bronx community health dashboard · bronx community health dashboard: asthma last updated:...

1

Bronx Community Health Dashboard: Asthma Last Updated: 9/24/2019 See end of presentation for more information about this project and links to data sources.

2 Data source: Global Burden of Disease Project, 2017.

Asthma is the 2nd leading cause of disability in the US among children 5-14y

4.1

4.3

5.9

5.9

6.7

6.7

7.3

9.2

0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0

Viral skin diseases

Depressive disorders

Headache disorders

Anxiety disorders

Neonatal disorders

Conduct disorder

Asthma

Dermatitis

Percent of Total DALYs

Disability-Adjusted Life Years (DALYs) are calculated by adding the Years of Life Lost due to premature mortality in the population and the Years Lost due to disability for people living with the health condition or its consequences.

3

Child & adolescent asthma

Lifetime prevalence | Current asthma | Asthma severity | Asthma ED visits | Asthma hospitalizations

4

The Bronx has the highest percentage of children 0-12 years old who have ever been diagnosed with asthma; within the Bronx, asthma is more common among boys

17.4

11.9

16.8

10.9 10.1

21.4

13.2

0

5

10

15

20

25

Bronx Brooklyn Manhattan Queens Staten Island Male Female

Age-

adju

sted

per

cent

(%) o

f chi

ldre

n 0

thro

ugh

12

year

s ol

d w

ho h

ave

ever

bee

n di

agno

sed

with

ast

hma Bronx only

Data source: New York City Child Health, Emotional Wellness and Development Survey, 2015

5

The Bronx has the second highest percentage of children 0-12 years old currently with asthma; within the Bronx, current asthma is higher among boys

9.1

6.0

12.3

4.4

10.8

7.4

0

2

4

6

8

10

12

14

Bronx Brooklyn Manhattan Queens Male Female

Age-

adju

sted

per

cent

(%) o

f chi

ldre

n 0

thro

ugh

12

year

s ol

d w

ho h

ave

had

an e

piso

de o

f ast

hma

or a

n as

thm

a at

tack

in th

e pa

st 1

2 m

onth

s

Bronx only

Data source: New York City Child Health, Emotional Wellness and Development Survey, 2015 Data suppressed for Staten Island

6

The Bronx has the highest percentage of teens who have ever been diagnosed with asthma; within the Bronx, asthma is higher among boys

27.7

22.7

26.2

21.4 23.0

30.8

24.6

0

5

10

15

20

25

30

35

Bronx Brooklyn Manhattan Queens Staten Island Male Female

Age-

adju

sted

per

cent

(%) o

f tee

n w

ho h

ave

ever

bee

n di

agno

sed

with

ast

hma

Bronx only

Data source: New York City Youth Risk Behavior Survey, 2017

7

Asthma rates among public school children aged 5-14 years old have increased in all 5 NYC boroughs and remain highest in the Bronx

75.8

102.5

47.9

59.6

51.0

68.4

56.4

73.9

54.3

63.1

0

20

40

60

80

100

2010-2011 2011-2012 2012-2013 2013-2014

Rat

e of

ast

hma

diag

nosi

s am

ong

publ

ic s

choo

l chi

ldre

n ag

ed 5

-14

year

s du

ring

the

curr

ent o

r pre

viou

s sc

hool

yea

r pe

r 1,0

00 p

ublic

sch

ool c

hild

ren

5 -14

y Bronx Brooklyn Manhattan Queens Staten Island

Data source: New York City Automated School Health Records (2010-2014), data from New York City DOHMH Environment & Health Data Portal

Rates are calculated by residence of the child. Use of a denominator consisting of all 5-14 year olds results in an underestimate of the true asthma prevalence, since the numerator represents only children enrolled in public schools that report to NYC DOHMH.

8

Persistent asthma rates among public school children aged 5-14 years old have increased in all 5 NYC boroughs and remain highest in the Bronx

24.6

35.3

13.5

17.8

15.1

21.5

12.3

16.0

13.8

0

5

10

15

20

25

30

35

40

2010-2011 2011-2012 2012-2013 2013-2014

Rat

e of

ast

hma

diag

nosi

s de

scrib

ing

sym

ptom

s oc

curr

ing

mor

e th

an tw

ice

per w

eek

amon

g pu

blic

sch

ool c

hild

ren

aged

5-1

4 ye

ars

durin

g th

e cu

rren

t or p

revi

ous

scho

ol y

ear

per 1

,000

pub

lic s

choo

l chi

ldre

n 5 -

14y

Bronx Brooklyn Manhattan Queens Staten Island

Data source: New York City Automated School Health Records (2010-2014), data from New York City DOHMH Environment & Health Data Portal

Rates are calculated by residence of the child. Use of a denominator consisting of all 5-14 year olds results in an underestimate of the true asthma prevalence, since the numerator represents only children enrolled in public schools that report to NYC DOHMH.

9

Asthma-related ED visit rates among children up to 4 years old have remained stable in the Bronx, but declined in all other NYC boroughs

685

602

310

228

376

278 267

189 193

136

0

100

200

300

400

500

600

700

800

900

1000

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Rat

e of

ast

hma-

rela

ted

ED v

isits

am

ong

NYC

resi

dent

ch

ildre

n up

to 4

yea

rs o

ld p

er 1

0,00

0


Data source: SPARCS Hospital Discharge Data (2005-2016), data from New York City DOHMH Environment & Health Data Portal An ED visit is included if it has an ICD-9 principal diagnosis code of 493.

10

The asthma-related ED visit rate among children 5 to 17 years old has increased by 45% in the Bronx

265

384

130

187

454

261

131 127

103 81

0

100

200

300

400

500

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Rat

e of

ast

hma-

rela

ted

ED v

isits

am

ong

NYC

resi

dent

ch

ildre

n 5

to 1

7 ye

ars

old

per 1

0,00

0



11

Asthma-related hospitalization rates among children up to 4 years old have declined in all 5 NYC boroughs; and remain highest in the Bronx

212

123 120

50

95

51

92

39

56

41

0

50

100

150

200

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Rat

e of

ast

hma-

rela

ted

hosp

italiz

atio

ns a

mon

g N

YC

resi

dent

chi

ldre

n up

to 4

yea

rs o

ld p

er 1

0,00

0


Data source: SPARCS Hospital Discharge Data (2003-2016), data from New York City DOHMH Environment & Health Data Portal A hospitalization is included if it has an ICD-9 principal diagnosis code of 493.

12

Asthma-related hospitalization rates among children 5 to 17 years old remain highest in the Bronx

58.0

51.1

32.2

24.1

41.5

27.9 25.0

15.4 14.4 12.4

0

10

20

30

40

50

60

70

80

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Rat

e of

ast

hma-

rela

ted

hosp

italiz

atio

ns a

mon

g N

YC

resi

dent

chi

ldre

n 5

to 1

7 ye

ars

old

per 1

0,00

0



13

The Bronx has the highest child asthma hospitalization rates in NYC

Data source: SPARCS Hospital Discharge Data (2014), data from New York City Neighborhood Health Atlas

The highest rates are in these Bronx Neighborhoods Mott Haven-Port Morris Claremont-Bathgate East Tremont Bedford Park-Fordham

North Hunts Point Bronxdale

14

Adult asthma

Lifetime prevalence | Current asthma | Asthma ED visits | Asthma hospitalizations

15

The percent of adults in the Bronx who have ever been diagnosed with asthma has remained relatively stable

Data source: New York City Community Health Survey, 2002-2017. Data missing for 2005 and 2015.

14.4

17.0

10.3

12.4 12.6

15.5

11.6 11.6

15.7

9.9

0

2

4

6

8

10

12

14

16

18

20

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

per

cent

(%) o

f adu

lts w

ho h

ave

ever

be

en to

ld b

y a

doct

or, n

urse

of o

ther

hea

lth

prof

essi

onal

that

they

had

ast

hma


16

In the Bronx, the percent of adults ever diagnosed with asthma is highest amongst those who are 45-64y, female, or Hispanic

18.2

13.0

21.9

17.0

13.9

19.4 19.7

15.6

13.1

0

4

8

12

16

20

24

18-24 25-44 45-64 65+ Male Female Hispanic Non-Hispanic

black

Non-Hispanic

white

Age-

adju

sted

per

cent

(%) o

f adu

lts w

ho h

ave

ever

bee

n to

ld b

y a

doct

or, n

urse

of o

ther

hea

lth p

rofe

ssio

nal t

hat

they

had

ast

hma

Data source: New York City Community Health Survey, 2017. Age group data are not age-adjusted.

There were no clear trends by education or income among adults.

17

The percent of adults currently with asthma has generally been highest in the Bronx, only surpassed by Staten Island in 2014

Data source: New York City Community Health Survey, 2002-2017. Data missing for 2005 and 2015.

6.2

6.8

3.8

3.7

4.6 4.6

3.7 3.9

5.7

*1.7

0

1

2

3

4

5

6

7

8

9

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

per

cent

(%) o

f adu

lts w

ho h

ave

had

an

epis

ode

of a

sthm

a or

an

asth

ma

atta

ck in

the

past

12

mon

ths


18

In the Bronx, the percent of adults currently with asthma is highest among those who are 45-64y, female, or Hispanic

5.0

11.1

5.5

4.5

8.5

7.8

5.8

*6.6

0

2

4

6

8

10

12

18-24 25-44 45-64 65+ Male Female Hispanic Non-Hispanic

black

Non-Hispanic

white

Age-

adju

sted

per

cent

(%) o

f adu

lts w

ho h

ave

had

an

epis

ode

of a

sthm

a or

an

asth

ma

atta

ck in

the

past

12

mon

ths

Data source: New York City Community Health Survey, 2017. Age group data are not age-adjusted. For 18-24 age group, data are suppressed due to imprecise and unreliable estimates. *Unreliable estimate due to small sample size, interpret with caution.

There were no clear trends by education or income among adults.

19

Asthma-related ED visit rates among adults are almost two-times greater than the rest of NYC

185

225

77

120

138

107

55 61 60 74

0

50

100

150

200

250

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Age-

adju

sted

rate

of a

sthm

a-re

late

d ED

vis

its a

mon

g N

YC

resi

dent

s 18

yea

rs a

nd o

lder

per

10,

000



20

Asthma-related hospitalization rates among adults are also considerably higher in the Bronx

53.9

44.8

28.6

22.1 22.2

17.4 16.0

12.9 14.3 15.7

0

10

20

30

40

50

60

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Age-

adju

sted

rate

of a

sthm

a-re

late

d ho

spita

lizat

ions

am

ong

NYC

resi

dent

s 18

yea

rs a

nd o

lder

per

10,

000



21

The Bronx and Harlem have the highest rates of preventable asthma hospitalizations among NYC adults

Data source: SPARCS Hospital Discharge Data (2014), data from New York City Neighborhood Health Atlas

The highest rates are in these Bronx Neighborhoods Mott Haven-Port Morris Claremont-Bathgate Melrose South-Mott

Haven North Longwood Hunts Point

22

Risk factors

Obesity | Housing quality | Smoking | Air quality

23

The Bronx has the highest percentage of obese youth compared to all NYC boroughs

15.3

17.6

15.1 13.0

12.2 11.7

12.9

10.5

12.4

0

2

4

6

8

10

12

14

16

18

20

2003 2005 2007 2009 2011 2013 2015 2017

Perc

ent (

%) o

f obe

se y

outh

Bronx Brooklyn Manhattan Queens Staten IslandObese is ≥95th percentile for

BMI, by age and sex

Data source: New York City Youth Risk Behavior Survey, 2003-2017 (Grades 9-12). Data captured biennially and not available before 2003.

24

The Bronx has the highest percentage of obese adults of all NYC boroughs

Data source: New York City Community Health Survey, 2002-2017. Body Mass Index (BMI) is calculated based on respondents self-reported weight and height.

A BMI of ≥30 is classified as

obese

23.7

34.9

0

5

10

15

20

25

30

35

40

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

per

cent

(%) o

f adu

lts w

ho a

re o

bese


25

The percent of homes with mice or rats remains highest in the Bronx

28.7 29.5

26.3

23.3 21.6

13.9 12.5 13.4

5.2 5.1

0

5

10

15

20

25

30

35

40

1999 2002 2005 2008 2011 2014

Perc

ent o

f hou

seho

lds

that

repo

rted

mic

e or

rats

in

thei

r bui

ldin

g in

the

past

90

days


Data source: New York City Housing and Vacancy Survey (1999-2014), data from New York City DOHMH Environment & Health Data Portal

26

The Bronx neighborhood with the highest percentage of homes with mice or rats in the building is University Heights/Fordham

48.0

36.1 36.3

39.7

15.3

21.8 20.0

4.8

49.2

27.7

18.5

0

5

10

15

20

25

30

35

40

45

50

Perc

ent o

f hou

seho

lds

that

repo

rted

mic

e or

rats

in

thei

r bui

ldin

g in

the

past

90

days

Data source: New York City Housing and Vacancy Survey (2014), data from New York City DOHMH Environment & Health Data Portal

102 103

2

3

7

9

1 Highbridge/South Concourse 2 Kingsbridge Heights/Mosholu 3 Morrisania/East Tremont 4 Mott Haven/Hunts Point 5 Pelham Parkway 6 Riverdale/Kingsbridge 7 Soundview/Parkchester 8 Throgs Neck/Co-op City 9 University Heights/Fordham 10 Williamsbridge/Baychester

6 10 2

9 1

3

4 7

5

8

27

The percent of homes with cockroaches has decreased in all 5 NYC boroughs since 2008, yet remains highest in the Bronx

42.3

35.0 32.9

26.4 26.4

19.7

23.7

19.3

6.0 4.8

0

5

10

15

20

25

30

35

40

45

2008 2011 2014

Perc

ent o

f hou

seho

lds

that

repo

rted

see

ing

at le

ast

one

cock

roac

h da

ily o

ver t

he la

st m

onth


Data source: New York City Housing and Vacancy Survey (2008-2014), data from New York City DOHMH Environment & Health Data Portal

28

The Bronx neighborhood with the highest percentage of homes with cockroaches is University Heights/Fordham

44.4 42.7 42.1

39.9

20.9

24.3

38.2

12.9

47.0

34.5

23.2

0

5

10

15

20

25

30

35

40

45

50

Perc

ent o

f hou

seho

lds

that

repo

rted

see

ing

at le

ast

one

cock

roac

h da

ily o

ver t

he la

st m

onth

Data source: New York City Housing and Vacancy Survey (2014), data from New York City DOHMH Environment & Health Data Portal

103

101 101

103

2

3

4

1 Highbridge/South Concourse 2 Kingsbridge Heights/Mosholu 3 Morrisania/East Tremont 4 Mott Haven/Hunts Point 5 Pelham Parkway 6 Riverdale/Kingsbridge 7 Soundview/Parkchester 8 Throgs Neck/Co-op City 9 University Heights/Fordham 10 Williamsbridge/Baychester

1 4

7 8 3

5

2

9

6 10

29

The Bronx has the highest percentage of adults reporting mold in the home

12.9

10.5

8.0 8.6

5.5

0

2

4

6

8

10

12

14


Perc

ent o

f adu

lts re

port

ing

mol

d in

at l

east

one

room

in

thei

r bui

ldin

g, e

xclu

ding

the

bath

room

, in

the

past

30

days

Data source: New York City Community Health Survey (2012), data from New York City DOHMH Environment & Health Data Portal

30

The Bronx neighborhood with the highest percentage of adults reporting mold in the home is Fordham – Bronx Park

18.7

8.4 8.9

14.4

11.8

9.5

0

2

4

6

8

10

12

14

16

18

20

Fordham -Bronx Pk (1)

Kingsbridge -Riverdale (2)

NortheastBronx (3)

Pelham -Throgs Neck

(4)

South Bronx(5)

NYC Overall

Perc

ent o

f adu

lts re

port

ing

mol

d in

at l

east

one

room

in

the

ir bu

ildin

g, e

xclu

ding

the

bath

room

, in

the

past

30

day

s Data source: New York City Community Health Survey (2012), data from New York City DOHMH Environment & Health Data Portal

102 103

104

102

4 7

9

1 Fordham – Bronx Pk 2 Kingsbridge – Riverdale 3 Northeast Bronx 4 Pelham – Throgs Neck 5 South Bronx

1 4

5

1

4

1

3

2

31

The percent of current adult smokers across New York City has fallen since 2002, but remains highest for Staten Island

Data source: Community Health Survey, 2002-2017. Staten Island 2010 data is likely an underestimate of the true prevalence of smoking due to random sampling variation.

25.2

19.7

13.6

12.0

20.8

12.2

27.2

24.0

0

5

10

15

20

25

30

35

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

per

cent

of a

dult

curr

ent s

mok

ers


32

Despite having middle of the road smoking rates, the percent of adults reporting second-hand smoke is highest in the Bronx

11.2

6.7

0

2

4

6

8

10

12

14

16

18

2004 2006 2008 2010 2012

Perc

ent o

f adu

lts e

xpos

ed to

sec

ond-

hand

sm

oke

at

hom

e


Data source: New York City Community Health Survey (2004-2012), data from New York City DOHMH Environment & Health Data Portal

33

The Bronx neighborhood with the highest percentage of adults reporting second-hand smoke in the home is South Bronx

6.6

1.5

7.1

9.4

4.9

0

1

2

3

4

5

6

7

8

9

10

Fordham - BronxPk (1)

Kingsbridge -Riverdale (2)

Pelham - ThrogsNeck (4)

South Bronx (5) NYC OverallPe

rcen

t of a

dults

exp

osed

to s

econ

d-ha

nd s

mok

e at

hom

e

Data source: New York City Community Health Survey (2012), data from New York City DOHMH Environment & Health Data Portal

102 103

104

102

4 7

9

1 4

5

1

4

1

2

1

5 4

2

4

34

Fine particulate concentrations are, on average, second highest in the Bronx, although they have improved across NYC

11.1

7.7

0

2

4

6

8

10

12

14

2009 2010 2011 2012 2013 2014 2015 2016 2017

Mea

n fin

e pa

rtic

ulat

e m

atte

r (PM

2.5)


Data source: New York City Community Air Survey (2009-2017), data from New York City DOHMH Environment & Health Data Portal

35

Potential risk factors for which there is evidence of an association with asthma, but no data available for the Bronx

Pets (exposure to pet dander exacerbates asthma)

Pollen (exposure to pollen exacerbates asthma)

36

About the Community Health Dashboard Project

The goal of the project is to provide Bronx-specific data on risk factors and health outcomes with an emphasis on presenting data on trends, socio-demographic differences (e.g., by age, sex, race/ethnicity, etc.) and sub-county/neighborhood level data

Data will be periodically updated as new data becomes available.

Produced by Montefiore’s Office of Community & Population Health using publicly-available data sources

For more information, please contact us at [email protected]

mailto:[email protected]

37

Links to data sources

Global Burden of Disease Project: https://vizhub.healthdata.org/gbd-compare/

New York City Child Health, Emotional Wellness and Development Survey: https://a816-healthpsi.nyc.gov/epiquery/Child/CCHSIndex.html

New York City Community Health Survey: https://a816-healthpsi.nyc.gov/epiquery/CHS/CHSXIndex.html

New York City Youth Risk Behavior Survey: https://a816-healthpsi.nyc.gov/epiquery/YRBS/yrbsIndex.html

New York City Environment & Health Data Portal: http://a816-dohbesp.nyc.gov/IndicatorPublic/publictracking.aspx

New York City Neighborhood Health Atlas: https://public.tableau.com/profile/nyc.health#!/vizhome/NewYorkCityNeighborhoodHealthAtlas/Home

https://vizhub.healthdata.org/gbd-compare/

https://a816-healthpsi.nyc.gov/epiquery/Child/CCHSIndex.html

https://a816-healthpsi.nyc.gov/epiquery/Child/CCHSIndex.html

https://a816-healthpsi.nyc.gov/epiquery/CHS/CHSXIndex.html

https://a816-healthpsi.nyc.gov/epiquery/YRBS/yrbsIndex.html

http://a816-dohbesp.nyc.gov/IndicatorPublic/publictracking.aspx

http://a816-dohbesp.nyc.gov/IndicatorPublic/publictracking.aspx

https://public.tableau.com/profile/nyc.health#!/vizhome/NewYorkCityNeighborhoodHealthAtlas/Home

bronx community health dashboard · bronx community health dashboard: asthma last updated:...

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