Upper West Side New York City Is the Most Diverse City in the U.S

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Community New York City Department of Health and Mental Hygiene Health SECOND EDITION — 2006

Profiles nyc.gov/health

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W 57 TH ST Manhattan Community Health Profile, Second Edition: The Upper West Side New York City is the most diverse city in the U.S. — a fact reflected in the distinct character of each neighborhood. The second edition of the Community Health Profiles uses Take Care New York (TCNY), the city’s health policy, to examine preventable causes of illness and death in all of NYC’s 42 neighborhoods. This report updates the 2002 profile (available at nyc.gov/health) by providing more recent and time-trend data, and a greater variety of health statistics. Key health issues on the Upper West Side include: ■ Cancer is the primary cause of premature death on the Upper West Side (page 4). ■ Adults on the Upper West Side are more likely to binge drink than adults in NYC overall (page 10). ■ Flu and pneumonia are the third leading cause of death on the Upper West Side, and the death rate due to flu and pneumonia has risen higher than the NYC overall rate in the past 10 years (page 14).

Methods: While this report provides important information, it is not intended to be an exhaustive examination of the health of Upper West Side residents, as not all health problems and their causes could be covered. Only statistically significant findings are discussed in the text. For complete information on methods, see Technical Notes (page 15).

The Upper West Side at a Glance Population Age Poverty Total number of People on the Upper West Side are slightly older than in On the Upper West Side, the percent of people living on New York City overall residents living below the poverty level is the Upper West lower than in Manhattan and NYC overall Side in 2000: Upper West Side Manhattan NYC 50 13% 222,100 0-17 years 17% 24% 40 s

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18-24 years 10% 10% n 40% e d

25-44 years 38% 33% i 25% s 30 45-64 years 23% 21% e r

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65+ years 12% 12% o 20

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P 10 Education Upper West Side residents aged 25 and older have completed more years of 0 education than those in Manhattan and NYC overall Upper West Manhattan New York City Side Upper West Side Manhattan NYC Foreign-born Up to 8th grade 5% 10% 12% The percent of Upper West Side residents 5% Some high school, no diploma 11% 16% born outside the U.S. is lower than in 9% High school diploma 14% 25% Manhattan and NYC overall Some college, no degree 13% 16% 20% College graduate 68% 49% 27% Upper West Side Manhattan NYC 22% 29% 36%

Race / Ethnicity Upper West Side Manhattan NYC

The Upper West Side has Other 3% Asian 9% Other 3% Other 4% Asian 6% a higher proportion of Asian 10% White 35% Black 9% white residents than Black Black 15% Manhattan and NYC Hispanic 16% White 46% 24% overall White 66% Hispanic 27% Hispanic 27%

Data Source: U.S. Census 2000/NYC Department of City Planning

2 T AKE CARE UPPER WEST SIDE Take Care Upper West Side

In 2004, the Health Department created a citywide health policy called Take Care New York (TCNY) to help improve the health of New Yorkers. TCNY identifies 10 key areas that cause significant illness and death but can be improved through intervention by individuals, health care providers, government agencies, and other organizations. This report examines how well Upper West Side residents are doing on health indicators for each of the 10 TCNY goals. It examines areas in which the community is a health leader, as well as areas that need improvement. The TCNY report card below shows where the Upper West Side ranks among all 42 New York City neighborhoods. (See Technical Notes for information about how neighborhoods were defined and ranked.)

Take Care New York report card The Upper West Side ranks as average or above on all the indicators when compared to the 41 other NYC neighborhoods

Below Average (bottom 10) Average (middle 22) Above Average (top 10) Take Care New York Goals

1 Have a regular doctor ✓ 2 Be tobacco-free ✓ 3 Keep your heart healthy ✓ 4 Know your HIV status ✓ 5 Get help for depression ✓ 6 Live free of alcohol and drugs ✓ 7 Get checked for cancer ✓ 8 Get the immunizations you need ✓ 9 Make your home safe and healthy ✓ 10 Have a healthy baby ✓

How Residents Rate Their Own Health Overall health Adults on the Upper West Side are less likely to consider People are good at rating their own health. In general, themselves to be in fair or poor health 40 when asked to rate their general health as excellent, very good, good, fair, or poor, those who say “fair” or “poor” are ) +

8 30 more likely to have health problems than those who report 1 (

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f On the Upper West Side, residents are less likely to report o

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e 11 being in fair or poor health (11%) than those in c r 10 e

P Manhattan (18%) and in New York City overall (21%).

0 Upper West Side Manhattan New York City

Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

TAKE CARE UPPER WEST SIDE 3 Overall Death Rates on the Upper West Side

Death rates On the Upper West Side, death rates have decreased in The death rate on the Upper West Side has decreased by the past 10 years 15% in the past decade, mirroring the rate drop in New 1000 York City overall. e l 800 p In 2003-2004, the average annual death rate on the Upper o e p

0 West Side was similar to the Manhattan rate and slightly

0 600 0 ,

0 lower than in New York City overall (669/100,000 vs. 0 1

e 400 697/100,000 in Manhattan and 718/100,000 in NYC). p

s Upper West Side h Throughout this profile, cause-specific death rates are t

a Manhattan e 200 D New York City provided for TCNY goals.

0 Line graphs. All time-trend data are presented as annual 1995-96 1997-98 1999-00 2001-02 2003-04 averages with 2 or 3 years of data combined. For example, in Rates are age-adjusted. this graph, the first point on each line represents the average Data Sources: Bureau of Vital Statistics, NYC DOHMH, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Planning annual death rate for 1995 and 1996 combined.

Premature death People who die before age 75 can be thought of as dying early, or prematurely. If a person dies early, their years of potential life lost (YPLLs) can be calculated by subtracting their age at death from 75 years to get a Death before age 75 measure of premature death. The 2003-2004 average annual death rate for people younger than The causes of premature death differ across communities. The primary cause 75 years on the Upper West Side of premature death on the Upper West Side is cancer, as well as in both ranks 12th among 42 NYC neighborhoods Manhattan and New York City overall. BETTER Top 5 causes of years of potential life lost Cancer causes the most years of potential life lost on the Upper West Side Upper West Side

Other* 35% Cancer 28% Manhattan 2,764 years lost 3,425 years lost NYC

Suicide 5% Heart Disease 17% WORSE 446 years lost 1,669 years lost Drug-related 5% 508 years lost HIV-related 10% Data Sources: Bureau of Vital Statistics, NYC 994 years lost DOHMH, 2003-04; U.S. Census 2000/NYC Department of City Planning

*Other includes Certain Perinatal Conditions (3%), Accidents (3%), Diabetes (2%), Pneumonia and Influenza (2%), Diseases of the Nervous System (2%), and Other (23%).

Data Source: Bureau of Vital Statistics, NYC DOHMH, 2002-04

4 T AKE CARE UPPER WEST SIDE Take Care New York Goals GOAL 1 Have a Regular Doctor or Other Health Care Provider

Access to good medical care helps people prevent illnesses, identify health conditions early, and treat health problems. Some conditions can and should be managed regularly outside the hospital. Higher rates of these avoidable hospitalizations can indicate reduced access to health care in a community. Avoidable hospitalizations Having a “medical home”— a personal doctor or other health care provider and a The 2004 avoidable hospitalization rate on the Upper West Side ranks well regular place of care other than the emergency department (ED) — is a critical (8th) among 42 NYC neighborhoods component of good health care access. On the Upper West Side, 22% of residents do not have a regular doctor, compared to the TCNY goal of less than BETTER 20%. Residents in this community are less likely to go to the ED when they are Upper West sick or need health advice (5%) than those in NYC overall (8%). Side Access to care Without a primary provider, people may seek routine health care in the Manhattan emergency department (ED) NYC 35 TCNY Target: <20% by 2008 Upper West Side 30

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0 No personal doctor1 Go to ED when sick or need health advice2 Percents are age-adjusted. Data Sources: 1NYC Community Health Survey 2002-03-04, 2NYC Community Health Survey 2003-04

Health insurance One in 5 adults on the Upper West Side is uninsured or went without Health insurance is important for health insurance during the past year access to health care. Residents on the 100 Upper West Side are less likely to be Insured now, and for )

4 80 entire past year uninsured (10%) than adults in New 6 -

8 Insured now, but 1

( York City overall (18%). In addition uninsured some time s 81 78 71 t 60 l in past year u to the currently uninsured, another d a

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Insurance rates are calculated for adults aged 18-64 and age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

TAKE CARE UPPER WEST SIDE 5 GOAL 2 Be Tobacco-Free Smoking is the leading cause of preventable death in New York City and the cause of many illnesses, including heart disease, stroke, emphysema, and lung cancer. Upper West Side residents are less likely to be current smokers than adults in NYC overall (11% vs. 18%). Many methods to quit smoking are available, and 8 in 10 smokers on the Upper West Side (80%) are trying to kick the habit. Residents who smoke Attempts to quit smoking in the past year Adults on the Upper West Side are less likely to smoke Most smokers are trying to quit than adults in NYC overall 50 100 ) +

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Percents are age-adjusted. Percents are age-adjusted. Data Source: NYC Community Health Survey 2004 Data Source: NYC Community Health Survey 2004

GOAL 3 Keep Your Heart Healthy Heart disease can cause severe illness and death. Upper West Side residents had an average annual heart disease hospitalization rate in 2003-2004 that was 10% lower than the Manhattan rate and 25% lower than the rate in NYC overall (1,335/100,000 vs. 1,489/100,000 in Manhattan and 1,856/100,000 in NYC). However, the heart disease hospitalization rate in this community has increased by more than 15% in the past decade. In contrast, the heart disease death rate has decreased by more than 20% in the past 10 years, and the 2003-2004 rate (246/100,000) was similar to the rate in Manhattan (234/100,000) and slightly lower than the NYC overall rate (297/100,000). Heart disease hospitalizations Deaths due to heart disease The heart disease hospitalization rate has increased but Death due to heart disease is less common on the remains lower on the Upper West Side Upper West Side than in NYC overall 3000 400 s t l u d

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500 D Manhattan p Manhattan s o New York City New York City H 0 0 1995-96 1997-98 1999-00 2001-02 2003-04 1995-96 1997-98 1999-00 2001-02 2003-04 Rates are age-adjusted. Data Sources: New York State Department of Health Statewide Planning and Research Rates are age-adjusted. Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Data Sources: Bureau of Vital Statistics, NYC DOHMH, 1995-2004; Planning U.S. Census 1990 and 2000/NYC Department of City Planning

High blood pressure and high cholesterol. Both of these conditions contribute to heart disease. On the Upper West Side, 22% of adults were told by a health care professional that they have high blood pressure (similar to 22% in Manhattan and 26% in NYC overall), and one quarter (24%) were told that they have high cholesterol (similar to 27% in Manhattan and 26% in NYC overall). Percents are age-adjusted. Data Source: NYC Community Health Survey 2002

6 T AKE CARE UPPER WEST SIDE Obesity Adults on the Upper West Side are less likely to be In addition to smoking, high blood cholesterol and high blood obese 30 pressure, other factors that put people at risk for heart disease — lack of physical activity and obesity — can be prevented or controlled. 25 ) +

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0 (20%). Upper West Side Manhattan New York City

Obesity is defined as a body-mass-index (BMI) of 30 or greater. Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

Diabetes Adults on the Upper West Side are less likely to The increasing prevalence of obesity in the U.S. has contributed to an have diabetes than in NYC overall 30 epidemic of diabetes. About 95% of diabetes cases are type 2 diabetes, which is strongly associated with obesity. Uncontrolled diabetes can 25 ) +

8 worsen the harmful effects of high blood pressure, high cholesterol, 1 ( 20 s t

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n 10 9 e 7 c New York City overall (5% vs. 9%). r

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Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

Days per week of recreational exercise Exercise habits on the Upper West Side are more healthy compared to Physical activity helps people maintain a New York City overall healthy weight and strengthens the

Upper West 25 20 34 21 cardiovascular system. Upper West Side Side residents are less likely to report doing no physical activity than residents in NYC overall Manhattan 32 17 28 23 (25% vs. 43%). Also, more than half of residents in this community (55%) report New York 43 15 23 19 City exercising at least 3 days a week.

0 20 40 60 80 100 Centers for Disease Control and Prevention Percent of adults (18+) Recommendations 0 days 1-2 days 3-4 days 5-7 days Adults should do either 20 minutes of vigorous

Survey Question: On average, how many days per week do you exercise for at least 30 minutes? exercise 3 times per week or 30 minutes of Percents are age-adjusted. moderate exercise 5 times per week. Data Source: NYC Community Health Survey 2003

TAKE CARE UPPER WEST SIDE 7 GOAL 4 Know Your HIV Status Wide disparities exist in HIV across New York City communities. On the Upper West Side, the rate of HIV diagnoses (32/100,000) is lower than both the Manhattan and NYC overall rates. The rate of people living with HIV/AIDS in the community is lower than the Manhattan rate but higher than the rate in NYC overall. The death rate due to HIV disease has dropped by 80% during the past decade in HIV/AIDS in 2004 this community. In 2003-2004, the average annual HIV-related death rate on the Total HIV diagnoses Upper West Side was slightly lower than the Manhattan rate and similar to the per 100,000 people* (13+) NYC overall rate (15/100,000 vs. 22/100,000 in Manhattan and 18/100,000 in Upper West Side 32 NYC). Manhattan 69 New York City 55 Death rate due to HIV % HIV diagnosed concurrently HIV-related death rates on the Upper West Side have dropped dramatically in the with AIDS** (13+) past decade 120 Upper West Side 15% Manhattan 23%

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p New York City 29% o

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TCNY Target: <12 per 100,000 by 2008

0 People living with HIV/AIDS 0 New York City 0

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Upper West Side 1,450 r e p

Manhattan 2,102 s h

t 30 New York City 1,419 a

e Rates are age-adjusted. D Data Sources: Bureau of Vital *Rates are age-adjusted. Statistics, NYC DOHMH, 1995-2004; **Within 31 days of HIV diagnosis — crude percents 0 U.S. Census 1990 and 2000/NYC Data Source and Analysis: HIV Epidemiology Program, NYC DOHMH, 2004 1995-96 1997-98 1999-00 2001-02 2003-04 Department of City Planning

HIV/AIDS testing and prevention Everyone should know their HIV status. However, an estimated one quarter of New Yorkers living with HIV do not know they are infected, delaying treatment and increasing the risk that they will transmit the disease to others. Only about one fifth of Upper West Side residents (22%) have been tested for HIV in the past year. In addition, 15% of positive HIV test results are “late” diagnoses (HIV has already progressed to AIDS) on the Upper West Side. The most common way people get HIV is through sexual contact, and having multiple sex partners increases the risk of HIV. Condoms offer protection from HIV when engaging in sexual activities. Only one third (33%) of Upper West Side adults who had more than 1 sex partner in the past year reported using a condom at their last sexual encounter. HIV testing Condom use at last sexual encounter Only about 1 in 5 Upper West Side adults has had an HIV Only 1 in 3 Upper West Side adults with multiple sex test in the past year partners used a condom 50 50

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0 0 Upper West Manhattan New York City Upper West Manhattan New York City Side Side Analysis limited to adults aged 18-64 who reported having >1 sex partner in the Percents are age-adjusted. past year, excluding women who reported having sex only with women. Data Source: NYC Community Health Survey 2003 Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

8 T AKE CARE UPPER WEST SIDE GOAL 5 Get Help for Depression Psychological distress One in 20 adults on the Upper West Side suffers Depression is a serious but treatable health condition that from serious psychological distress 10 frequently goes undiagnosed. Serious psychological distress is associated with depression and other mental illnesses.

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0 Upper West Side Manhattan New York City

Serious psychological distress can be identified in individuals using Kessler’s K6 scale, a validated measure consisting of 6 simple questions about mood. Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03

Mental illness Hospitalizations for mental illness are lower on the Hospitalization rates are one way to look at serious mental Upper West Side illness in a neighborhood. Residents on the Upper West 1500 Side have had a lower mental illness hospitalization rate

0 1200 0 over the past 10 years (excluding alcohol- or drug-related , 0 0 1

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p mental illness hospitalizations (613/100,000) was more s 300 o Manhattan H than 35% lower than the Manhattan rate (1,011/100,000) New York City 0 and 25% lower than the rate in New York City overall 1995-961997-98 1999-00 2001-02 2003-04 (813/100,000). Rates are age-adjusted. Data Sources: New York State Department of Health Statewide Planning and Research Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Planning

Understanding hospitalizations and access to health care. Hospitalization data are useful in understanding the burden that certain conditions place on the health care system, but not necessarily in measuring the exact extent of illness in a community. Variations in hospitalization rates may reflect not only differences in rates of illness, but also differences in access to health care. For example, the kinds of health institutions available to residents differ by community, as might the ability of residents to pay for those resources. If a community has a specialized residential institution for a certain type of disease, such as mental illness or stroke, people from outside that neighborhood may come to reside at this institution for care, resulting in an increase in reported hospitalizations for that disease in the community.

TAKE CARE UPPER WEST SIDE 9 GOAL 6 Live Free of Dependence on Alcohol and Drugs Binge drinking Upper West Side adults are more likely to engage in binge The abuse of alcohol and drugs can lead to many drinking in the past month than adults in NYC overall 25 preventable injuries, illnesses, and deaths, including injury in motor-vehicle crashes, liver disease, and violence.

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u alcohol-related problems, such as alcohol-poisoning, injury d a

f and violence. Adults are more likely on the Upper West o 10 t n

e Side than in NYC overall to report engaging in at least one c r e

P 5 episode of binge drinking (defined as consuming 5 or more drinks on one occasion) in the past month. 0 Upper West Side Manhattan New York City Alcohol-related hospitalizations reflect both acute and Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04 chronic (e.g., liver disease) consequences of alcohol abuse. The alcohol-related hospitalization rate on the Upper West Alcohol-related hospitalizations Side has decreased slightly in the past decade. In 2003-2004, The alcohol-related hospitalization rate is lower on the the average annual alcohol-related hospitalization rate in this Upper West Side community was lower than in Manhattan and in New York 1000 Upper West Side City overall (290/100,000 vs. 595/100,000 in Manhattan

0 Manhattan 0 800 and 439/100,000 in NYC). 0

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i (595/100,000). p s 200 o H The death rate due to drugs in 2003-2004 was 35% lower on 0 the Upper West Side than in Manhattan overall (6/100,000 1995-961997-98 1999-00 2001-02 2003-04 vs. 11/100,000). Rates are age-adjusted. Data Sources: New York State Department of Health Statewide Planning and Research Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Planning

Drug-related hospitalizations Drug-related death rates The drug-related hospitalization rate has decreased The drug-related death rate is lower on the Upper West Side and remains lower on the Upper West Side than in Manhattan overall 1000 35 s t l u 30 d e a l

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Upper West Side Manhattan New York City Upper West Side Manhattan New York City

Rates are age-adjusted. Data Sources: New York State Department of Health Statewide Planning and Research Rates are age-adjusted. Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Data Sources: Bureau of Vital Statistics, NYC DOHMH, 1995-2004; U.S. Census Planning 1990 and 2000/NYC Department of City Planning

10 T AKE CARE UPPER WEST SIDE GOAL 7 Get Checked for Cancer Cancer screenings Cancer screening are an important part of regular preventive health Cancer screening can save lives by preventing disease, care catching cancer in its early stages and providing 100 TCNY Target: >85% by 2008 87 83 80 80 78 opportunities for treatment. TCNY has set specific

) 80 76 + TCNY Target: >60% by 2008 screening targets for cervical, breast, and colon 8 1 (

63 s 54 cancers. t l 60 u

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f Women on the Upper West Side are more likely to o

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e get regular Pap tests for cervical cancer than women c r e

P 20 in NYC overall (87% vs. 80%). They are also getting mammograms for breast cancer at a rate close to the 0 Cervical cancer Breast cancer screening Colon cancer screening TCNY target of more than 85%. Adults aged 50 and screening (Pap test), (mammogram), past 2 (colonoscopy), past 10 older on the Upper West Side are more likely to have past 3 years (all women)1 years (women 40+)1 years (adults 50+)2 had a colonoscopy in the past 10 years than those in Upper West Side Manhattan New York City

Percents are age-adjusted. NYC overall (63% vs. 47%). Data Sources: 1NYC Community Health Survey 2002 & 2004, 2NYC Community Health Survey 2003-04

Cancer deaths The death rates due to cancer is similar on the Upper West Side, The death rate due to cancer has remained fairly Manhattan, and NYC overall 300 steady on the Upper West Side during the past decade. The 2003-2004 average annual cancer death 250 e l

p rate in this community was similar to both the o e p

200 Manhattan and NYC overall rates (168/100,000 vs. 0 0 0 , 171/100,000 in Manhattan and 161/100,000 in 0 150 0 1

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D 50 New York City Preventing cancer and related deaths. Individuals can reduce their risk of the most common cancers. Never 0 smoking or quitting the habit greatly reduces the risk of 1995-96 1997-98 1999-00 2001-02 2003-04 lung and other cancers. High colon and breast cancer Rates are age-adjusted. death rates highlight the importance of getting Data Sources: Bureau of Vital Statistics, NYC DOHMH, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Planning recommended screenings so treatment can begin early.

The highest cancer-related death rates among men on the Upper West Side are due to lung, prostate, and blood-related (such as lymphoid) cancers. Among women, lung, breast, and blood-related cancers are the top 3 causes of cancer-related death.

Highest cancer death rates on the Upper West Side (2003-2004) MEN WOMEN DEATHS / 100,000 PEOPLE DEATHS / 100,000 PEOPLE

Upper Upper Type of Cancer West Side NYC Type of Cancer West Side NYC

Lung, trachea, bronchus 43 51 Lung, trachea, bronchus 29 28 Prostate 27 25 Breast 27 26 Blood-related 21 18 Blood-related 17 12 Colorectal 17 23 Colorectal 15 17 Pancreas 11 12 Ovary 14 8 Rates are age-adjusted. Data Sources: Bureau of Vital Statistics, NYC DOHMH, 2003-2004; U.S. Census 2000/NYC Department of City Planning

TAKE CARE UPPER WEST SIDE 11 GOAL 8 Get the Immunizations You Need Immunizations Flu shot rates among older adults fall below the TCNY target Immunizations are not just for kids. Of all the deaths that and pneumococcal (pneumonia) immunizations are even lower could have been prevented by vaccination, 99% occur in 100 TCNY Target: >80% by 2008

) adults. Take Care New York has set a target that more + 5

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73 than 80% of adults aged 65 and older will get an annual s 68 t l

u 60 d 60 flu (influenza) shot by 2008. The Upper West Side flu a 53

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f NYC overall but still falls short of the TCNY target by o

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e 20 about 10%. c r e P 0 Immunization rates for pneumonia are lower than those Flu immunization in past year Pneumococcal immunization ever (adults aged 65+) (adults aged 65+) for flu across NYC. Only about half of older adults on the Upper West Side Manhattan New York City Upper West Side have ever received the pneumococcal Data Source: NYC Community Health Survey 2002-03-04 vaccine, which protects against one common cause of pneumonia.

GOAL 9 Make Your Home Safe and Healthy Childhood lead poisoning Lead poisoning among young children continues to be a problem Childhood lead poisoning is a health problem that may 16 14 be associated with decreased intelligence, learning and )

7 14 1

- behavioral problems, and delayed growth and development. 0 (

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h old) in New York City has declined dramatically over the e c t 8 s 0 e 0 t past decade, the Health Department aims to eliminate lead 0

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t paint and other sources of lead.

a 2 R 0 In 2004, 78 children on the Upper West Side (14/1,000) Upper West Manhattan New York City Side were newly identified with lead poisoning (defined as a Lead poisoning is defined as a blood lead level ≥10 µg/dL. Data Source and Analysis: Lead Poisoning Prevention Program, NYC DOHMH, 2004 blood lead level greater than or equal to 10 µg/dL).

Asthma in Adults and Children Asthma Nearly 1 in 20 adults on the Upper West Side suffers Conditions, or “triggers,” in the home environment, such from asthma 16 as the presence of second-hand smoke or dust, can cause 14 asthma attacks. Some housing conditions associated with ) +

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0 Upper West Manhattan New York City Side Percents are age-adjusted. Data Source: NYC Community Health Survey 2002-03-04

12 T AKE CARE UPPER WEST SIDE Neighborhood asthma hospitalization rates depend in part on the percent of residents who have asthma. However, good medical management of asthma can prevent many asthma-related hospitalizations, and patients can work with health care providers to better control their asthma. Thus, the asthma hospitalization rate can also indicate poor access to health care. Asthma hospitalization rates for both adults and children (0-17 years old) on the Upper West Side are lower than in Manhattan and NYC overall. In addition, rates among both adults and children have decreased in the past decade. Adult asthma hospitalizations Child asthma hospitalizations Rates of asthma hospitalization are lower on the The child asthma hospitalization rate remains lower Upper West Side on the Upper West Side 20 20

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0 0 1995-961997-98 1999-00 2001-02 2003-04 1995-96 1997-981999-00 2001-02 2003-04 Upper West Side Manhattan New York City Upper West Side Manhattan New York City Rates are age-adjusted. Data Sources: New York State Department of Health Statewide Planning and Data Sources: New York State Department of Health Statewide Planning and Research Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Research Cooperative System, 1995-2004; U.S. Census 1990 and 2000/NYC Department of City Planning Department of City Planning

Goal 10 Have a Healthy Baby The health of babies depends on the health of mothers. Good health care for pregnant women includes high quality prenatal care beginning in the first trimester of pregnancy. The average annual percent of women who received late or no prenatal care has decreased by one third on the Upper West Side during the past decade. The 2003-2004 percent (14%) was lower than in Manhattan (22%) and NYC overall (28%). Teenage mothers and their babies face a number of risks. Pregnant teens are more likely to be poor and not complete high school than other teens, and they are more likely to have babies born with low birthweight than older women.The birth rate to teenage mothers has decreased in the past 10 years by more than half on the Upper West Side. Also, the average teen birth rate in 2003-2004 in this community (21/1,000) was lower than in Manhattan (59/1,000) and NYC overall (75/1,000). Prenatal care Teenage mothers Mothers on the Upper West Side are less likely to receive The birth rate to teenage mothers (15-19 years) is late or no prenatal care in New York City lower on the Upper West Side

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Data Source: Bureau of Vital Statistics, NYC DOHMH, 1995-2004 Data Source: Bureau of Vital Statistics, NYC DOHMH, 1995-2004

TAKE CARE UPPER WEST SIDE 13 Babies born with low birthweight tend to have more health problems than others. In 2003-2004, the average percent of babies born with low birthweight is the same on the Upper West Side, in Manhattan and in NYC overall (9%). Infant mortality (the death of babies in the first year of life) has declined over the past 10 years in NYC. The 2002-2004 rate on the Upper West Side (3/1,000) was lower than in NYC overall (6/1,000), meeting the TCNY target. Low birthweight Infant mortality rate (IMR) About 1 in 10 babies on the Upper West Side is The IMR on the Upper West Side is lower than the NYC born with low birthweight overall rate 20 20 s h t r s i h

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Neighborhood Health Highlight: Flu and Pneumonia Leading Causes of Death: Upper West Side Every New York City neighborhood has different health concerns. Here we highlight flu (influenza) and pneumonia on the Upper West Side. Rate per Cause of Death 100,000 people The flu (also called influenza) can be dangerous for the very young, Heart Disease 246 older adults and people with long-term health problems. Bacterial Cancer 168 pneumonia is a serious complication of the flu. However, there are Influenza (flu) & pneumonia 55 effective vaccines (shots) to prevent illness, serious complications and Stroke 25 death from these diseases. Chronic Lung Diseases 20 AIDS 15 Despite the flu shot and the pneumococcal vaccine for one type of Diabetes 14 bacterial pneumonia, flu and pneumonia remain the third leading Rates are age-adjusted. cause of death on the Upper West Side. The average annual death rate Data Source: Bureau of Vital Statistics, NYC DOHMH, 2003-04; U.S. Census 2000/NYC Department of City Planning has increased by almost 30% in the past decade on the Upper West

Death rates due to influenza and pneumonia Side, and the 2003-2004 rate was 35% higher than the NYC overall The flu and pneumonia death rate on the Upper rate (55/100,000 vs. 36/100,000). This is likely due in part to an West Side is higher than in NYC overall 60 increasingly older population — as people live longer, they are more s

t likely to die if they catch the flu.

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D diabetes, or underlying heart disease and cancer. Many cases of pneumonia 0 are caused by a bacterial infection that is a complication of the flu and for 1995-961997-98 1999-00 2001-02 2003-04 which there is an effective immunization (pneumococcal vaccine). All adults aged 65 and older should have a pneumonia vaccine once Upper West Side Manhattan New York City for life- long protection. Individuals younger than 65 with long-term health problems Rates are age-adjusted. Data Source: Bureau of Vital Statistics, NYC DOHMH, 1995-2004; U.S. should have one shot immediately and a single revaccination after 5 years. Census 1990 and 2000/NYC Department of City Planning For more information on where to get flu/pneumonia shots, call 311.

14 T AKE CARE UPPER WEST SIDE Technical notes

Analyses All analyses were conducted by the Bureau of Epidemiology Services, NYC DOHMH, unless otherwise indicated. All estimates in this report were age standardized to the Year 2000 Standard Population, except for age-specific data and mother-child health indicators. All CHS analyses were done in SUDAAN to account for complex survey design and were weighted to the New York City population according to the U.S. Census 2000. Data sources NYS DOH hospitalization data: Includes hospitalizations of NYC residents that occurred anywhere in New York State. Patient zip code was used to classify hospitalizations into 42 neighborhoods. Data from 1995-2003 updated in April 2005; 2004 data updated in July 2005. Vital Statistics data: Includes births and deaths of NYC residents that occurred within New York City. Data were combined across years to increase statistical stability and average annual rates are presented. In addition, infant mortality rates (IMR) were calculated as 3-year annual averages, and this statistic and others may differ from the presentation in “Summary of Vital Statistics” reports from the Bureau of Vital Statistics, NYC DOHMH. Community Health Survey data: The NYC Community Health Survey (CHS) is an annual random-digit-dial telephone survey of approximately 10,000 adults in New York City. This profile uses the following datasets from this survey: NYC CHS 2002, NYC CHS 2003, NYC CHS 2004, NYC CHS 2002-03-04, NYC CHS 2002-03, NYC CHS 2002 & 2004, and NYC CHS 2003-04. The combined-year datasets increase statistical power, allowing for more stable analyses at the neighborhood level. Neighborhood Definitions The 42 NYC neighborhoods are based on the United Hospital Fund definitions of neighborhood, which are specified by zip code. For a complete listing of all 42 neighborhoods and their zip codes, go to nyc.gov/health. The zip codes included in analyses of the Upper West Side are 10023, 10024, 10025, and 10069. Please note that some neighborhoods were combined for statistical purposes in the CHS 2002, CHS 2003 and CHS 2004 datasets to make a total of 33 (2002) or 34 (2003, 2004) neighborhoods. Upper West Side statistics from the 2003 and 2004 individual-year datasets include data from the neighboring communities of the Lower East Side, Chinatown and the East Village. Avoidable Hospitalizations Data based on Ambulatory Care Sensitive Conditions (called “avoidable hospitalizations” in this report) were calculated using the Agency for Healthcare Research and Quality (AHRQ) classification of inpatient hospitalization data. Conditions in the overall measure include: Diabetes Short-term Complications Admission Rate, Diabetes Long-term Complications Admission Rate, Pediatric Asthma Admission Rate, Chronic Obstructive Pulmonary Disease Admission Rate, Pediatric Gastroenteritis Admission Rate, Hypertension Admission Rate, Congestive Heart Failure Admission Rate, Dehydration Admission Rate, Bacterial Pneumonia Admission Rate, Urinary Tract Infection Admission Rate, Angina without Procedure Admission Rate, Uncontrolled Diabetes Admission Rate, Adult Asthma Admission Rate, and Rate of Lower-extremity Amputation among Patients with Diabetes. Significance Testing For all data, 95% confidence limits were calculated for neighborhood, borough, and NYC estimates. If these ranges did not overlap, a significant difference was inferred. This is a conservative measure of statistical difference. This methodology also was used to examine differences between years in neighborhood trend data. Only robust findings found to be statistically significant are discussed in the text. In addition, all NYC CHS estimates were evaluated for statistical stability using the relative standard error (RSE). Those estimates with an RSE > .30 are flagged in graphs, “Estimate is unstable due to small sample size and should be interpreted with caution." TCNY report card The neighborhood was classified according to where it ranked in comparison to the other 41 NYC neighborhoods with Above Average = rankings 1-10, Average = rankings 11-32, and Below Average = rankings 33-42 where 1 = the best neighborhood score. Rankings were computed by combining (or in some cases, using only one indicator) standardized measures (z-scores) of the following health indicators for each TCNY goal: TCNY#1 - primary care provider, insurance, ED visits; TCNY#2 - current smokers; TCNY#3 - diabetes, obesity, exercise, heart disease hospitalizations, heart disease mortality; TCNY#4 - HIV testing, AIDS mortality; TCNY#5 - serious psychological distress, mental illness hospitalizations; TCNY#6 - binge drinking, alcohol-related hospitalizations, drug-related hospitalizations, drug- related mortality; TCNY#7 - cervical cancer screening, breast cancer screening, colon cancer screening, cancer mortality; TCNY#8 - flu immunization; TCNY#9 - child lead poisoning, adult asthma rates; TCNY#10 - prenatal care, teenage mothers, low birthweight, infant mortality. Cover Photograph: Broadway and 75th Street, Manhattan. Photo by Marty Kim. Maps by Susan Resnick.

Thank you to all the individuals who contributed to these reports: Sonia Angell, Fatima Ashraf, Birgit Bogler, Shadi Chamany, Louise Cohen, Lorna Davis, Erica Desai, Tamara Dumanovsky, Donna Eisenhower, Jennifer Ellis, Tim Frasca, Stephen Friedman, Renu Garg, Chris Goranson, Leena Gupta, Charon Gwynn, David Hanna, Kelly Henning, Mary Huynh, John Jasek, Qun Jiang, Deborah Kaplan, Adam Karpati, Elizabeth Kilgore, Marty Kim, Vani Kurup, Brooke Levinson, Cortnie Lowe, Jingsong Lu, Xiaowu Lu, Jenna Mandel-Ricci, Thomas Matte, Tina McVeigh, Rachel Miller, Trang Nguyen, Leze Nicaj, Preeti Pathela, Robyn Philburn, Jane Plapinger, Chitra Ramaswamy, Judy Sackoff, Julia Schillinger, Tejinder Singh, Sally Slavinski, Catherine Stayton, Parisa Tehranifar, William Vaughn, Joshua Volle, Joyce Weinstein, Kellee White, Candace Young, and Regina Zimmerman.

TAKE CARE UPPER WEST SIDE 15 Community Health Profile for the Upper West Side

This report is an updated, expanded second edition of the 2002 Community Health Profile for the Upper West Side. Inside NEW IN THE SECOND EDITION: ■ Take Care New York report card Community-specific ■ Time-trend data on births, hospitalizations, and deaths information on . . . ■ More neighborhood-specific health statistics Census Data 2 ■ Robust estimates from data through 2004 TCNY Report Card 3 Death Rates 4 First and second edition reports on all 42 New York City neighborhoods are available from the New York City Take Care New York Department of Health and Mental Hygiene online or by mail. Have a Regular Doctor 5 Be Tobacco Free 6 Web: nyc.gov/health Keep Your Heart Healthy 6 Click on “My Community’s Health” Know Your HIV Status 8 Email: [email protected] Get Help for Depression 9 Live Free of Dependence Mail: on Alcohol and Drugs 10 Community Health Profiles Get Checked for Cancer 11 New York City Department of Health and Mental Hygiene Division of Epidemiology Get the Immunizations You Need 12 125 Worth Street, Room 315, CN-6 New York, NY 10013 Make Your Home Safe and Healthy 12 For more information about health issues Have a Healthy Baby 13 in this report, Neighborhood Health please call 311. Highlight 14

PRST STD NYC Community Health Profiles U.S. POSTAGE nyc.gov/health PAID New York City Department of Health and Mental Hygiene NEW YORK, N.Y. Division of Epidemiology, Bureau of Epidemiology Services, 125 Worth Street, CN-6, New York, NY 10013 PERMIT NO. 6174

Michael R. Bloomberg Mayor

Thomas R. Frieden, MD, MPH Commissioner of Health and Mental Hygiene

3 York City. R 2

2 Suggested citation: 1

I Olson EC, Van Wye G, Kerker B, Thorpe L, Frieden TR. Take Care Upper West P

E Side. NYC Community Health Profiles, Second Edition; 2006; 22(42):1-16.