Wednesday, December 19, 2012

End of Year Celebrations & Reflections

Before the tragic events of last week, there were several major pieces of health news. Each gave us cause for a moment of celebration and a moment of reflection.

Childhood Obesity Decreasing for the First Time in Several Cities
First, the New York Times reported last Monday that several large cities, including New York City (NYC), have seen declines in childhood obesity rates for the first time. Before this, obesity rates were going up every year. NYC first celebrated this tide change one year ago. However, the Times article was a nice reminder that we are not alone. Philadelphia, Los Angeles, and El Paso also achieved some level of success with obesity prevention programs.

This is some of the first good news in the obesity epidemic, but it but it also reminds us how much work is left to be done.  Declines were relatively small, just 3%-5%. We still have a lot of overweight and obese children who are likely to develop health problems over the course of their life.  Also, in NYC, obesity rates among white children declined much more than blacks (13% versus 2%). That means we have lots of work to do to ensure that health programs and their benefits reach ALL of our children. Luckily Philadelphia shows us that this is not an impossible dream. Even with higher rates of poverty, their obesity rates dropped the most among minority children.

New Yorkers are Living Longer
Last Tuesday, Mayor Bloomberg announced that life expectancy in NYC hit a record high. Babies born in NYC in 2010 can expect to live on average two years longer than babies born in other parts of the country. The NY Post suggested that the city has become a “fountain of youth”. NYC Health Commissioner Thomas Farley credited the city’s efforts to reduce infant mortality, detect and treat HIV, and address heart disease and cancer through improved health care and anti-smoking efforts for the city’s success.

While we agree that increased rates of life expectancy are good news, a closer look at the data shows that not all New Yorkers benefited equally. While Hispanics can expect to live to be 81.9 years old, non-Hispanic Whites live 6 months less on average. Life expectancy for non-Hispanic Blacks is only 77.4, a difference of more than four years. Over ten years the gaps between groups shrunk somewhat. However, similar to our work around childhood obesity, we clearly have a lot more work to do to make health equity a reality.

Life Expectancy Improving Faster in Other Countries
Finally, last week the news media widely covered a report about life expectancy worldwide. Across the globe, many more people reach old age as compared to 20 years ago. Life expectancy is increasing, because deaths from malnutrition and infectious disease are significantly down. As a result, infant mortality has also been cut in half.
While celebrating these improvements, we noted two important facts. First, as fewer people die of hunger and infectious diseases, more people have chronic diseases such as obesity, heart disease, and diabetes. More and more, we are not alone in addressing these problems and the related health disparities. Second, life expectancy in the U.S. went up over twenty years, but not as much as in other places. Countries including Cyprus and Canada saw greater improvements than we did.  As we develop new programs, we should consider what we can learn from other countries. 

Learn More
For the most part, media coverage of these stories reported the numbers without digging very deeply into what they really mean. For more insight, we recommend a story published last summer in the Lancet, a highly respected British medical journal. The article describes disparities in life expectancy in NYC, how they stack up globally and historically, as well as what’s being done about it in the Bronx.

As always, we invite you to visit the Bronx Health REACH website to learn more about what we are doing to make health equality a reality.



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