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Health of the City 2018 2 Health of the City 2018

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Health of the City 2018 2 Health of the City 2018 PHILADELPHIA’S COMMUNITY HEALTH ASSESSMENT HEALTH OF THE CITY 2018 2 HEALTH OF THE CITY 2018 TABLE OF CONTENTS INTRODUCTION ............................. 2 Behavioral Health............................ 11 CLINICAL CARE ............................ 30 About Philadelphia............................ 3 Infectious Health Conditions .......... 14 PHYSICAL ENVIRONMENT .......... 34 HEALTH OUTCOMES ...................... 4 Infant and Child Health .................. 18 SOCIAL & ECONOMIC Summary Health Measures .............. 4 Injuries ............................................ 22 DETERMINANTS .......................... 37 Chronic Health Conditions ................7 HEALTH BEHAVIORS ................... 26 ACKNOWLEDGMENTS ................. 43 INTRODUCTION Health is infl uenced by many factors, including social and economic conditions, the built environment, accessibility of healthy products, the behavioral choices people make, and the medical care system. Health of the City describes the health and well-being of people who live in Philadelphia. The Philadelphia Department of Public Health produces this annual report to help health care providers, city offi cials, people who make decisions for non-governmental organizations, and individual residents make more informed decisions about health. Health of the City includes summaries of data from various sources to describe the demographics of the city’s residents as well as health outcomes and key factors that infl uence health in fi ve broad areas: 1 2 3 4 5 HEALTH HEALTH CLINICAL PHYSICAL SOCIAL AND OUTCOMES BEHAVIORS CARE ENVIRONMENT ECONOMIC represent how healthy include behaviors encompasses both includes air quality DETERMINANTS Philadelphians are, that directly impact access to and quality and access to include education, including measures health, such as of preventive, primary, housing and employment, income of quality of life, rates nutrition, exercise, and acute care. transportation. and community of infectious and tobacco and drug safety. chronic illnesses, and use, and sexual premature death. activity. HEALTH OF THE CITY 2018 3 ABOUT PHILADELPHIA THE SIXTH LARGEST CITY POPULATION BY AGE GROUP | 2017 Philadelphia is the sixth largest city 0-4 5-9 in the United States (behind New 10-14 York City, Los Angeles, Chicago, 15-19 20-24 Houston, and Phoenix), with an 25-29 estimated population of 1,580,863 30-34 35-39 in 2017. Philadelphia’s young adult 40-44 45-49 population (ages 20 to 34 years) 50-54 continued to grow and represented 55-59 60-64 the largest portion of the population. 65-69 70-74 75-59 80-84 85+ 15% 10% 5% 0% 5% 10% 15% SOURCE: 2017 American Community Survey Estimates, U.S. Census Bureau MALE FEMALE A DIVERSE CITY POPULATION BY RACE/ETHNICITY | 2017 Philadelphia is racially and ethnically 41% 35% 15% 8% 2% diverse – 41 percent non-Hispanic black, 35 percent non-Hispanic white, 15 percent Hispanic, and 8 percent WHITE ASIAN OTHER BLACK Asian. Yet, Philadelphia continued to HISPANIC be segregated along racial lines, with one race or ethnic group representing the majority in 84 percent of the city’s 381 census tracts. SOURCE: 2017 American Community Survey Estimates, U.S. Census Bureau FORTY-EIGHT ZIP CODES PHILADELPHIA ZIP CODES POPULATION BY PLANNING AND EIGHTEEN PLANNING AND PLANNING DISTRICTS DISTRICTS | 2017 UPPER FAR DISTRICTS NORTHEAST 65,824 LOWER FAR NORTHESAT Philadelphia consists of forty- CENTRAL 69,905 NORTHEAST LOWER UPPER NORTHWEST 84,634 eight zip codes and eighteen NORTHWEST 84,013 UPPER 52,765 NORTH 155,100 planning districts representing LOWER NORTH DELAWARE NORTHEAST 105,560 92,209 distinct economic, geographic, NORTH 139,780 and social units. WEST PARK LOWER RIVER 44,707 71,168 NORTH WARDS 91,603 Ɲ44,707 WEST CENTRAL 112,437 Ɲ UNIVERSITY/ 80,645 123,803 SOUTHWEST Zip Codes Ɲ SOUTH Planning Districts 138,507 Ɲ SOURCE: 2017 American Community Survey LOWER LOWER SOUTH 5,835 Estimates, U.S. Census Bureau SOUTHWEST 41,443 Ɲ 4 HEALTH OF THE CITY 2018 SUMMARY HEALTH MEASURES Measuring life expectancy and examining trends in causes of death show how people are dying, who is dying prematurely and how these deaths may be prevented. After improving for more than a decade, life expectancy in Philadelphia and nationally has started to decline for many groups. Increases in premature mortality due to drug overdoses and homicides are the primary causes. Increases in chronic conditions and other poor health behaviors are likely to further reverse the trend. HEALTH MOST RECENT POPULATIONS WITH CHANGE IN ESTIMATE POORER OUTCOMES RECENT YEARS DEATHS OUTCOMES (ALL CAUSES) 857.2 per >> IMPROVING 100,0001 Despite experiencing one of the worst public health crises of our time — the YEARS OF POTENTIAL LIFE LOST BEFORE AGE 75 opioid epidemic — most key health indicators in Philadelphia continued 9,900.8 Non-Hispanic blacks << WORSENING 1 to improve over the last year. Yet, some years health indicators have moved in the wrong direction and Philadelphia’s health LIFE EXPECTANCY (MALES) signifi cantly lags behind other major cities. Also, many disparities in key 72.4 Non-Hispanic blacks << WORSENING years1 health outcomes and behaviors persist particularly for racial/ethnic minorities LIFE EXPECTANCY and those experiencing poverty. The (FEMALES) following sections provide more details. 79.3 << WORSENING years1 ADULTS SELF-REPORTING POOR OR FAIR HEALTH 2 22% Hispanics; NO CHANGE Non-Hispanic blacks SOURCE: 1 2017 Preliminary Vital Statistics Report, PDPH 2 2017 PA Behavioral Risk Factor Surveillance System HEALTH OF THE CITY 2018 5 SUMMARY HEALTH MEASURES OVERALL MORTALITY DEATH RATE | 2006–2017 In 2017, an estimated 15,776 1,200 Philadelphia residents died. CITYWIDE 857.2 100,000) 1,000 Heart disease, cancer and 959.3 BLACK unintentional injuries were the 800 848.6 WHITE leading causes of death. 695.5 HISPANIC 600 400 305.9 ASIAN 200 AGE-ADJUSTED DEATH RATE (PER (PER RATE DEATH AGE-ADJUSTED 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 LEADING CAUSES OF DEATH IN PHILADELPHIA | 2017 Heart disease 3,472 Cancer 3,021 Drug overdoses 1,041 Cerebrovascular diseases 714 Chronic respiratory diseases 558 Diabetes mellitus 374 Chronic kidney disease 354 Septicemia 349 Unintenional Injuries 331 Homicide 322 0 500 1000 1500 2000 2500 3000 3500 SOURCE: 2007-2017 Vital Statistics, PDPH NUMBER OF DEATHS PREMATURE DEATHS YEARS OF POTENTIAL LIFE LOST BEFORE AGE 75 BY RACE/ETHNICITY | 2006–2017 Premature deaths are those 20,000 that occur before age 75. As CITYWIDE 9,901 many of these deaths may 15,000 be preventable, estimating the years of potential life lost 12,311 BLACK (YPLL) is a key measure of 10,000 9,296 WHITE YEARS Philadelphia’s health. From 2000 7,911 HISPANIC to 2014 YPLL declined, reaching 5,000 a low of 9,004 years in 2014. In 2015, this trend reversed 2,471 ASIAN and has continued to increase 0 due to increasing deaths from 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 drug overdoses and homicides among young adults. SOURCE: 2007-2017 Vital Statistics, PDPH 6 HEALTH OF THE CITY 2018 SUMMARY HEALTH MEASURES LIFE EXPECTANCY LIFE EXPECTANCY BY RACE AND SEX Similarly, life expectancy 100 98.0 at birth in men and women 80 88.2 84.9 increased until 2014 and 79.7 79.6 77.9 72.4 73.8 74.7 declined in recent years. 60 69.1 Non-Hispanic Asians had the highest life expectancy overall. YEARS 40 Life expectancy at birth was 20 shortest among non-Hispanic black men at 69.1 years. 0 Citywide White Black Asian Hispanic (Non-Hispanic) (Non-Hispanic) (Non-Hispanic) Male Female SOURCE: 2017 Preliminary Vital Statistics, PDPH Life expectancy varies LIFE EXPECTANCY BY CENSUS TRACT considerably by neighborhood in Philadelphia. Life expectancy was lowest in communities with high rates of adverse behavioral and economic determinants, including poverty, substance use/abuse, and community violence. SOURCE: U.S. Small-area Life Expectancy Estimates Project 64.3 87.08 (USALEEP): Life Expectancy Estimates File, National Center for Health Statistics via City Health Higher values (lighter colors) Dashboard indicate greater life expectancy SELF-REPORTED HEALTH SELF-REPORTED POOR OR FAIR HEALTH STATUS 40% 35% While life expectancy indicates 36.2% how long people are living, 30% self-reported health status 25% 25.2% provides a measure of quality 20% 15% of life. Overall, 22 percent of 16.0% Philadelphians rated their health 10% as poor or fair. There were 5% 7.0% 0 signifi cant differences among White Black Hispanic Asian racial/ethnic groups with rates being highest among Hispanics. SOURCE: 2015-2017 PA Behavioral Risk Factor Surveillance System HEALTH OF THE CITY 2018 7 CHRONIC HEALTH CONDITIONS MOST RECENT POPULATIONS WITH CHANGE IN ESTIMATE POORER OUTCOMES RECENT YEARS OBESITY IN CHILDREN (AGES 5 – 18) Six of the leading causes of 1 21.9% Hispanic boys; << WORSENING death in Philadelphia are Non-Hispanic black girls related to chronic health conditions: heart disease, OBESITY IN ADULTS cancer, cerebrovascular disease, 2 35.0% Non-Hispanic blacks; << WORSENING chronic respiratory disease, Hispanics diabetes, and chronic kidney disease. These conditions often HYPERTENSION IN ADULTS signifi cantly reduce quality 2 33.0% Non-Hispanic blacks << WORSENING of life and life expectancy, and lead to disability and DIABETES IN ADULTS high health care costs. Many 2 12.0% Non-Hispanic blacks NO CHANGE factors, particularly poor health behaviors and lack of access CANCER INCIDENCE to care, contribute to these 502.5 >> IMPROVING conditions, resulting in varying per 100,0003 rates among the population.
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