Bronx Community Health Dashboard: Smoking Created: 6/12/217 Last Updated: 1/23/217 See last slide for more information about this project. 1
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 Smoking Status
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 3 27.2 25 25.2 2 2.8 19.7 17.4 15 14.9 14 12.9 1 5 22 23 24 25 26 27 28 29 21 211 212 213 214 215 4 Data source: Community Health Survey, 22-215. Analysis by Montefiore OCPH. Staten Island 21 data is likely an underestimate of the true prevalence of smoking due to random sampling variation.
Fewer Bronx adults are current smokers and more Bronx adults report having never smoked in 215, compared to 22 22 215 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.
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 5 45 47.5 44.7 25 215 Results restricted to those who reported being a current or former smoker 4 35 3 27.1 25 23.3 2 18.5 19.2 15 1 1.7 8.9 5 12 years and under 13-17 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.
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 2 19.7 15 14.2 14.9 12.9 14 17.4 16.5 16.7 12.3 16.1 13.9 14.3 11.8 14.9 1 7 5 4.4 7 Data source: Community Health Survey, 215. Analysis by Montefiore OCPH. Age results not age-adjusted.
Age-Adjusted Percent of Current Smokers In the Bronx, the unemployed, least educated, and most impoverished individuals are most likely to smoke 3 25 25.5 2 17.7 18 16.9 18 15 1 1.5 12.8 8 11.9 11.7 12 11.2* 5 8 Data source: Community Health Survey, 215. Analysis by Montefiore OCPH. * Lowest Poverty data point is unstable.
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 3 25 25.8 24.5 24.3 1.5 2 15 1 16.1 14.3 13.9 2.2 5 22 23 24 25 26 27 28 29 21 211 212 213 214 215 9 Data source: Community Health Survey, 22-215. Analysis by Montefiore OCPH. Non-Hispanic white 21, 212-214 data should be interpreted with caution. All Bronx Asian smoking data unstable.
Percent of Adult Current Smokers 3 of 1 community districts with highest percentages of current smokers are in the Bronx 25 2 15 Bronx 16 NYC 15 21 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 28 27 25 26 24 23 21 22 212 211 29 21 1 5 25 2 15 12 13 14 15 16 16 17 18 19 2 2 2 1 5 1 Data source: NYC Community Health Profiles.
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 22 3 25 Non-daily Smoker Light daily smoker Heavy daily smoker Heavy smokers: more than 1 cigarettes a day 2 7.5 Light smokers: between 1 and 1 cigarettes a day 6.7 5.4 15 1.2 5.5 4. 2.9 4. 3.5 2.9 4.7 3.1 2.2 1 8. 8.5 7.8 9. 8.6 6.2 6.4 7.4 7.4 7.5 6.5 5 7.4 6.6 6.5 5.7 4.2 6.4 6. 7.2 5.5 4.1 5.7 5.5 22 23 24 26 28 29 21 211 212 213 214 215 11 Data source: Community Health Survey, 22-215. Analysis by Montefiore OCPH. Data restricted to those that indicated they are current smokers.
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 9 8 83.9 7 69 6 5 4 3 29.9 2 15.1 1 23 24 25 26 27 28 29 21 212 213 214 215 12 Data source: Community Health Survey, 22-215. Analysis by Montefiore OCPH. Results restricted to current smokers whose most recent cigarette smoked was from a carton, pack or single/loosie.
Percent of Respondents Reporting Quit Attempts Quit Attempts were consistent across all five boroughs between 22 and 213 8 75 Bronx Brooklyn Manhattan Queens Staten Island Quit attempts defined as an attempt to quit smoking for 24 hours or longer during the past year 7 65.6 65 63.7 6 55 5 22 23 24 25 26 27 28 29 21 211 212 213 13 Data source: Community Health Survey, 22-215. Analysis by Montefiore OCPH. Data not collected after 213.
Tobacco Retailer Rate per 1, 3 of 1 community districts with highest tobacco retailer rates are in the Bronx 64 32 16 Bronx 11 Highest: Midtown 8 NYC 11 21 Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights 28 25 26 24 23 27 212 211 29 21 4 2 26 Belmont & East Tremont 21 22 27 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 18 16 14 12 1 8 8 9 9 1 1 1 12 12 13 16 16 17 6 4 2 14 Data source: NYC Community Health Profiles.
15 Youth Smoking
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 25 22.7 Bronx Brooklyn Manhattan Queens Staten Island Bronx Staten Island 2 15 16.2 14.3 13.8 13 1.6% decrease 15.4% decrease 1 5 7.4 5.9 5.3 3.2 23 25 27 29 211 213 215 16 Data source: Youth Risk Behavior Survey, 23-215. Analysis by Montefiore OCPH. Current smoker is defined as smoking at least one or more times in the previous 3 days.
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 1.6 8 7.3 7.4 6 5.9 5.3 5.5 4 3.2 3.4 2.9 2.7 3.5 3.3 3.1 3.2 2 1.8 1.7 17 Data source: Youth Risk Behavior Survey, 215. Analysis by Montefiore OCPH. Age results not age-adjusted.
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 16 15.2 Male Female 14 12 12.5 1 8 6 4 2 3.4 2.9 23 25 27 29 211 213 215 18 Data source: Youth Risk Behavior Survey, 23-215. Analysis by Montefiore OCPH. Current smoker is defined as smoking at least one or more times in the previous 3 days.
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 14 12 13.8 Heavy Smokers Current Smokers 1 8 6 11% increase 26% decrease 4 3.2 2 23 25 27 29 211 213 215 19 Data source: Youth Risk Behavior Survey, 23-215. Analysis by Montefiore OCPH. Data is age-adjusted. Heavy Smoker results restricted to students who smoked in the past 3 days.
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 23 215 24.6 35.2 Purchased from a Store From Someone Other 33.5 35.4 Purchased from a Store From Someone Other 4.1 31.1 2 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 Health Consequences of Tobacco Use
22 Lung Cancer
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, 29-213 9 Males Females 8 8.3 7 65.1 64.1 6 55.6 59.6 59.5 5 47.2 4 41.2 39.4 39.7 3 2 1 Bronx Brooklyn Manhattan Queens Staten Island 23 Data source: New York State Cancer Registry, 29-213. Analysis by Montefiore OCPH. Data is age-adjusted.
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 1 8 89.4 6 55.7 4 38.6 2 22.8 24 Data source: New York State Cancer Registry, 1976-213. Analysis by Montefiore OCPH. Data is age-adjusted.
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 6 56.4 5 4 3 2 43.4 41.4 39.8 43.3 32.3 29.6 28.7 27.1 1 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 25 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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 7 6 62.2 5 4 44.3 3 2 3.7 24.8 1 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 26 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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 25 247.9 217.7 2 15 138.1 1 66.8 5 24.8 44.3 16.2 36.1 42.1 23.2 27 Female Male 45-54 55-64 65-74 75-84 85+ 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
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 6 55.4 5 4 3 26.5 45.3 28.9 42.1 36.1 18.9 2 23.2 1 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 28 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
29 Chronic Lower Respiratory Disease
Chronic obstructive pulmonary disease (COPD) is the largest contributor to chronic lower respiratory disease mortality in the Bronx 15.1 1.4 3.4 Chronic obstructive pulmonary disease Bronchitis and Bronchiectasis Emphysema Asthma (including Status Asthmaticus) 8.1 3 Data source: Underlying Cause of Death, 213-215. Analysis by Montefiore OCPH. Bronchitis sub-categories grouped due to unstable data.
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 4 35 3 25 27.7 26.9 2 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 31 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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 4 35 3 34.9 33.1 25 2 24.1 23.5 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 32 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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, 45 435.3 4 35 3 25 2 27.6 15 1 5 23.5 33.1 11.5 35 Female Male 45-54 55-64 65-74 75-84 85+ Non- Hispanic Black 77.5 22.6 31.2 24.8 Non- Hispanic White Hispanic 33 Data source: Underlying Cause of Death, 215. Analysis by Montefiore OCPH. Age group data is not age-adjusted.
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 4 35 34.5 31.2 3 25 26 12.4 24.8 8.6 2 22.1 22.6 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 34 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
Avoidable Child Asthma Hospitalization Rate per 1, 6 of 1 community districts with highest avoidable child asthma hospitalization rates are in the Bronx 12 1 8 6 Bronx 72 21 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 28 25 26 24 23 27 21 22 212 211 29 21 4 2 NYC 36 12 1 8 74 74 87 88 89 112 6 4 3 39 51 55 55 59 2 35 Data source: NYC Community Health Profiles.
Age-Adjusted Avoidable Asthma Hospitalizations per 1, 6 of 1 community districts with highest asthma hospitalization rates are in the Bronx 8 7 6 5 Bronx 58 21 Mott Haven & Melrose 22 Hunts Point & Longwood 23 Morrisania & Crotona 24 Highbridge & Concourse 25 Fordham & University Heights 28 27 25 26 24 23 212 211 29 21 4 3 2 NYC 249 26 Belmont & East Tremont 27 Kingsbridge Heights & Bedford 21 22 1 28 Riverdale & Fieldston 29 Parkchester & Soundview 21 Throgs Neck & Co-op City 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester 9 8 7 6 5 452 51 57 571 596 619 749 769 786 4 3 2 192 235 329 1 36 Data source: NYC Community Health Profiles.
Cardiovascular Disease Chronic Heart Disease Includes: Stroke/Cerebrovascular disease Heart attack/myocardial infarction 37
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 3 29.3 25 22.7 2 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 38 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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 35 3 34.9 25 25.8 25.3 2 2.4 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 39 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
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, 45 4 35 3 25 2 15 1 5 2.4 25.3 13.6 26.6 49.9 177.4 48.7 Female Male 45-54 55-64 65-74 75-84 85+ Non- Hispanic Black 24.2 2.8 21.7 Non- Hispanic White Hispanic 4 Data source: Underlying Cause of Death, 215. Analysis by Montefiore OCPH. Age grouped data is not age-adjusted.
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 35 35.1 3 26.6 1 25 2 25.1 24.2 21.7 2.8 3.4 15 1 5 2 21 22 23 24 25 26 27 28 29 21 211 212 213 214 215 41 Data source: Underlying Cause of Death, 2-215. Analysis by Montefiore OCPH. Data is age-adjusted.
42 Diabetes
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 14 14 Bronx Miami-Dade San Bernardino 12 12.3 1.5 1.7 12 Bexar (TX) Dallas Los Angeles 12.3 1 8 6.9 8.6 7.2 9.3 9. 9.6 9. 1 8 8.8 6 4 6 2 4 2 Bronx: +4% Peer Counties Average: +31% 24 25 26 27 28 29 21 211 212 213 43 Data source: United States Diabetes Surveillance System, Division of Diabetes Translation, CDC. Data not comparable to NYC CHS data presented elsewhere.
18-24 25-44 45-64 65+ 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 215 4 35 3 36.1 25 23.4 2 15 1 14.7 15.4 17.4 14.5 8.8 18.9 15.6 12.3 1.3 5.8 4.6 Not age-adjusted 44 Data source: New York City Community Health Survey, 22-215. Analysis by Montefiore OCPH.
Age- Adjusted Mortality Rate per 1, Diabetes Mortality Rate has fallen by 1 percentage points over the last 15 years in the Bronx 45 4 36.8 Bronx NYC Excluding Bronx 5 45 44.9 Bronx NYC Excluding Bronx Miami-Dade San Bernadino Bexar (TX) Dallas Los Angeles 35 3 25 2 15 2.2 26.9 19 4 35 3 25 2 15 36.8 3.3 26.9 26.8 24.9 25.4 22.1 22.7 21.2 2.2 19 18 33.1 1 1 5 5 45 Data source: Underlying Cause of Death, 1999-215. Analysis by Montefiore OCPH.
Age-Adjusted Mortality Rate per 1, 5 Males have a higher diabetes mortality rate, adjusting for age in the Bronx Male Female 5 45-54 55-64 65-74 75-84 85+ 45 43 45 4 35 33 35.6 4 35 3 3 25 2.7 25 2 2 15 15 1 5 Bronx Diabetes Mortality Rates from 27-215 for Females are divergent from national trends 1 5 46 Data source: Underlying Cause of Death, 1999-215. Analysis by Montefiore OCPH.
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