To Serve our Communities We Must Understand Them

The 2015 New York City community health profiles produced by the New York City Department of Health and Mental Hygiene are an essential tool in understanding and improving the health of New Yorkers. As Dr. Mary Bassett, Commissioner, explains in the introduction to the profiles “…longstanding and rising income inequality, combined with a history of racial residential segregation, has let to starling health inequities between neighborhoods.  Poor health outcomes tend to cluster in places that people of color call home and were many residents live in poverty.”

As of today, the Department of Health has produced 18 profiles for Brooklyn, 12 profiles in Manhattan, 3 profiles in Staten Island and 14 profiles in Queens. The Bronx will be released soon.

While there is an immense amount of information in the reports, we want to focus on two neighborhoods that both include NYC Hospitals – the Coney Island Profile  and the East Flatbush profile in Brooklyn.   Coney Island, which includes the neighborhoods of Coney Island, Brighton Beach, Gravesend, Homecrest, Sea Gate and West Brighton, also includes Coney Island Hospital.  The profiles address everything from housing quality and air pollution to income and incarceration rates as well as leading mortality indexes.   The profiles make the point that we have to look beyond traditional health outcomes to understand the health of the community.  For example Coney Island “ranks six lowest citywide in terms of supermarket space.” Income is a particularly important way of understanding the neighborhood health.  According to the Profile “Living in poverty limits healthy lifestyle choices and makes it difficult to access health care and resources that can promote health and prevent illness….One way to consider the effect of income on health is by comparing death rates among neighborhoods.  Assuming that the death rates from the five neighborhoods with the highest incomes are achievable in Coney Island, it is estimated that 26% of deaths could have been averted.“(emphasis in original)  (For some more thoughts on health disparities, where you live and a call for health justice, see our previous blog.)  Finally, in Coney Island the preterm birth rate at 11.3% of all live births is higher than the city average of 9 and the Brooklyn average of 8.8.   The East Flatbush profile which includes the neighborhoods of East Flatbush, Eramus, Farragut, Northeast Flatbush, Remsen Village and Rugby has a total population of 156,151 and is 89% black.  The preterm birthrate at 13.8 is the highest in the city.  The rate of non-fatal assault hospitalizations is 85 per 100,000, higher than the Brooklyn average of 66. Impressively, East Flatbush has the lowest rate of percentage of current smokers in the city. Dr. Turkmen, an OB/GYN physician and Doctors Council Member at Coney Island Hospital reacting to the information explained that “we have to reach out to the community and let them know that whatever your immigration status and whether you have insurance or not we will take care of you.” Producing the data is an important step.  The real question is how health professionals and the community itself can use this data.  As a first step we want to make sure that all our members have access to this data so they can understand the communities they serve.