Stark Health Disparities Between Bedford Stuyvesant and Bay Ridge/Dyker Heights

Photo via Flickr by Eli Duke

The New York City Department of Health and Mental Hygiene continues to address health disparities across New York City. Below is an article from Raven Rakia comparing the Bedford Stuyvesant section of Brooklyn to the Bay Ridge/Dyker Heights neighborhood and the stark health disparities between the two areas.

To read the full Community Health Profile for Bed Stuy click here

To read the full Community Health Profile for Bay Ridge click here

In New York City’s black neighborhoods, poverty, housing issues, and asthma go together

By Raven Rakia on 16 Oct 2015

It’s a tale of two cities. New data from the New York City Department of Health shows the health of New Yorkers can vary drastically by neighborhood and is linked to race, housing issues, and poverty.

Earlier this week, the Department of Health published community public-health profiles that take an in-depth look at each neighborhood in Brooklyn (other boroughs will be coming over the next two months). The profiles detail the poverty rate, access to health care, life expectancy, strokes, asthma, mental illness, and cause of death for each neighborhood’s population. They reveal the stark reality of how health in New York varies along race and income lines.

Living in Brooklyn’s predominantly black neighborhoods comes with an increased rate of asthma hospitalizations. In all but one of Brooklyn’s predominantly black neighborhoods, the number of asthma hospitalizations was higher than the borough and city average for both children and adults. The whiter the neighborhood got, the fewer asthma hospitalizations there were.

The difference is stark: In Bed-Stuy, a neighborhood that is 64 percent black, there were 531 avoidable adult asthma hospitalizations per 100,000 people and 54 child asthma hospitalizations per 10,000 people. In the Bay Ridge and Dyker Heights neighborhood, which is 60 percent white, there were 94 avoidable adult asthma hospitalizations per 100,000 people and nine child asthma hospitalizations per 10,000 people.

The four neighborhoods in Brooklyn with the highest avoidable adult asthma hospitalization rates are all over 83 percent black and Latino, and they also have some of the highest poverty rates in the borough. While showing the connections between race, poverty, and health on a microscopic level, the data also offers a glimpse into some of the reasons why the differences may be so high. In Brooklyn, most of the levels of particulate matter (as a form of air pollution) range from 8 to 9.5 micrograms per cubic meter. When it comes to housing quality, in six neighborhoods, 70 percent or more rented homes have at least one maintenance defect. All six of those neighborhoods are predominantly black and Latino, and four out of the six neighborhoods have high rates of asthma hospitalizations. Poor housing quality could mean the presence of mold or asbestos, which are associated with respiratory illnesses.

The most important thing about all of this data is that it shows a complete picture of how the neighborhood you live in can affect how healthy you are. As NYC’s Health Commissioner Mary Bassett told CBS New York, “The health of a neighborhood doesn’t just rely on the decisions an individual makes, but on the resources that are available to them in that neighborhood.”

New Yorkers, if you want to be healthy, it’s going to be much easier if you’re white and can afford to live in a richer neighborhood. For everyone else: good luck.

Does Soda Need a Warning Label?

Image from Public Health Advocacy website

The harmful effects of cigarettes have been well documented, requiring them to have warning labels on the package. With  recent studies revealing the harmful health effects, should soda also have a warning label? New York State Assembly Member Jeffrey Dinowitz and state Senator Gustavo Rivera believe so and have introduced legislation (Assembly Bill 2320-B& Senate Bill S 6435)  requiring that any sugar sweetened beverages sold in New York State have a warning labels.

The label would state:

SAFETY WARNING: Drinking beverages with added sugar contributes to obesity, diabetes and tooth decay.

The label would be affixed to any carbonated or noncarbonated sweetened nonalcoholic beverage that has seventy-five calories or more per every twelve fluid ounces. Warning labels would not be needed for beverages consisting of one hundred percent natural fruit juice or natural vegetable juice that does not contain caloric sweeteners. A larger sign/poster would be posted in places such as restaurants and any establishment that dispenses sodas.

California lawmakers tried to pass similar legislation (SB203) but the bill died in committee in April 2015. CalBev, the California arm of the American BeverageAssociation, argued against the California bill by stating that soft drinks are not “uniquely responsible for weight gain,” and added that affixing a warning label would not change behaviors or teach people about healthy lifestyles.

But contrary to what CalBev has stated, various studies have confirmed that a warning label for soda is warranted. The California Center for Public Health Advocacy (CCPHA) states in a factsheet, “An overwhelming body of scientific research shows that liquid sugar is uniquely harmful because it gets absorbed so quickly, and much faster than solid food. When sugar floods the bloodstream, it overloads the pancreas and causes the liver to store much of the sugar as fat – which leads to fatty liver disease. Both of these conditions contribute directly to diabetes. Research shows that drinking one or two cans of a soda a day increases the risk of developing diabetes by 26 percent.”

Nutrition experts agree that sweetened beverages, such as soft drinks, energy drinks, sweet teas and sports drinks, offer little or no nutritional value, and contain large quantities of added sugars. A 20 ounce bottle of soda contains the equivalent of approximately 17 teaspoons of sugar, whereas the American HeartAssociation recommends consuming no more than five to nine teaspoons of sugar daily.

In New York City the harmful effects of soda consumption are more acute. Providing testimony before the New York State Assembly Standing Committee on Consumer Affairs and Protection on April 13, 2015, Christine Johnson, Assistant Commissioner of the Bureau of Chronic Disease Prevention and Tobacco Control at the New York City Department of Health and Mental Hygiene stated, “In New York City, 56% of adults are overweight or obese and over 10% have diagnosed diabetes. Rates are even higher in New York City’s poorest communities, which also bear a greater burden of chronic disease.

Nearly a quarter of adults drink at least one sugary drink per day, and consumption rates are nearly double in New York City’s lowest-income communities compared to the highest-income communities, and over 40% of New York City public high school students report drinking one or more sugary drinks daily. The proportion of New Yorkers regularly consuming sugary drinks has declined in recent years; however, these rates are still too high.”

A studyfunded by the Healthy Eating ResearchProgram of the Robert Wood Johnson Foundation, and conducted by University ofPennsylvania, Harvard T.H. Chan School of Public Health and the University ofWaterloo asked 2381 parents to select a beverage from a simulated vending machine containing a variety of were sweetened and unsweetened drinks. The study revealed that those drinks with warning labels were three times as effective in making parents less likely to purchase a sweetened beverage. The warning labels also were effective among parents of varying educational backgrounds revealing that not just the most educated parents read the labels, but all parents read and considered the labels.

Assembly Bill 2320-B & Senate Bill S 6435 is important. Having that warning on soda labels means that each time a consumer goes to buy or drink that soda they would know of the danger to their health and hopefully, would put that soda down.  We know, however, that getting these two bills passed will not be easy. It will draw the ire and enormous money and power of the Soda Beverage industry to defeat it. The Bronx Health REACH Coalition knows how critical it is to reduce the overweight and obese epidemic in the Bronx  where 2 in 3 adults are overweight or obese, and where 4 in 10 public school elementary students are either obese or overweight. Efforts of our policy makers to make it easy for residents to make healthy choices is extremely important.

Should warning labels be placed on soda? Join in the conversation below.

Rev. Dr. J. Albert Bush – A Strong Voice for the Bronx Community and Beyond

Bronx Health REACH  will be featuring individuals that have made a significant contribution to not only the Institute for Family Health's Bronx Health REACH, but have been strong activists for needed change in the Black and Latino communities in the Bronx as well as elsewhere. A notable member of this group of change agents is the Rev. Dr. J. Albert Bush, Sr. pastor of Walker Memorial Church in the Bronx. Rev. Bush is a 1983 graduate of the Lutheran Theological Southern Seminary in Columbia, South Carolina where he earned a Master of Divinity degree, and later earned a Doctor of Ministry Degree from the Drew University Theological Seminary in New Jersey. 2016 marks his 34th Pastoral Anniversary at Walker Memorial Church.

Growing up in South Carolina as the second of nine children, Rev. Dr. J. Albert Bush was the first in his family to graduate from college. Adopting a liberationist approach to theology, Rev. Bush started to see and understand how God could use poor people as an instrument to make change in their community.

Answering the call to serve at Walker Memorial Church in 1982 provided a wake-up call for him. Walker Memorial Church had been at 116th Street in Harlem, and moved to the Bronx prior to his arrival. “The Bronx at the time had no housing, no industry, just burned out buildings and depression all around. Many of the people in the congregation saw my arrival as a ticket back to Harlem,” says Rev. Bush. Believing that his time in the Bronx would only be two years, Rev. Bush found himself asking God, “Why did you send me here? Do I belong here?”

Out of his quest he discovered that Walker Memorial Church did not need to return to Harlem. He could learn to love and care for the people of this community and lead them so that they could take responsibility for the change that needed to come. Looking back Rev. Bush admits that was a painful decision, but is convinced that it was the right one at the time. “God was making plans for me to do something, and when I embraced that concept, I led my congregation to become involved in the renewal and rebuilding of this community,” says Rev. Bush.

That renewal and rebuilding has included the Grand Concourse Academy Charter School. “We purchased the empty lot next door twelve years ago and built Grand Concourse Academy Charter School without any federal, state, or grant money. The school was built with all the financial support coming from members of Walker Memorial Church,” says Rev. Bush.

Rev. Bush has also been a long time member of the Bronx Health REACH Coalition where he provides Walker Memorial Church as the meeting place of the Faith Based Outreach workgroup and the quarterly Coalition meetings. He has seen the damage health disparities has done to the community. “This community unfortunately has some of the highest breast cancer rates, highest heart disease rates, and highest amputation rates from diabetes. The thing that surprised me most was the lack of awareness in the community itself. People did not know they were unhealthy,” says Rev. Bush

He believes that healthcare should be more affordable, and more accessible. “You are talking to a man that was once paying $2,500 a month for health insurance over four years to cover his family. That is crazy! One needs a full time job just to pay for health care and that is senseless. It seems that we are comfortable in America keeping and maintaining an underclass,” says Rev. Bush. Rev. Bush adds, “I have experienced a great deal of what the people I seek to help have experienced. I was born in poverty, raised in poverty, and knows what it is like to not have health insurance. I feel every American should have the same level of healthcare that every Senator and Congressman receive. If we can grant it to them, they can return the favor.”

One thing Rev. Bush would change to make health care more equitable would be the elimination of the two class system where those with insurance can see anyone faster than those without insurance that have limited options. “I know of people that have died in the emergency room that had been waiting up to fourteen hours to be seen by a doctor, but people with same problem that have health insurance, they can be seen by someone lickety-split,” says Rev. Bush.

Rev. Bush still continues his work assisting those that have been displaced by disasters in places such as Mississippi and Georgetown, South Carolina. “I am the lead for our denomination (National Baptist Convention) for the disaster response team to any man-made and natural disasters. I have fifteen men on the ground in Mississippi providing relief to those affected by the tornadoes. I have thirty-seven men in Georgetown, South Carolina who are working in partnership with the American Red Cross, FEMA, and other disaster relief agencies, as well as congregations, to aid and assist the people of South Carolina with emergency supplies, such as food, water, and clothing, helping people rebuild homes damaged by the floods,” says Rev. Bush. Currently Rev. Bush is working with officials in Flint, Michigan trying to resolve the man-made disaster of poisoned water.

And the relief efforts are not limited to the United States. In response to the Ebola crisis in Liberia, Rev. Bush Sent aid project through his missionary organization, So Send I You to Providence Baptist Church in Monrovia. “We have sent food relief to Liberia by shipping two ninety foot containers to Liberia with $90,000 worth of food. We also have a daycare center in South Africa in the poorest section of Soweto, and a food kitchen in Swaziland that feeds seventy-five orphan children that have lost both parents to AIDS. We are also building a church and library in South Africa,” says Rev. Bush.

Pastor Robert L. Foley Sr. – From Civil Rights’ Marches of the 60s to Championing the Cause of Eliminating Racial and Ethnic Health Disparities in the Bronx.

Bronx Health REACH continues it’s series of individuals that have made a significant contribution to not only the Institute for Family Health's Bronx Health REACH, but have been strong activists for needed change in the Black and Latino communities in the Bronx. 

 

A notable member of this group of change agents is Pastor Robert Lewis Foley, Sr., D. Min, D.D. Pastor of Cosmopolitan Church of the Lord Jesus in the Bronx, New York. Rev. Foley was raised in Georgia, graduated from Morris Brown College in Atlanta, and received a master of divinity degree from the Interdenominational Theological Center in Atlanta, and a doctor of ministry degree at Drew University in Madison, New Jersey.

Pastor Robert Lewis Foley, Sr. was born in Marietta, Georgia. His father had been a pastor serving several congregations in Georgia and Birmingham, Alabama and would become an influence on Pastor Foley's decision to enter the Christian ministry in 1956 and a pastor himself in 1962. After becoming a pastor in Atlanta, Georgia, Pastor Foley became involved in the civil rights movement by attending meetings in Atlanta with  Dr. Martin Luther King, Jr.  and Dr. Ralph Abernathy,  participating in events with Julian Bond and Stokely Carmichael, and marching  from Selma to Montgomery. At the time Pastor Foley did not realize that working with and marching alongside these historical civil rights leaders would put him on the path to becoming a community leader and providing a voice for underserved communities. "During the time of my involvement with these civil protests, I had no idea that what we were doing would have the impact on this nation that became the reality. I did it because I thought it was the right thing to do, and now I realize it is part of the reason God sent me to this world," says Pastor Foley.

While attending the ITC Seminary in 1965, he married and continued his pastoral ministry in Atlanta. In 1967, after a meeting with the late Bishop John Bright (the leader of all the New York based AME churches), Pastor Foley was transferred to New York where he continued his pastoral ministry in Tuckahoe, New York and in Harlem. After a few years, he decided to organize and establish an independent church. The first worship service of this new church named Cosmopolitan Church of the Lord Jesus, took place at a Prince Hall Masonic Lodge in Manhattan, and the next several services of worship were held in the auditorium of a public school also in Manhattan.

As fate or more likely providence would have it, a colleague of Pastor Foley spoke to him about a realtor who had placed an advertisement regarding a church building for sale in the Bronx, New York. The owner of the Bronx church invited Pastor Foley and his congregation to hold a service in the space, and soon after accepted an offer to purchase the church. At first Pastor Foley was uncertain if the congregation would be able to pay the mortgage, but soon discovered his congregation wanted to stay permanently. “We never missed a payment on the mortgage and retired that 18 year mortgage in 16 years, even though many of our members at that time were retired senior citizens living on a fixed income,” says Pastor Foley, and he continues to serve this congregation after 38 years.

In 1999 Joyce Davis and Maxine Golub from the Institute for Family Health met with Pastor Foley as the Institute for Family Health was launching a community coalition whose goal was the elimination of racial and ethnic health disparities in the South Bronx. A special emphasis of the soon to be formed coalition was to focus attention on the discrimination and health disparities in health services provided by many of New York City’s teaching hospitals. "They gave an overview of how widespread the problem was, and it was an eye-opener for me since I was not aware how large and devastating health disparities were, and seeing how the minority communities were not being properly attended to by the medical community motivated me to join," says Pastor Foley.

Pastor Foley continues to be an active participant in many Bronx Health REACH initiatives. He not only graciously provides his church as a monthly meeting place for the Health Disparities Workgroup, but Cosmopolitan Church of the Lord Jesus has been host to several of Bronx Health REACH’s pastors breakfasts.  The most recent event was the hosting of a meeting of local elected officials and clergy leaders to address the Bronx being ranked 62 out of the 62 New York State counties in health outcomes and health factors in the Robert Wood Johnson’s County Health Ranking Report.

The pulpit is the one place Pastor Foley believes he has the most influence. "Every week I try to say something that speaks to the importance of maintaining your physical and mental well-being. Maintaining a healthy lifestyle is an extension of our ministry, and the church must maintain relevancy to the community if we are to serve effectively and meaningfully," says Pastor Foley. Additionally, he serves as a member of the Community Advisory Board of Montefiore Hospital, the Advisory Board of the Bronx Region of the American Cancer Society, the New York Yankees Community Relations Council, and the Police/Clergy Liaison of the NYPD.

Dr. Eric Gayle – A Commitment and Passion for Providing Underserved Communities with High Quality Medical Care

Bronx Health REACH continues its series on individuals who have made a significant contribution to not only the Institute for Family Health, but to the African-American, Black and Latino communities in the Bronx where they have been strong activists for needed change. A notable member of this group of change agents is Dr. Eric Gayle, Vice President, Medical Services and Regional Medical Director, in New York City for the Institute for Family Health. Dr. Gayle also mentors minority students who are interested in careers in medicine, and leads the Institute’s credentialing committee.

Growing up in Kingston, Jamaica Dr. Eric Gayle quickly learned that a community lacking robust healthcare means having to wake up at 4:30 in the morning to stand in line for hours to be seen by a doctor. To Dr. Gayle, this did not seem right, and those experiences influenced him to become a doctor. The path to becoming a doctor began following his arrival in New York with his mother after completing high school in Jamaica. Dr. Gayle found having to navigate getting into college and medical school in the United States had its challenges. One was the few financial resources available to him; the other was improving his language skills since his spoken language was his native Jamaican patois. He found that he had to work hard to enhance his own standing in the eyes of others for them to give him access to opportunities. After determining the best avenue for getting into medical school, Dr. Gayle enrolled at the Sophie Davis Biomedical Education/CUNY School of Medicine, beginning his path to a career in medicine.

One class he took opened his eyes to the poor health services many New Yorkers received. Dr. Gayle had to review health services offered to the Harlem community and in doing so he was shocked to learn that Harlem residents received the same poor health services as Dr. Gayle experienced growing up in Jamaica. As a Bronx resident Dr. Gayle also observed that his neighbors in the community were not getting what they needed to become healthy. After completing his B.S. from the Sophie Davis Biomedical Education/CUNY School of Medicine, Dr. Gayle transferred to the Mount Sinai School of Medicine to complete his medical degree. He then did his residency in family medicine at Beth Israel Hospital, and upon completion of his residency in 1998, went to work at one of the Institute for Family Health’s (IFH), clinics in the Bronx.

His current responsibilities relate to the overall operations of the IFH New York City clinical centers. Dr. Gayle is responsible for ensuring that there is enough provider staff at all IFH centers, and that providers meet expectations on the quality of care for patients. "We are here for the patients, to improve their health and to serve the community. My principal responsibility is to give all health centers everything they need to be successful and meet that objective. Even though practicing in underserved communities is not easy, I can impact someone’s health by prescribing medication or offering them advice. It is hard to impact some of the social determinants of their health. Those are outside my control," says Dr. Gayle.

From his days growing up in Jamaica, Dr. Gayle knows what his patients are experiencing when it comes to accessing healthcare in underserved communities. "I know what it means to be in poverty and have social determinants impact your health. When my mother and I arrived in New York we did not have health insurance so I understand what my patients are going through and I have an understanding of what it takes to get them through these challenges," says Dr. Gayle. Addressing the current state of health disparities, Dr. Gayle believes there is more work to be done. "I don’t think we have impacted social determinants of health. I see there is dialogue and research but nothing has been done to improve income equality or housing, as many are still dealing with the same issues that were there 20 years ago. People are struggling to find food. Why does that continue to be a problem? It would take commitment and resources such as money to revamp the whole system," says Dr. Gayle.

A commitment to providing underserved communities with high quality medical care is what has been a guiding passion throughout Dr. Gayle’s career. So what advice would he give to those graduating medical school seeking a similar career but who are graduating with $200,000-$300,000 in student debt? “Though, this may be seen as a significant barrier I tell students not to be discouraged. If you have the passion, and really want to do this work, you can be successful," says Dr. Gayle.