Robert M. Hayes, President and CEO Phone: (212) rhayes@chnnyc.org Ali Forney Center 224 West 35th Street, Suite 1500 New York, NY Contact: Carl Siciliano, Executive Director Phone: (212) carls@aliforneycenter.org Exponents, Inc. 2 Washington St, 4 th Floor New York, NY Contact: Samantha Lopez-Fernandez, Chief Administrative Officer Phone: (212) slopez@exponents.org APICHA Community Health Center 400 Broadway New York, NY Contact: Teresita R. Rodriguez, CEO Phone: (646) trodriguez@apicha.org Gay Men's Health Crisis, Inc. 446 West 33rd St, 6 th Floor New York, NY Contact: Kelsey Louie, CEO Phone: (212) kelseyl@gmhc.org OneCity Health PPS Executive Summary page 9

10 Harlem Dowling-Westside Center for Children and Families, Inc Adam Clayton Powell Jr Boulevard Suite 108 New York, NY Contact: Karen Dixon, Executive Director Phone: (212) Harm Reduction Coalition 22 West 27th St, 5 th Floor New York, NY Contact: Demetrius McCord, Deputy Executive Director Phone: (212) mccord@harmreduction.org Hetrick Martin Institute, Inc. 2 Astor Pl, 3 rd Floor New York, NY Contact: Thomas Krever, Executive Director Phone: (212) tkrever@hmi.org New York City Gay & Lesbian Anti- Violence Project, Inc. 116 Nassau Street, 3 rd Floor New York, NY Contact: Beverly Tillery, Executive Director Phone: (212) BTillery@AVP.org Hispanic AIDS Forum, Inc Park Ave, 5 th Floor New York, NY Contact: Heriberto Sanchez Soto MSW, Executive Director Phone: (212) hsanchezsoto@hafnyc.org Positive Health Project, Inc. 301 West 37th St New York, NY Contact: Linney Smith, COO for Health Services Phone: (347) smith@housingworks.org Institute for Family Health 16 East 16th St New York, NY Contact: Edward Fried, Sr VP, Administration Phone: (212) efried@institute2000.org Safe Horizon, Inc. 2 Lafayette St, 3 rd Floor New York, NY Contact: Ariel Zwang, Chief Executive Director Phone: (212) ariel.zwang@safehorizon.org Mount Sinai Diagnostic and Treatment Center One Gustave L Levy Place, Box 1068 New York, NY Contact: David Reich, MD, President and Chief Operating Officer Phone: (212) david.reich@mountsinai.org Upper Room AIDS Ministry, ADHC 306 Lenox Ave, 3rd Fl New York, NY Contact: Tamisha McPherson, Chief Program Officer Phone: (212) tmcpherson@harlemunited.org OneCity Health PPS Executive Summary page 10

11 Washington Heights CORNER Project 566 West 181st Street, 2 nd Floor New York, NY Contact: Daniel Raymond, Board Chair Phone: (212) admin@cornerproject.org Women's Prison Association and Home, Inc nd Ave New York, NY Contact: Georgia Lerner, Executive Director Phone: (646) glerner@wpaonline.org William F. Ryan Community Health Center 110 West 97th Street New York, NY East 3rd St New York, NY Contact: Ana Taras Phone: ana.taras@ryancenter.org Acacia Network (PROMESA, Inc. & United Bronx Parents) 300 East 175th St, 6 th Floor Bronx, NY Prospect Ave Bronx, NY Contact: Pamela Mattel, Chief Operating Officer Phone: (718) pmattel@promesa.org BOOM!Health (& Citiwide Harm Reduction) 540 East Fordham Road Bronx, NY Contact: Jose Davila, President Phone: (718) jdavila@boomhealth.org St. Ann's Corner of Harm Reduction, Inc. 886 Westchester Avenue Bronx, NY Contact: Joyce Rivera, Executive Director Phone: (718) jrivera@sachr.org BronxWorks, Inc. 60 East Tremont Avenue Bronx, NY Contact: Eileen Torres, Executive Director Phone: (646) etorres@bronxworks.org New York Harm Reduction Educators 155 E 149th St, 2 nd Floor Bronx, NY Contact: Dart Westphal, Interim Executive Director Phone: (718) dwestphal@nyhre.org The Osborne Association, Inc. 809 Westchester Ave Bronx, NY Contact: Elizabeth Gaynes, Executive Director Phone: (718) egaynes@osborneny.org OneCity Health PPS Executive Summary page 11

12 Additional Resources AIDS Institute HIV Education & Training Program The site offers a range of trainings that are intended for non-physician health and human services providers who offer HIV, STI and viral hepatitis prevention, testing, care, and support services. All trainings are free of charge and funded by the New York State Department of Health AIDS Institute. Ending the Epidemic (ETE) Dashboard This purpose of this site is to measure, track and disseminate actionable information on progress towards achieving New York State s Ending the Epidemic (EtE) Initiative s goals to all interested stakeholders. NYS Department of Health HIV/AIDS Home Page The New York State Department of Health, AIDS Institute has lead responsibility for coordinating state programs, services and activities relating to HIV/AIDS, sexually transmitted diseases (STDs) and hepatitis C. The site provides resources related to the AIDS Institute s priorities and work as well as links to resources for consumers and providers and surveillance statistics. NY Links NY Links focuses on improving linkage to care and retention in care and supports the delivery of routine, timely, and effective care for Persons living with HIV/AIDS (PLWHA) in New York State. NY Links uses a regional approach, utilizing the learning collaborative model, to fortify the links holding together communities of practice, and the links grounding them in the communities of consumers they serve. OneCity Health PPS Executive Summary page 12

13 DEMOGRAPHICS i Bronx County Community Profile Bronx County s Total Population is 1,418,733. Residents of Bronx are younger; they have a median age of 33.1, and 15.4% are 60 or older. 10.5% of the population is White, 29.7% is Black, 54.1% Hispanic, 1.0% Multi-Race and 4.7% Other Races. 37.5% of residents are foreign-born. Of these, the majority (76%, or 365,688 residents) were born in Latin America. Next, 10% (48,501) were born in Africa. About 8% (37,058 residents) were born in Asia (including 10,423 from Bangladesh and 4,997 from Philippines). Only 42% of residents speak only English at home; 46.9% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Bronx County NY Statewide Rate Median Household Income $34,284 $58,687 % living at less than 100% of Federal Poverty Level 30.5% 16.0% Unemployment Rate 15.0% 8.9% % receiving Medicaid / means-tested Public Coverage 44.0% 22.5% % Uninsured 14.8% 10.6% HIV/AIDS IN BRONX COUNTY New HIV Infections: In 2014, the total number of new HIV diagnoses in Bronx County was 520. Annual HIV incidence is 36.2 per 100,000 residents. (New York State s overall incidence rate is 19.1 per 100,000 residents.) PLWHA: As of December 31, 2014, there were 28,416 people living with HIV/AIDS (PLWHA) in Bronx County. HIV prevalence rate is 1,979 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: In 2014, the total number of deaths among PLWHA was 481. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses (2014) % # of PLWHA (Dec 2014) Bronx County page 1 % # Deaths among PLWHA (2014) Total % % % Sex at Birth Male % % % Female % % % Age 12 and under 4 0.8% % 0 0.0% % % 0 0.0% % % % % % % % % % % % % % % % %

14 HIV/AIDS Hospitalization Costs iv In 2014, a total of $83,782,932 in costs were incurred by 1,308 patients admitted for HIV with Major and Multiple Major Related Conditions. 694 patients were treated for HIV with Major Related Conditions, accounting for $27.8 million in hospitalization costs. 614 patients were treated for HIV with Multiple Major Related Conditions, at a cost of $56.0 million. HIV/AIDS Disparities In Bronx County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals, who comprise 47.3% of all PLWHA in the county but only 29.7 of the county s total population. People of Hispanic ethnicity (of any race) represent 47.1% of PLWHA and 54.1% of the population. Of the 370 males newly diagnosed with HIV in 2014, 61.4% identified their transmission risk as men who have sex with men (MSM); 8.4% identified transmission as heterosexual; only 2.7% indicated transmission by injection drug use (IDU) or MSM / IDU. Over 26% indicated unknown transmission risk. Of the 150 females newly diagnosed in 2014, 83.3% indicated a transmission risk of heterosexual contact; 6.7% indicated transmission by IDU. Of all PLWHA in the county, 21.6% (6,138 individuals) indicated transmission by IDU or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Males Total % % MSM % % IDU 6 1.6% % MSM/IDU 4 1.1% % Heterosexual % % Other 0 0.0% % Perinatal Risk 3 0.8% % Unknown % % Bronx County page 2

15 HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Females Total % % IDU % % Heterosexual Contact % % Other Risk 0 0.0% % Perinatal 1 0.7% % Unknown % % HIV/AIDS RISK FACTORS Substance Use County-wide, 15.2% of adults smoke cigarettes, similar to the New York State-wide rate of 15.9% of adults. The percentage of adults in Bronx County who report binge drinking in the past month is 12.5%, less than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Bronx County had a total cost of over $121.9 million for 7,181 patients admitted for 34,724 total days. o The largest proportion of hospitalization costs was for 2,387 patients admitted for Alcohol Abuse and Dependency, which accounted for 10,914 hospital days and $53.6 million in costs. o Opioid Abuse and Dependence incurred $25.8 million in costs for 1,760 patients and 7,125 days. o Drug/Alcohol Dependence with Rehab Stay incurred $7.6 million in costs for 482 o o patients with an average length of stay of 16 days (7,529 total hospital days). Cocaine Abuse and Dependence and Other Drug Abuse and Dependence incurred a combined $17.5 million in costs for 1,039 patients and 5,303 days. An additional $17.2 million was attributed to Drug/Alcohol Abuse and Dependence, Patient Left Against Medical Advice for 1,513 patients and 3,853 days. vii Bronx County page 3

16 Mental Health In 2014, the age-adjusted percentage of adults in Bronx County who reported poor mental health for 14 or more days in the past month was 18.5% higher than the statewide rate of 11.1%. viii Hospitalizations due to mental health issues had a total cost of over $301.5 million for 9,035 patients admitted for 134,058 hospital days in o Mood disorders (3,441 patients) accounted for 39,939 hospital days and $94.8 million in costs. o Schizophrenia or other psychotic disorders (4,576 patients) accounted for 82,301 o hospital days and $169.4 million in costs. In addition, 1,018 patients were admitted for an other mental health disorder, for a total 11,818 days and cost of $37.3 million. ix REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at Bronx County page 4

17 vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Bronx County page 5

18 DEMOGRAPHICS i Kings County Community Profile Kings County s Total Population is 2,570,801. Residents of Kings County are younger; they have a median age of 34.3, and 16.9% are 60 or older. 35.7% of the population is White, 31.6% is Black, 19.7% Hispanic, 1.4% Multi-Race and 11.6% Other Races. 37.5% of residents are foreign-born. Of these, the majority (50.2%, or 484,202 residents) were born in Latin America, (including 70,533 in Jamaica and 57,250 in Dominican Republic). 26.2% (252,225) were born in Asia (incl. 132,123 in China); and 19.1% (191,845) in Europe. 54% of residents speak only English at home; 16.7% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Kings County NY Statewide Rate Median Household Income $46,958 $58,687 % living at less than 100% of Federal Poverty Level 23.4% 16.0% Unemployment Rate 10.6% 8.9% % receiving Medicaid / means-tested Public Coverage 34.9% 22.5% % Uninsured 13.1% 10.6% HIV/AIDS IN KINGS COUNTY New HIV Infections: In 2014, the total number of new HIV diagnoses in Kings County was 747. HIV incidence is 28.5 per 100,000 residents. (New York State s overall incidence is 19.1 per 100,000.) PLWHA: As of December 31, 2014, there were 29,111 people living with HIV/AIDS (PLWHA) in Kings County. HIV prevalence rate is 1,132 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: In 2014, the total number of deaths among PLWHA was 411. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses (2014) % # of PLWHA (Dec 2014) Kings County page 1 % # Deaths among PLWHA (2014) Total % % % Sex at Birth Male % % % Female % % % Age 12 and under 1 0.1% % 0 0.0% % % 0 0.0% % % % % % % % % % % % % % % % %

19 HIV/AIDS Hospitalization Costs iv In 2014, a total of $54,181,953 costs were incurred by 830 patients admitted for HIV with Major and Multiple Major Related Conditions. 435 patients were treated for HIV with Major Related Conditions, accounting for $17.8 million in hospitalization costs. 395 patients were treated for HIV with Multiple Major Related Conditions, at a total cost of $36.4 million. HIV/AIDS Disparities In Kings County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals, who comprise 61.5% of all PLWHA in the county but only 31.6% of the county s total population. Also disproportionately impacted are people of Hispanic ethnicity (of any race), who represent 24.0% of PLWHA and 19.7% of the overall population. Of the 568 males newly diagnosed with HIV in 2014, 67.3% identified their transmission risk as men who have sex with men (MSM); 6.5% identified transmission as heterosexual; only 3.7% indicated transmission by injection drug use (IDU) or MSM / IDU. Over 22% indicated unknown transmission risk. Of the 179 females newly diagnosed in 2014, 71.5% indicated a transmission risk of heterosexual contact; 5.0% indicated transmission by IDU. Of all PLWHA in the county, 15.5% (4,528 individuals) indicated transmission by IDU or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Males Total % % MSM % % IDU % % MSM/IDU % % Heterosexual % % Other 0 0.0% % Perinatal Risk 1 0.2% % Kings County page 2

20 HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Unknown % % Transmission Risk Group Females Total % % IDU 9 5.0% % Heterosexual Contact % % Other Risk 0 0.0% % Perinatal 0 0.0% % Unknown % % HIV/AIDS RISK FACTORS Substance Use County-wide, 14.8% of adults smoke cigarettes, less than the New York State-wide rate of 15.9% of adults. The percentage of adults in Kings County who report binge drinking in the past month is 15.0%, less than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Kings County had a total cost of over $129.2 million for 7,621 patients admitted for 36,139 total days. o The largest proportion of hospitalization costs was for 2,596 patients admitted for Alcohol Abuse and Dependency, which accounted for 12,911 hospital days and over $56.6 million in costs. o Opioid Abuse and Dependence incurred $26.9 million in costs for 2,061 patients and 10,014 days. o Drug/Alcohol Dependence with Rehab Stay incurred $13.9 million in costs for 179 o o patients with an average length of stay of 23 days (4,055 total hospital days). Cocaine Abuse and Dependence and Other Drug Abuse and Dependence incurred a combined $13.5 million in costs for 965 patients and 4,416 days. An additional $18.0 million was attributed to Drug/Alcohol Abuse and Dependence, Patient Left Against Medical Advice for 1,820 patients and 4,743 days. vii Kings County page 3

21 Mental Health In 2014, the age-adjusted percentage of adults in Kings County who reported poor mental health for 14 or more days in the past month was 12.4% higher than the statewide rate of 11.1%. viii Hospitalizations due to mental health issues had a total cost of over $566.1 million for 14,685 patients admitted for 231,402 hospital days in o Mood disorders (5,468 patients) accounted for 64,655 hospital days and $167.8 million in costs. o Schizophrenia or other psychotic disorders (7,624 patients) accounted for 150,836 o hospital days and $349.7 million in costs. In addition, 1,593 patients were admitted for an other mental health disorder, for a total 15,911 days and cost of $48.5 million. ix REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at Kings County page 4

22 vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Kings County page 5

23 DEMOGRAPHICS i New York County Community Profile New York County s (Manhattan s) Total Population is 1,618,398. Residents of New York County have a median age of 36.6, and 19.5% are 60 or older. 47.4% of the population is White, 12.8% is Black, 25.7% Hispanic, 2.1% Multi-Race and 12.0% Other Races. 28.9% of residents are foreign-born. 43.3% (202,292) were born in Latin America, the majority (131,165) from the Caribbean. Next, 29.5% (137,752) were born in Asia; 19.3% (90,051) in Europe; and 4.2% were born (19,601) in Africa, 60% of residents speak only English at home; 22.6% speak Spanish at home, and 8.2% speak other Indo-European languages. 7.7% speak an Asian or Pacific Islander language. ECONOMIC INDICATORS ii Indicator New York County NY Statewide Rate Median Household Income $71,656 $58,687 % living at less than 100% of Federal Poverty Level 17.7% 16.0% Unemployment Rate 8.2% 8.9% % receiving Medicaid / means-tested Public Coverage 21.1% 22.5% % Uninsured 9.8% 10.6% HIV/AIDS IN NEW YORK COUNTY New HIV Infections: In 2014, the total number of new HIV diagnoses in New York County was 668. Annual HIV incidence is 41 per 100,000 residents. (New York State s overall incidence rate is 19.1 per 100,000 residents.) PLWHA: As of December 31, 2014, there were 31,776 people living with HIV/AIDS (PLWHA) in New York County. HIV prevalence rate is 1,963 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: In 2014, the total number of deaths among PLWHA was 303. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses (2014) % # of PLWHA (Dec 2014) % # Deaths among PLWHA (2014) Total % % % Sex at Birth Male % % % Female % % % Age 12 and under 0 0.0% % 0 0.0% % % 0 0.0% % % 3 1.0% % % % % % % % New York County page 1

24 % % % % % % HIV/AIDS Hospitalization Costs iv In 2014, a total of $131,772,616 in costs were incurred by 1,517 patients admitted for HIV with Major and Multiple Major Related Conditions. 815 patients were treated for HIV with Major Related Conditions, accounting for $46.4 million in hospitalization costs. 702 patients were treated for HIV with Multiple Major Related Conditions, at a total cost of $85.4 million. HIV/AIDS Disparities In New York County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals, who comprise 31.3% of all PLWHA in the county but only 12.8% of the county s total population. Also disproportionately impacted are people of Hispanic ethnicity (of any race), who represent 24.0% of PLWHA and 19.7% of the county population. Overall, the largest proportion of PLWHA in New York County are White (37.5% of the County s PLWHA). Of the 592 males newly diagnosed with HIV in 2014, 82.8% identified their transmission risk as men who have sex with men (MSM); 2.0% identified transmission as heterosexual; and, 3.0% indicated transmission by injection drug use (IDU) or MSM / IDU. Of the 179 females newly diagnosed in 2014, 72.4% indicated a transmission risk of heterosexual contact; 5.3% indicated transmission by IDU; and, 22.4% indicated unknown transmission risk. Of all PLWHA in the county, 12.6% (4,013 individuals) indicated transmission by IDU or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Males Total % % MSM % % IDU 5 0.8% % MSM/IDU % % New York County page 2

25 HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Heterosexual % % Other 0 0.0% % Perinatal Risk 0 0.0% % Unknown % % Transmission Risk Group Females Total % % IDU 4 5.3% % Heterosexual Contact % % Other Risk 0 0.0% % Perinatal 0 0.0% % Unknown % % HIV/AIDS RISK FACTORS Substance Use County-wide, 13.1% of adults smoke cigarettes, less than the New York State-wide rate of 15.9% of adults. The percentage of adults in New York County who report binge drinking in the past month is 21.0%, higher than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in New York County had a total cost of over $277.9 million for 13,840 patients admitted for 66,351 total days. o The largest proportion of hospitalization costs was for 4,079 patients admitted for Alcohol Abuse and Dependency, which accounted for 17,247 hospital days and over $91.5 million in costs. o Opioid Abuse and Dependence incurred $72.7 million for 4,354 patients, 10,014 days. o Drug/Alcohol Dependence with Rehab Stay incurred $56.1 million in costs for 1,104 patients with an average length of stay of 15 days (16,371 total hospital days). o Cocaine Abuse and Dependence accounted for $25.4 million for 1,764 patients and 6,334 hospital days. o Other Drug Abuse and Dependence totaled $8.9 million for 309 patients and 1,654 days. o An additional $23.0 million was attributed to Drug/Alcohol Abuse and Dependence, Patient Left Against Medical Advice for 2,230 patients and 4,781 days. vii New York County page 3

26 Mental Health In 2014, the age-adjusted percentage of adults in New York County who reported poor mental health for 14 or more days in the past month was 10.6% slightly lower than the statewide rate of 11.1%. viii Mental Health-Related Hospitalizations in New York County had a total cost of over $851.0 million for 18,674 patients admitted for 263,199 hospital days in o Mood disorders (8,344 patients) accounted for 95,585 days and $356.3 million in costs. o Schizophrenia or other psychotic disorders (7,777 patients) accounted for 145,478 days and $411.0 million in costs. o In addition, 2,553 patients were admitted for an other mental health disorder, for a total 22,136 days and cost of $83.6 million. ix REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV New York County page 4

27 Epidemiology and Field Services Program. Accessed July 2016 at vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. New York County page 5

28 DEMOGRAPHICS i Queens County Community Profile Queens County s Total Population is 2,280,602. Residents of Queens County have a median age of 37.5, and 18.6% are 60 or older. 26.5% of the population is White, 17.5% is Black, 27.8% Hispanic, 2.2% Multi-Race, and 25.9% Other Races. 47.8% of residents are foreign-born. (521,527) born in Latin America (including 176,642 in Caribbean, 99,052 in Central America, 245,833 in South America - 77,824 from Guyana alone). (410,519) in Asia (including 33,387 in Philippines, 48,481 in India, 44,483 in Bangladesh); (24,632) born in Africa. 44% of residents speak only English at home; 23.9% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Queens County NY Statewide Rate Median Household Income $57,210 $58,687 % living at less than 100% of Federal Poverty Level 15.3% 16.0% Unemployment Rate 9.5% 8.9% % receiving Medicaid / means-tested Public Coverage 26.4% 22.5% % Uninsured 17.1% 10.6% HIV/AIDS IN QUEENS COUNTY New HIV Infections: In 2014, the total number of new HIV diagnoses in Queens County was 464. Annual HIV incidence is 19.9 per 100,000 residents. (New York State s overall incidence rate is 19.1 per 100,000 residents.) PLWHA: As of December 31, 2014, there were 17,613 people living with HIV/AIDS (PLWHA) in Queens County. HIV prevalence rate is 772 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: In 2014, the total number of deaths among PLWHA was 157. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses (2014) % # of PLWHA (Dec 2014) % # Deaths among PLWHA (2014) Total % % % Sex at Birth Male % % % Female % % % Age 12 and under 0 0.0% % 0 0.0% % % 0 0.0% % % 6 3.8% % % % % % % % Queens County page 1

29 % % % % % % HIV/AIDS Hospitalization Costs iv In 2014, a total of $30,475,894 in costs were incurred by 370 patients admitted for HIV with Major and Multiple Major Related Conditions. 186 patients were treated for HIV with Major Related Conditions, accounting for $7.2 million in hospitalization costs. 184 patients were treated for HIV with Multiple Major Related Conditions, at a cost of $23.3 million. HIV/AIDS Disparities In Queens County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals, who comprise the largest proportion of PLWHA in the county (40.5%) but only 17.5% of the county s total population. Also disproportionately impacted are people of Hispanic ethnicity (of any race), who represent nearly 38% of PLWHA and 28% of the county population. The least impacted demographic is Other Races (not Hispanic), which only comprise 5.2% of PLWHA but represent 26% of residents. Of the 395 males newly diagnosed with HIV in 2014, 80.3% identified their transmission risk as men who have sex with men (MSM); 5.3% identified transmission as heterosexual; and, 1.8% indicated transmission by injection drug use (IDU) or MSM / IDU. Of the 69 females newly diagnosed in 2014, 75.4% indicated a transmission risk of heterosexual contact; 2.9% indicated transmission by IDU; and, 21.7% indicated unknown transmission risk. Of all PLWHA in the county, 14.6% (2,586 individuals) indicated transmission by IDU or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Males Total % % MSM % % IDU 3 0.8% % MSM/IDU 4 1.0% % Queens County page 2

30 HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Heterosexual % % Other 0 0.0% % Perinatal Risk 0 0.0% % Unknown % % Transmission Risk Group Females Total % % IDU 2 2.9% % Heterosexual Contact % % Other Risk 0 0.0% % Perinatal 0 0.0% % Unknown % % HIV/AIDS RISK FACTORS Substance Use County-wide, 13.0% of adults smoke cigarettes, less than the New York State-wide rate of 15.9% of adults. The percentage of adults in Queens County who report binge drinking in the past month is 15.0%, less than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Queens County had a total cost of over $85.1 million for 4,127 patients admitted for 19,524 total days. o The largest proportion of hospitalization costs was for 2,335 patients admitted for Alcohol Abuse and Dependency, which accounted for 12,877 hospital days and over $60.5 million in costs. o o o o o Opioid Abuse and Dependence incurred $8.2 million for 498 patients and 2,439 days. Cocaine Abuse and Dependence accounted for $4.2 million in costs for 271 patients and 1,193 hospital days. Other Drug Abuse and Dependence totaled $2.49 million for 115 patients and 606 days. Drug/Alcohol Dependence with Rehab Stay incurred $142,226 in costs for only five patients with an average length of stay of 5 days (23 total hospital days). An additional $9.5 million was attributed to Drug/Alcohol Abuse and Dependence, Patient Left Against Medical Advice for 903 patients and 2,386 days. vii Queens County page 3

31 Mental Health In 2014, the age-adjusted percentage of adults in Queens County who reported poor mental health for 14 or more days in the past month was 8.9% lower than the statewide rate of 11.1%. viii Mental Health-Related Hospitalizations in Queens County had a total cost of over $625.4 million for 12,007 patients admitted for 187,443 hospital days in o Mood disorders (5,477 patients) accounted for 66,053 days and $248.6 million in costs. o Schizophrenia or other psychotic disorders (5,575 patients) accounted for 111,334 o days and $342.0 million in costs. In addition, 955 patients were admitted for an other mental health disorder, for a total 10,056 days and cost of $34.8 million. ix REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at Queens County page 4

32 vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Queens County page 5