Community Meetings 2005 Health Status Report for West Roxbury February 22, 2005 Presented by the Boston Public Health Commission
Boston Neighborhoods Charlestown Allston- Brighton Back Bay Fenway Roxbury South End East Boston North End South Boston Jamaica Plain North Dorchester West Roxbury Roslindale Mattapan South Dorchester Hyde Park MAP PREPARATION: Boston Public Health Commission Research Office
Population by Age Group, Boston and West Roxbury 2000 65+ years 10% 0-17 years 20% 65+ years 20% 0-17 years 20% 45-64 years 18% 18-24 years 6% BOSTON 25-44 years 36% 18-24 years 16% 45-64 years 22% 25-44 years 32% WEST ROXBURY DATA SOURCE: U.S. Department of Commerce, Bureau of the Census, American FactFinder, Census 2000
Population of Residents Ages 65 And Over by Neighborhood, Boston, 2000 25% 20% 20% 12% 15% 14% 14% 13% 12% 12% 10% 11% 9% 10% 10% 9% 9% 8% 7% 5% 5% 0% 10% South End West Roxbury Boston Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale Roxbury South Boston South Dorchester DATA SOURCE: US Department of Commerce, Bureau of the Census, American Fact Finder, Census 2000 Percentage of Total Population. In Neighborhood
Racial and Ethnic Makeup, Boston and West Roxbury 2000 Other Race 2% 2 or More Races 3% Asian 8% Other Race 1% 2 or More Asian Races 4% 2% Black 6% Latino 5% Black 24% White 49% White 82% BOSTON Latino 14% WEST ROXBURY DATA SOURCE: U.S. Department of Commerce, Bureau of the Census, American FactFinder, Census 2000
Selected Socioeconomic Indicators, Boston and West Roxbury, 2000 Indicator Less than High School Graduation or GED (Adults Ages 25 and Over) % Population Below Poverty Level % of Children (Under 18) Below Poverty Level* % of Adults 65 and Older Below Poverty Level* Median Household Income in 1999 Boston Overall 21% 20% 26% 18% $39,629** West Roxbury 13% 7% 10% 9% $52,406** *Based on 1999 income ** Estimated median household income DATA SOURCE: US Department of Commerce, Bureau of the Census, American A Fact Finder, Census 2000, Summary File 3-Sample 3 Data
6 Key Health Issues in Your Neighborhood and What You Can Do About Them Obesity Cancer Asthma Substance Abuse Maternal and Child
OBESITY
What health problems does obesity make worse or cause? Diabetes High blood pressure High cholesterol Heart Disease/Stroke Asthma Arthritis Certain cancers (especially breast, uterus, colon, esophagus)
70% Obesity by Race/Ethnicity, Boston, 2001* 64% Percentage of Respondents 60% 50% 40% 30% 20% 47% 23% 53% 44% 10% 0% Boston Asian Black Latino White *Includes data collected from January 2001 through May 2001. The term obesity refers to all levels of excess weight combined. Blacks significantly different from Whites, Latinos, and Asians (p<.05). Latinos significantly different from Whites and Asians (p<.05) DATA SOURCE: Behavioral Risk Factor Survey, Behavioral Risk Factor Surveillance System (BRFSS), 2001, Massachusetts Department of Public Health and Boston Public Health Commission
Obesity by Neighborhood, Boston, 1999-2001 100% 48% 35% 80% 60% 40% 66% 61% 58% 60% 58% 55% 55% 53% 49% 51% 46% 35% 38% 41% 32% 20% 0% BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale Roxbury South Boston South Dorchester South End West Roxbury DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health Percentage of Respondents
Obesity by Age Boston* and West Roxbury, 1999-2001 100% Boston (except West Roxbury) Percentage of Respondents 80% 60% 40% 20% 46% 53% West Roxbury 61% 44% 0% 18-64 65 and Over *Excluding West Roxbury. NOTE: No significant difference between Boston and West Roxbury residents for either age groups, p<.05 DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health
Diabetes Mortality by Neighborhood: Age-Adjusted Adjusted Rates, Boston, 2000-2002 2002 Deaths per 100,000 Population 45 30 15 23 18 N<5 15 18 38 22 24 40 28 14 23 38 24 30 19 12 0 BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale Roxbury South Boston South Dorchester South End West Roxbury Note: The difference between the West Roxbury rate and the Boston rate is statistically significant (p< 0.05) DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
High Blood Pressure Among Adults by Neighborhood, Boston, 1999 and 2001 45% 38% 33% 30% 15% 33% 25% 20% 17% 29% 29% 25% 24% 19% 14% 16% 12% 10% 6% Percentage of Respondents 0% BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester Roslindale Roxbury South Boston South Dorchester South End West Roxbury DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health
Inadequate Physical Activity by Neighborhood, Boston, 2000-2001* 2001* 100% Percentage of Respondents 80% 60% 40% 20% 63% 58% 38% 58% 68% 38% 71% 51% 81% 68% 65% 72% 46% 66% 56% 63% 0% BOSTON Allston/Brighton Back Bay** Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester Roslindale Roxbury South Boston South Dorchester South End West Roxbury *Includes data collected from January 2000 through May 2002 ** Includes the North End NOTE: Inadequate physical activity means having no physical activity or less than 30 or more minutes, five or more times a week. DATA SOURCE: Behavioral Risk Factor Survey, Behavioral Risk Factor Surveillance System (BRFSS), 2000-2001, Massachusetts Department of Public Health and Boston Public Health Commission
Inadequate Physical Activity by Age Boston* and West Roxbury, 1999-2001 100% Boston (except West Roxbury) Percentage of Respondents 80% 60% 40% 20% 61% 69% West Roxbury 70% 65% 0% 18-54 55 and Over *Excluding West Roxbury. NOTE: No significant difference between West Roxbury and Boston for either age groups, p<.05. DATA SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health
What Can Be Done About It? Focus on eating healthy foods Avoid sugary sodas, snack foods Reducing portion sizes and eating smaller more frequent meals Exercise daily walking is safe and effective Talk to your primary care doctor Boston Steps Program
CANCER
What increases the chances of getting of cancer? Smoking Excessive alcohol Family history Excessive exposure to sunlight Exposure to certain cancer causing chemicals Some viruses or other germs (like HIV, HPV or Chlamydia) Certain hormones or medications Age
Leading Causes of Death: Age-Specific Rates, Boston and West Roxbury, 2000-2002 2002 Cancer Stroke COPD Septicemia Diabetes Alzheimers Disease All Injuries TOTAL Boston Ages 65+ Heart Disease Pneumonia/Flu Nephritis/Nephrosis 1,383.6 1,233.1 348.4 246.2 242.4 152.2 145.6 137.5 138.6 98.4 5,299.8 Stroke Pneumonia/Flu COPD Alzheimers Disease Septicemia Nephritis/Nephrosis All Injuries Diabetes TOTAL W. Roxbury Ages 65+ Heart Disease Cancer 1,401.1 1,251.2 397.5 332.4 247.6 202.0 189.0 149.9 104.3 91.2 5,617.5 NOTE: Rates reflect actual numbers of deaths due to specific causes per 100,000 population aged 65+. Differences between Boston rates and West Roxbury rates are not statistically significant at α =.05. DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
Cancer Mortality: Age-Adjusted Adjusted Rates by Race/Ethnicity and Year, Boston, 1999-2002 Deaths per 100,000 Population 300 250 200 150 100 50 0 1999 2000 2001 2002 Asian 157 113 112 160 Black 247 277 254 257 Latino 112 128 155 139 White 230 241 220 231 NOTE: In 2002, the rates for Asians and Latinos were significantly lower than the rates for Blacks and Whites, p<.05 DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
Cancer Mortality by Neighborhood: Age-Adjusted Adjusted Rates, Boston, 2000-2002 2002 Deaths per 100,000 Population 350 303 300 241 250 231 218 227 200 178 177 185 198 217 229 222 182 195 218 215 196 150 100 50 0 BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale Roxbury South Boston South Dorchester South End West Roxbury NOTE: Difference between Boston and West Roxbury not statistically significant at α =.05 DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
Leading Causes of Cancer Mortality: Age- Adjusted Rates, West Roxbury, 2000-2002 2002 Lung cancer 53 Breast cancer 37 Colorectal Cancer 25 Prostate Cancer 22 Ovarian Cancer Liver Cancer 10 10 Pancreatic Cancer 9 0 10 20 30 40 50 60 Deaths per 100,000 population NOTE: Boston excludes W. Roxbury; differences between W. Roxbury rates and Boston rates not statistically significant at α =.05 DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
Heart Disease Mortality by Neighborhood: Age-Adjusted Adjusted Rates, Boston, 2000-2002 2002 Deaths per 100,000 Population 350 300 244 253 250 207 201 206 224 232 197 200 183 179 150 115 100 50 0 BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale 297 214 213 187 174 145 Roxbury South Boston South Dorchester South End West Roxbury NOTE: Difference between West Roxbury rate and Boston rate is statistically significant (p<.05). DATA SOURCE: Boston resident deaths, Massachusetts Department of Public Health
What Can Be Done About It? Don t smoke Avoid excessive intake of alcohol Maintain a normal weight with exercise and a diet that is low in fat and high in fruits and vegetables Avoid excessive sun exposure Get regular cancer screening especially breast, colon, prostate, skin Join community efforts to promote health & combat cancer
BPHC Health Initiatives Cancer program Screening and education about cancer Steps to a Healthy Boston walking groups, smoking cessation Substance Abuse Services treatment for alcohol or substance abuse Health Connection Van Screening for skin and prostate cancer, education about all forms of cancer Mammography Van Screening for breast cancer
ASTHMA
Asthma Hospitalization, Age-Specific Rates, Boston* and West Roxbury, 1998-2002 10 Boston (except West Roxbury) Hospitalizations per 1,000 Population 8 6 4 2 8 4 4 West Roxbury 3 3 1 1 1 1 1 0 0-4 5-17 18-44 45-64 65 and over *Excluding West Roxbury DATA SOURCE: Acute Care Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy
Asthma Hospitalizations Among Children Under Age 5 by Neighborhood, Boston, 1998-2002 18 16 14 12 10 8 6 4 2 0 15 13 11 9 10 8 7 6 5 6 5 3 3 3 10 4 Hospitalizatons per 1,000 Population BOSTON Allston/Brighton Back Bay* Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester Roslindale Roxbury South Boston South Dorchester South End West Roxbury *Includes the North End DATA SOURCE: Acute Care Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy
What Can Be Done About It? Don t smoke and avoid exposure to smoke Eliminate pests Remove rugs, if possible. If not, use a special dust removing vacuum Cover mattresses Consider whether pets might be making asthma worse Get regular and consistent medical care and try not to run out of medications BPHC Asthma Program - Healthy Homes Initiative
SUBSTANCE ABUSE
Publicly-Funded Substance Abuse Treatment Admission Rates by Neighborhood, Boston, July 2001-June 2002 Admissions per 1,000 Population 120 100 80 60 40 20 37 10 17 37 29 9 19 52 32 38 13 89 51 59 104 9 0 BOSTON Allston/Brighton Back Bay* Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester Roslindale Roxbury South Boston South Dorchester South End West Roxbury *Includes the North End DATA SOURCE: Massachusetts Department of Public Health, Bureau of Substance Abuse Services, Substance Abuse Management Information System (SAMIS)
Leading Causes of Hospitalization: Age-Adjusted Adjusted Rates, West Roxbury, 2000-2002 2002 Pregnancy 28 Substance Abuse Psychoses 3 3 Heart Failure & Shock Simple Pneumonia & Pleurisy Chest Pain Cardiac Arrhythmia COPD Nutrit. & Metabolic Disorder Gastroenteritis* 2 2 2 2 2 2 2 0 5 10 15 20 25 30 Hospitalizations per 1,000 population *Also includes esophagitis and miscellaneous digestive disorders DATA SOURCE: Acute Care Hospital Case Mix Files, Massachusetts Division of Health Care Finance and Policy
Substance Abuse Hospitalization*: Age-Specific Alcohol and Illegal Drug Rates, West Roxbury, 1998-2002 5.0 4.5 Hospitalizations per 1,000 Population 4.0 3.0 2.0 1.0 2.8 0.8 3.4 2.9 3.3 3.0 0.9 Alcohol Illegal Drugs 2.5 0.5 0.4 0.2 0.0 15-24 25-34 35-44 45-54 55-64 65-74 *Hospitalization in acute care hospitals for substance abuse problem DATA SOURCE: Acute Care Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy
Drug Abuse Hospitalization*: Age-Specific Rates, Boston and West Roxbury, 1998-2002 6.0 Hospitalizations per 1,000 Population 5.0 4.0 3.0 2.0 1.0 0.0 1.4 2.8 2.9 3.4 4.8 3.3 15-24 25-34 35-44 45-54 55-64 65-74 2.5 0.9 Boston West Roxbury 0.6 0.4 0.4 0.2 *Hospitalization in acute care hospitals for treatment of illegal drug abuse problem DATA SOURCE: Acute Care Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy
Alcohol Abuse Hospitalization*: Age-Specific Rates, Boston and West Roxbury, 1998-2002 5.0 Hospitalizations per 1,000 Population 4.0 3.0 2.0 1.0 0.9 0.8 3.4 2.9 4.1 3.0 3.2 4.5 Boston West Roxbury 1.8 2.5 0.5 0.2 0.0 15-24 25-34 35-44 45-54 55-64 65-74 *Hospitalization in acute care hospitals for alcohol abuse problem DATA SOURCE: Acute Care Hospital Case Mix files, Massachusetts Division of Health Care Finance and Policy
Drug use among youth (from YRBS, 2001) 43% of Boston high school students reported lifetime illegal drug use. 24% of Boston high school students reported past month illegal drug use. 74% of Boston high school students reported lifetime alcohol use (other than few sips for religious purposes). 42% of Boston high school students reported past month alcohol use.
PREMATURITY and INFANT MORTALITY
Adequacy of Prenatal Care by Neighborhood, Boston, 2002 Percentage of Births Within Neighborhood. 100% 88% 83% 80% 60% 40% BOSTON 95% 90% 91% 91% 84% 78% 79% 76% Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester 94% 88% 88% 90% 85% 81% 81% North End Roslindale Roxbury South Boston South Dorchester South End West Roxbury NOTE: Adequate prenatal care defined as care delivered at the adequate or intensive levels according to the APNCU Index; West Roxbury percentage is significantly higher than the Boston percentage (p<.05). DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health
Low Birthweight by Neighborhood, Boston, 2002 14% 12% 10% 13% 12% 11% 11% 10% 9% 9% 8% 7% 7% 7% 7% 6% 4% 2% 0% 10% 12% 7% 10% 8% 7% West Roxbury South Dorchester South End Roxbury South Boston BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale NOTE: West Roxbury percentage not significantly different from Boston percentage at α =.05 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health. Percentage of Births Within Neighborhood.
Preterm Birth by Neighborhood, Boston, 2002 14% 12% 10% 8% 12% 12% 11% 10% 10% 7% 8% 9% 8% 7% 7% 6% 4% 2% 0% 12% 12% 8% 12% 8% 9% West Roxbury South End Roxbury South Boston South Dorchester BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale NOTE: West Roxbury percentage not significantly different from Boston percentage at α =.05 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health. Percentage of Births Within Neighborhood
14 12 10 8 11 11 8 8 8 8 7 6 4 5 5 4 4 3 2 0 3 12 6 5 South End West Roxbury Infant Mortality by Neighborhood, Boston, 1997-2002 N<5 BOSTON Allston/Brighton Back Bay Charlestown East Boston Fenway Hyde Park Jamaica Plain Mattapan North Dorchester North End Roslindale Roxbury South Boston South Dorchester NOTE: Difference between West Roxbury rate and Boston rate not statistically significant at α =.05 DATA SOURCE: Boston resident live births and infant deaths, Massachusetts Department of Public Health Infant deaths per 1,000 Live Births
What Can Be Done About It? Improve the health of women before they get pregnant Discourage smoking/alcohol use during pregnancy Good prenatal care to detect medical problems Substance abuse treatment for women who have addictions Support through pregnancy and infant s first year for new mothers Encourage good nutrition before and during pregnancy Encourage teens to use contraception and wait until their 20 s to get pregnant
BPHC Programs Healthy Baby/Healthy Child Mayor s Health Line BAHEC/Youth to Health Careers Adolescent Wellness Program Central Intake Unit, (617) 534-5554