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A Policy for a Healthier New York City

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A Policy for a Healthier New York City A Policy for a Healthier New York City Forth Year Progress Report December 2008 Table of Contents I. Executive Summary . 2 II. Take Care New York Indicators—Status and Goals . 4 III. Overview . 6 IV. Implementing Take Care New York . 6 V. 2007 Key Activities and Accomplishments . 7 1. Have a Regular Doctor or Other Health Care Provider . 8 2. Be Tobacco-Free . 9 3. Keep Your Heart Healthy . 10 4. Know Your HIV Status . 11 5. Get Help for Depression . 12 6. Live Free of Dependence on Alcohol and Drugs . 13 7. Get Checked for Cancer . 14 8. Get the Immunizations You Need . 15 9. Make Your Home Safe and Healthy . 16 10.Have a Healthy Baby . 18 IV. Looking Ahead: The Next Phase of Take Care New York . 19 Take Care New York Partners . 20 Technical Notes and Acknowledgements . 21 New York City Department of Health and Mental Hygiene • Third Year Progress Report 2007 1 Executive Summary Take Care New York (TCNY) is a comprehensive health policy crafted TCNY set ambitious goals for 2008 in each of the 10 priority areas; progress by the Department of Health and Mental Hygiene (DOHMH) to help New has been measured annually, and, since 2002, the Health Department has Yorkers live longer and healthier lives. made progress in eight priority areas outlined in TCNY (See Figures 1-8 Launched in March 2004, TCNY provides a policy for evidence-based and Figure 9 on page 21) as well as reaching or surpassing the original interventions in 10 priority health areas that are key to prevent illness and 2008 goals by 2007 in four areas. death. The policy outlines steps that individuals, health care providers, 1. 364,000 more New Yorkers have a regular doctor. The number businesses and community- and faith-based organizations can take to of New Yorkers with a regular health care provider increased from 4,469,000 improve the health of New Yorkers. in 2002 to 4,833,000 in 2007. In 2002, 26% of New Yorkers did not have a Take Care New York advises that every New Yorker take these regular doctor. The TCNY goal was to reduce this to 20% of New Yorkers 10 steps to lead a healthier life: without a regular doctor, which was surpassed. (See Figure 1 below) 1. Have a regular doctor or other health care provider. 2. 300,000 fewer New Yorkers smoke. The percentage of New 2. Be tobacco free. Yorkers who smoke decreased from 21.5% in 2002 to 16.9% in 2007, surpassing the 2008 goal of a reduction to 18%. (See Figure 2). 3. Keep your heart healthy. 3. 609 fewer deaths from HIV. The number of New Yorkers who died 4. Know your HIV status. from HIV/AIDS-related illness decreased from 1,713 in 2002 to 1,104 in 5. Get help for depression. 2007, on track to reach the TCNY goal of fewer than 1,000 by 2008. 6. Live free of dependence on alcohol and drugs. (See Figure 3) 7. Get checked for cancer. 4. 143 fewer deaths from alcohol. The number of New Yorkers who 8. Get the immunizations you need. died from alcohol-attributable causes decreased from 1,551 in 2002 to 9. Make your home safe and healthy. 1,408 in 2006, almost reaching the 2008 goal of a reduction to 1,400 10. Have a healthy baby. deaths. (See Figure 4) Figure 1. 364,000 More New Yorkers Have a Regular Doctor Figure 3. Number of New Yorkers who died from HIV/AIDS-related causes, 2002-2007. 364,000 More New Yorkers Have a Regular Doctor 609 Fewer New Yorkers Died from HIV/AIDS 5,000,000 1,800 4,724,000 4,745,000 1,713 1,700 1,656 4,554,000 4,833,000 4,469,000 4,757,000 1,600 1,451 Take Care New York 1,500 1,419 Target: 4,850,000 by 2008 1,400 4,000,000 1,300 1,205 Take Care New York Target: Fewer than 1,200 1,104 1,000 by 2008 Number of New Yorkers 18+ 1,100 Number of New Yorkers 18+ 1,000 900 3,000,000 1234567 2002 2003 2004 2005 2006 2007 2008 2002 2003 2004 2005 2006 2007 2008 Figure 2. 300,000 fewer New Yorkers smoke. Figure 4. Number of New York deaths due to alcohol, 2002-2006. 300,000 fewer New Yorkers smoke. 143 Fewer New Yorker Died Due to Alcohol 1,600 Take Care 22 21.5 1,551 New York Target: 1,514 1,400 deaths due to alcohol by 2008 21 1,500 1,444 1,450 Exceeded 1,408 20 Take Care 19.2 New York Goal 1,400 18.9 of 18 19 18.3 1,300 18 17.5 16.9 1,200 17 Number of New Yorkers 18+ Percent of New Yorkers 18+ 1,100 16 1,000 15 2002 2003 2004 2005 2006 2007 2008 2002 2003 2004 2005 2006 2007 2008 2 Take Care New York: A Policy for a Healthier New York City 5. 73 fewer drug-related deaths. The number of New Yorkers who The progress resulting from the Take Care New York initiative has come died from drug-related causes decreased from 905 in 2002 to 832 in 2007. in part due to the many outside agencies and individuals who are involved. (See Figure 5). This past year, DOHMH worked with a broad network of partners to expand 6. 319 fewer young children were newly identified with lead programs that encourage New Yorkers to use preventive services, reduce their poisoning. In 2006, there were 319 fewer children under the age of six risk of chronic disease and adopt health behaviors and environmental years newly identified with lead poisoning and an associated lead-based changes improved their health. paint violation than in 2002, more than two-thirds of the way to the 2008 While there has been considerable progress toward many TCNY goals, goal of fewer than 260 children. (See Figure 6) more remains to be done, particularly in reducing infant mortality, 7. 20% reduction in women (ages 12+ years) who died from increasing cervical cancer and mammography screenings, and increasing intimate partner homicide. The three-year average rate of women flu immunizations. In addition, health disparities persist among economic killed by an intimate partner decreased from 1.0 death per 100,000 women and racial/ethnic groups in New York City. Focusing on reducing these for 2000 to 2002, to 0.8 per 100,000 for 2004 to 2006, meeting the revised disparities will improve the city’s overall health. 2008 goal. (See Figure 7) This fourth TCNY progress report since the March 2004 launch includes an 8. 10% decrease in infant deaths. The infant mortality rate has overview of the Take Care New York policy, updated data on the status and decreased from 6.0 per 1,000 live births in 2002 to 5.4 per 1,000 live births goals of Take Care New York indicators, and key activities and in 2007, almost two-thirds of the way to the 2008 goal of a reduction to accomplishments for 2007–2008. 5.0 per 1,000 live births. (See Figure 8) Figure 5. Number of New Yorkers who died due to drug-related causes, Figure 7. Rate of women killed by an intimate partner in New York, 2002-2007. 2000-2006. 73 Fewer New Yorkes Died From Drug-Related Causes 20% Reduction In Intimate Partner Homicide 1,000 1.5 Take Care 900 New York Achieved 960 Target: 655 2008 Take Care 905 939 by 2008 New York Goal 800 906 11 1 of 0.8 855 832 1 0.9 700 0.8 600 500 0.5 3-Yr Average Rate per 100,000 Women Age 12+ 400 Number of New Yorkers 18+ 300 0 200 2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2002 2003 2004 2005 2006 2007 2008 Target revised in 2006 from .9 to .8 per 100,000 women age 12+ Figure 6. Number of children newly identified with lead poisoning in Figure 8. Infant mortality in New York City, 2002-2007. New York City, 2002-2007. 319 Fewer Young Children Newly Identified With Lead Poisoning* 10% Decrease in Infant Mortality Deaths 10 800 740 8.8 680 7.8 Take Care 700 8 New York 630 7.1 6.9 Target: 5.0 per 6.8 6.7 6.5 593 6.1 6.1 1,000 live births 600 6 6 5.9 529 6 5.4 500 421 Take Care New York Target: Fewer than 4 400 260 by 2008 2 300 Rate per 1,000 live births Number of Children under 6 Years 200 0 2002 2003 2004 2005 2006 2007 2008 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 *Blood lead levels (BLL)>=15ug/DL and an identiÞed lead-based paint hazard. New York City Department of Health and Mental Hygiene • Third Year Progress Report 2007 3 Summary Table of Take Care New York Indicators Status and Goals TCNY Agenda Item Indicator 2008 Goal HaveaRegularDoctor Adult New Yorkers without a regular doctor More than 300,000 fewer New Yorkers without a doctor 1orOtherHealthCare (20% reduction in NY’ers w/o doctor, or prevalence to drop from Provider 26% to 20% of NY’ers without a doctor) BeTobacco Adult New Yorkers who smoke 240,000 fewer smokers (18% reduction in number of people 2Free who smoke, or drop in prevalence to 18%) Havea Proportion of New Yorkers with 134,000 more New Yorkers with hypertension that is well controlled 3HealthyHeart hypertension that is well controlled1 (20% increase) Proportion of NY’ers with diabetes or cardiovascular 85,000 fewer New Yorkers with diabetes or cardiovascular disease disease2 who have an elevated LDL3 who have a high LDL (20% reduction) Proportion of NY’ers with elevated A1C4 22,000 fewer adults with an A1C >9.0% (20% reduction) KnowYour Number of New Yorkers who die from HIV/AIDS Under 1,000 (42% fewer than 2002) 4HIVStatus GetHelp Prevalence of untreated depression5 44,000 more adults with depression that are 5forDepression receiving treatment (10% increase) Live Free of Alcohol-attributable mortality 1,400 deaths (10% reduction) 6Alcohol and Drugs Drug-related deaths 655 deaths (250 fewer than 2002) GetChecked Screening rates for breast cancer 1.5 million women age 40+ (85%) who received 7forCancer a mammogram in the past 2 years (10% increase) Screening rates for cervical cancer 2.8 million women age 18+ who received a Pap test in the past 3 years (2.8 million) Screening rates for colon cancer 60% of New Yorkers age 50+ screened for colon cancer (20% more than 2003) Future target is 80% of NY’ers age 50+ screened by 2011.
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