Keeping Brooklyn Healthy by Assessing Population Health and Driving Innovation 11234, 11236, 11239
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 290 723 1,245 808 80-84 yrs 339 778 1,214 937 75-79 yrs 666 869 1,202 1,303 70-74 yrs 1,101 1,003 1,315 1,947 65-69 yrs 1,677 1,161 1,360 2,702 375 60-64 yrs 355 2,491 1,744 1,977 3,723 526 55-59 yrs 405 3,185 1,709 1,941 4,820 557 50-54 yrs 498 277 3,718 1,794 1,878 5,647 678 45-49 yrs 482 3,716 1,472 1,560 5,634 746 40-44 yrs 499 3,274 1,248 1,337 5,182 678 35-39 yrs 484 3,209 1,287 1,276 4,748 638 30-34 yrs 527 3,285 1,195 1,209 4,704 655 25-29 yrs 516 3,724 1,203 1,175 4,659 646 20-24 yrs 627 4,514 1,287 1,187 4,747 712 18-19 yrs 1,891 429 459 1,994 15-17 yrs 429 2,951 757 674 3,022 427 12-14 yrs 393 2,632 722 668 2,631 432 10-11 yrs 261 1,598 481 478 1,639 5-9 yrs 602 3,782 1,287 1,226 3,881 637 1-4 yrs 528 2,819 1,023 983 2,812 497 Younger than 1 yr 686 712 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 0 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. http://nyc.gov/health/epiquery
Socioeconomic Conditions Economic Conditions Percentage of population in each zip code representing the various economic indicators Source: U.S. Census Bureau. 2012 American Community Survey 5-year estimates Median income ranges from $24,640 to $68,177 across the three zip codes Zip code 11239 has a higher proportion of people living in poverty at 31.4% compared to 9.6% in zip code 11234
Nativity and Language Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 47.4% of the population in zip code 11236 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. 2012 American Community Survey 5-year estimates Educational Attainment Nearly 41% of the population in zip code 11234 has completed some college Highest level of education attained by population 18 years and over Source: U.S. Census Bureau. 2012 American Community Survey 5-year estimates
Health Insurance Status: 2002-2012 Trends in health insurance types from 2002-2012, by percentage of population within each category Source: Community Health Survey. 2002-2012. New York City Department of Health & Mental Hygiene Each year, private insurance has comprised at least 48% of the neighborhood s coverage
Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 Health Conditions Self-reported Health Status: 2002-2012 Trends in self-reported health from 2002-2012, by percentage of population within each category Source: Community Health Survey, 2002-2012. New York City Department of Health & Mental Hygiene Since 2002, all subsequent years had a lower proportion of persons reporting fair or poor health
Prevalence of Diabetes Body Weight: 2002-2012 Trends in self-reported medical conditions based on diagnosis through lab results or having been told by a physician from 2002-2012 Source: Community Health Survey. 2002-2012. 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: 2002-2012 Trends in self-reported medical conditions based on diagnosis through lab results or having been told by a physician from 2002-2012 Source: Community Health Survey. 2002-2012. New York City Department of Health & Mental Hygiene Between 2002-2012, the prevalence of hypertension increased to 31.4%
Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 People living with HIV/AIDS by Race/Ethnicity: 2006-2011 People living with HIV/AIDS per 100,000 from 2006-2011, 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 2006-2011
Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 All-Cause Mortality: 2000-2011 Trend in all-cause mortality (age-adjusted per 1,000) from 2000-2011 Source: Deaths Epiquery, 2000-2011. 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
Cigarette Smoking Status: 2002-2012 Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 Trends in self-reported cigarette smoking status from 2002-2012, by percentage of population within each category Source: Community Health Survey, 2002-2012. 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 2002-2012 Cancer Screening: 2002-2012 Trends in self-reported breast and colon cancer screening from 2002-2012 Source: Community Health Survey. 2002-2012. 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
Access to Healthcare Services: 2002-2012 Trends in self-reported HIV testing and having a personal doctor from 2002-2012 Source: Community Health Survey. 2002-2012. 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
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 2002. 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.
Table 1: Domains and Indicators: Domain Subdomain Indicator Year/Period 1. Demographics Population Population 2010 Veterans 2008-2012 Birth Birth data 2000-2007 Fertility data 2000-2007 Mortality Age adjusted mortality rate 2000-2011 Migration Foreign born 2008-2012 2. Socioeconomic Economic Median household income 2008-2012 Unemployment status 2008-2012 Below poverty level (individuals) 2008-2012 Below poverty level (families) 2008-2012 Education Educational attainment 2008-2012 Language Language spoken at home 2008-2012 Insurance Health insurance type 2002-2012 3. Health outcomes Morbidity Prevalence of diabetes 2002-2012 Prevalence of asthma 2002-2012 Prevalence of obesity 2002-2012 Prevalence of hypertension 2002-2012 Disability status 2002-2012 Serious psychological distress 2002-2012 4. Health services Preventive services Flu vaccination 2002-2012 Colon cancer screening 2002-2012 Breast cancer screening 2002-2012 Treatment related services Mental health counseling or treatment 2002-2012 Personal doctor 2002-2012 HIV testing 2002-2012
Table 1: Domains and Indicators (cont): Neighborhood Profiles 2015 : Williamsburg - Bushwick 11206, 11221, 11237 Domain Subdomain Indicator Year/Period 5. Health behaviors Health awareness Rode bicycle in past year 2002-2012 Last routine health check up 2002-2012 Exercise 2002-2012 Condom use 2002-2012 Nutrition Healthy diet 2002-2012 Consumption of fruits and vegetables 2002-2012 Economic Heavy drinking 2002-2012 Binge drinking 2002-2012 Smoking Smoking status 2002-2012 Quit smoking attempts 2002-2012 6. Quality of life Health related quality of life Self-reported health status 2002-2012 Indicators used to develop thehealth Needs Index 7. Environmental health Air quality Secondhand smoke 2002-2012 Transport Walk/bike for transport 2002-2012 Table 2: Indicators used to develop Health Needs Index: Domain Subdomain Indicator Year 1. Demographics Migration Foreign born 2011 2. Socioeconomic Economic Below poverty level (individuals) 2011 Education High school graduates 2012 Insurance Health insurance - Medicaid 2012 3. Health Outcomes Morbidity Prevalence of diabetes 2012 Prevalence of asthma 2012 Prevalence of hypertension 2012 4. Health services Treatment related services HIV testing 2012 5. 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 2012 6. Quality of life Health related quality of life Self-reported health status 2012
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 11 11222 11211 11206 11237 11201 11205 11221 11231 11217 11238 11216 11233 11215 11225 11213 11212 11207 11208 11232 11203 11218 11226 11220 11219 11210 11209 11230 11204 11228 11236 11239 11234 11214 11223 11229 11224 11235
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
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. 2015 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 11201 hsrbrooklyn@nyp.org