NEW YORK CITY – February 8, 2006 – Despite steady progress in closing racial health gaps, disparities still plague New York City. Black men die from AIDS at six times the rate of white men, and mortality among black infants is double that of whites. In honor of Black History Month, the Health Department today reasserted its commitment to advancing health equity in New York City.
"Our city is getting healthier overall, but differences along racial and economic lines are still large and unacceptable," said Health Commissioner Dr. Thomas R. Frieden. "All New Yorkers should have access to the same preventive services, care, and resources that they need to be healthy."
"These unfair racial differences in health are social and economic in origin, not genetic," said Dr. Mary Bassett, Deputy Commissioner for Health Promotion and Disease Prevention. "These gaps often reflect higher rates of poverty, with all its disadvantages, among blacks as compared to whites."
The heart of the Health Department's response to disparities is a neighborhood-level effort to address the underlying causes and work directly with community and faith-based organizations, doctors, neighborhood businesses and community leaders. The Health Department established district health offices in 2003 in the South Bronx, East/Central Harlem and North/Central Brooklyn, all largely Black and Hispanic communities with high poverty rates as well as the highest rates of preventable illness and death. These communities often lack key health services, access to healthy food, open space and other resources that keep people in poverty and poor health.
"Health flows from the social and economic fabric of our communities," said Dr. Adam Karpati, Assistant Commissioner for the Brooklyn District Public Health Office. "Whether we're promoting fresh fruit or funding affordable clinics, our goal is the same: to create environments where good health will flourish."
Narrowing the Gaps – Five Programs that are Making a Difference
1. Free Condom Initiative
Blacks account for more than half of the city's new HIV diagnoses – and those diagnoses often come late. Each year, more than 500 black New Yorkers find out that they are HIV-positive when they are already sick with AIDS, having missed opportunities for life-saving treatment.
To address this continuing crisis, the Health Department works with community organizations including Gay Men of African Descent and People of Color in Crisis to promote voluntary testing and distribute free condoms. With the help of local businesses, such as barber shops and beauty salons, the Health Department now distributes more than 1.5 million free condoms every month.
"Twenty-five years into the epidemic, condoms still save lives," said Tokes Osubu, Executive Director at Gay Men of African Descent. "Help us protect and preserve our community during Black History Month and beyond. Short of abstinence, using condoms is the surest way to reduce the spread of HIV, to protect ourselves and the ones we love."
While much remains to be done, new HIV diagnoses declined dramatically in black women between 2001 and 2005. Free condoms, as well as other Department efforts to increase testing, make testing more routine, and link HIV positive people to care, are helping close the gap.
2. Newborn Home Visiting Program
Infant death rates remain highest in black communities, where the rate is double that of whites. Teenage pregnancy rates also remain higher. Teen mothers have significantly higher risks of adverse pregnancy outcomes and other health and social problems.
To help reverse these trends, the Health Department offers every new mother in Bedford-Stuyvesant, Bushwick and East/Central Harlem a visit from a community health worker. Health workers help ease the transition into parenthood by educating new moms on such critical topics as breastfeeding, smoking and post-partum depression. Health workers also help ensure a safe living environment by checking for window guards and peeling paint and by talking to moms about safe sleep habits. More than 3,000 mothers received a home visit last year.
These efforts, bolstered by improvements in medical care, are making a difference. Over the past decade, the infant mortality rate has decreased by 25% among black New Yorkers. Teen pregnancy rates have declined by 18% since 2000, indicating steady progress in improving the health of black mothers and babies.
3. Nurse-Family Partnership (NFP)
The Nurse Family Partnership is an anti-poverty strategy with a proven track record in improving health and social outcomes. NFP is an intensive nurse home-visiting program for low-income, first-time mothers and their children. Nurses conduct regular home visits during pregnancy and early childhood. Moms in this program learn critical parenting skills, improve their health, and better their economic prospects by going back to school or finding better jobs. NFP is set to serve as many as 1,320 low-income families by fall 2007, a 50% increase over current capacity.
The NFP program improves maternal and child health, and decreases child abuse, drug use, and crime. "I am encouraged by the positive changes I see in these women who are often faced with every obstacle and still succeed beautifully," said Lisa Landau, Director of the Nurse Family Partnership. "The success of this program is due in large part to our nurses' dedication to making a difference in the lives of women and their babies."
4. Shape Up
The twin epidemics of diabetes and obesity are getting worse quickly in New York City. Among black New Yorkers, nearly one in four children and one in three adults is obese. This compares to one in six white children and adults.
The Health Department is teaming up with churches public agencies and community organizations to physical activity more accessible -- and to reduce obesity, heart disease, and diabetes. One initiative, known as Shape Up, logged 40,000 workout sessions last year, reaching hundreds of families in target neighborhoods. At the same time, other Health Department programs are increasing access to healthy foods in low-income neighborhoods and bringing physical fitness to daycare programs and schools throughout the city.
5. Colonoscopy Patient Navigator Program
Black New Yorkers die of colon cancer at higher rates than all other racial and ethnic groups. Unlike some cancers, colon cancer is preventable. The Health Department launched the Colonoscopy Patient Navigators program to helps residents over 50 in predominantly Black and Latino neighborhoods navigate the process of colonoscopy screenings in eight City hospitals. When patients are referred by their regular doctor for a colonoscopy, a Navigator helps explain why the procedure is so important and how to prepare for it. Navigators help alleviate fears about the procedure by explaining what patients can expect and answering their questions.
The percent of black New Yorkers who said they'd had a colonoscopy increased from 44% to 56% between 2002 and 2005.The program has helped improve colon cancer screening rates over the last three years by making sure that New Yorkers who need the screening have the support they need to follow through.