New Yorkers Need to Get Serious about Getting Active: New Report

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FROM THE URBAN HEALTH MATTERS BLOG BY ELLIE DEGARMO

New Yorkers are exercising less than they did five years ago and at a rate below that of the average American. That’s what a newly released Behavioral Risk Factor Surveillance System (BRFSS) report tells us. BRFSS, an annual nationwide survey, assessed physical activity among American adults by measuring Leisure-Time Physical Activity (LTPA)—a fancy term used to encompass a broad range of activities like gardening, swimming, and golf.

The survey findings are particularly important tools for evaluating the progress made towards the New York State (NYS) Prevention Agenda (NYSPA). The NYSPA identifies increasing physical activity, as a way to prevent chronic disease, as one of five core goals. Unfortunately, this goal has not been met. The NYSPA calls for increasing exercise rates by 5 percent, from 73.7 percent in 2011, to 77.4 percent by the end of 2018.

So far, New Yorkers have failed to hit this target and are now farther from it than in 2011. By 2015, the percentage had actually dropped 3 percent, to 70.7, the lowest it had been for five years, slipping below the national average of 73.8 percent.

As New Yorkers spend more time sitting and less time walking, running, riding bikes or otherwise on the move, their chances of developing chronic diseases, like type 2 diabetes, increase. To improve this situation, the NYSPA offers several suggestions, such as investing in community-based organizations dedicated to increasing physical activity, as well as creating safe public spaces for exercise.

Communities across the state are also working toward the goal. For example, David Sandman, PhD, president and CEO of the New York State Health Foundation, discusses the revamping and renaming of the Corning Riverfront Park in Albany as a successful way of attracting more visitors to the site.

The survey also revealed that some NYS residents were more likely to get a healthy amount of physical activity than others. People living with disabilities or struggling with obesity spent less time engaged in physical activity. Rates were also lower in some ethnic groups, such as Hispanic adults, and among people with less than a high school education.

In an ongoing effort to address disparities, the NYSPA‘s mission includes a commitment to improving these discrepancies: “reduce health disparities for racial, ethnic, disability, and low socioeconomic groups, as well as other populations who experience them.”

Specifically tailoring interventions to certain groups has also proven to increase physical activity among individuals in communities facing greater health disparities. Another article by Sandman demonstrates this by explaining the success of the Citi Bike program in the Brooklyn neighborhood of Bedford-Stuyvesant. Making Citi Bikes available in Bedford Stuyvesant adds to local resources like the YMCA and may help residents address high rates of obesity and diabetes.

As part of the Academy’s dedication to improving health in New York City and State, our Advancing Prevention Project and Designing a Strong and Healthy NY project teams energetically support the BRFSS report’s call to increase opportunities for physical activity for all New Yorkers.  Continuing to turn NYSPA objectives into action is one of the best ways to help all New York communities get moving.

Paving the Road for Expansive Policies, the Complete Streets List is In

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People everywhere are demanding safer, innovative streets for their towns. One of the ways to go about this is to come up with new transportation policies that will accommodate every citizen, regardless of race, ethnicity, socioeconomic status, and ability. The top 15 best policies to enhance localities’ roads for 2016 were named earlier this month.

In 2004, the community planning and advocacy organization Smart Growth America launched the National Complete Streets Coalition. The coalition was a call for localities across the country to draft policies for that Smart Growth calls Complete Streets, which are “for everyone,” meaning that they should be accessible to pedestrians, bikers, and people of all ages and abilities. A Complete Street includes sidewalks, special lanes for public transit, more median islands in crosswalks, and curb extensions. 2016 saw more than a thousand towns in the United States draft policies towards safer and more accessible streets. 2016 saw the most policies than any other year of the coalition existing, with a whopping 222 new policies drafted. They were also the strongest ever, many of them achieving scores of 90 or higher. Among them was our own Binghamton, NY, whose policy included adding more walkways for access to public transit, bike racks on buses to allow for more travel destinations for bikers, and add greenways in parks. These simple additions will improve air quality, increase physical activity, and will overall enhance quality of life for Binghamton’s residents.

On a national scale, the promises of safe streets are an immensely positive step, as these localities are leading the way in equitable and safe roads. The United States is steadily improving to avoid accidents and harm coming to pedestrians. A Smart Growth report called Dangerous by Design 2016 highlighted alarming statistics of disparate pedestrian accidents and deaths. It reported that the aging, low-income, and communities of color were the most susceptible to pedestrian deaths because of roads being more catered to cars. For example, Non-White populations make up 34.9 percent of the national population, but make up 46.1 percent of pedestrian deaths. At the same time, individuals that are 65 years or older are 50 percent more likely to be hit and killed by a car while walking. It also stated that many individuals in those communities do not have access to a car and must walk, putting them at risk of injury or death.

Not only is the sheer number of new policies monumental, it also shows a shift in the nation’s thinking. More and more, localities and states are implementing projects and policies to make their landscape more equitable and safe, taking the first steps to lessen the disparities between communities, building crosswalks instead of road blocks. We hope the results of Complete Streets will start a trend for even more localities to make their spaces more accessible and safe for everyone. The Advancing Prevention Project (APP) and DASH-NY are proud to support Complete Streets initiatives, which is part of our ongoing support to Local Health Departments’ Prevention Agenda plans and our advocacy for Active Communities around New York State.

Congratulations to all the ranking towns on their policies, keep paving the road for equity and justice.

Does a One-Size-Fits-All Approach Work When It Comes to Reducing Sodium Intake?

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FROM THE URBAN HEALTH MATTERS BLOG BY AMANDA LI

Cardiovascular disease (CVD) currently ranks as the number one killer in the United States. In fact, one out of every four deaths can be attributed to CVD. In New York City, more than one in three adults lives with cardiovascular disease. Many factors contribute to CVD, but most research suggests that one of the major risks can be attributed to something we eat every day: salt.

Our bodies need sodium to function as it helps regulate fluid balance, transmit nerve impulses, and control muscle function. Yet, when consumed in excess, sodium can cause severe damage to our heart and blood vessels. With 75 percent of the population eating nearly two times the amount of daily recommended sodium, and almost 1.65 million CVD-related deaths in the world associated with high sodium consumption, there’s a critical need to find an effective way to lower the amount of salt in our national and international diet.

Multiple government and community-based initiatives have attempted to help people reduce excessive sodium intake. This includes the American Heart Association’s #BreakUpWithSalt Campaign, New York City’s sodium warning label requirement for chain restaurants, and recommendations encouraging health professionals to advise patients on reducing their sodium intake. New research suggests, however, that a one-size-fits-all approach may not be effective.

A 2017 study conducted at The New York Academy of Medicine by Yan Li, PhD, José Pagán, PhD, and Julia Berenson, MS, along with Andrew Moran, MD, from Columbia University Medical Center, investigates this question. The research team identified key characteristics (i.e., age, geographic location, income, ethnicity, race, body mass index, and self-reported hypertension status) that they used to categorize people into subgroups based on how likely they might be to heed professional recommendations to reduce sodium consumption. The study was based on survey data on 125,764 respondents to the 2013 Behavioral Risk Factor Surveillance System.

Li and colleagues found that age was the most significant predictor for whether a person would follow recommendations from their health professional on sodium intake. The study results also revealed that within each age group, predictors of sodium intake were quite different. For instance, for people ages 18 through 64, the predictors of sodium intake behavior were linked to geographic location, income, and self-reported hypertension status. For the younger group, under age 45, BMI was also a factor. Yet, for people 65 and older, diabetes, hypertension, race, ethnicity, and geographic location shaped their sodium-intake choices.

Findings like these suggest that a one-size-fits-all approach to reducing sodium intake at the population level, such as simply informing people about the sodium content of popular foods, may not be enough to get people to act. When it comes to reducing sodium consumption, a more productive approach may be to segment populations into different groups based on demographic, clinical, and geographic characteristics, and tailor interventions to the needs and interests of each subgroup.

Earlier work by Pagán and Li found that among New York City residents, cutting salt intake could actually add years to life. With this new research, the Center for Health Innovation team may be a few steps closer to figuring out the best ways to convince people to shake off the salt for better health.

Partners in Health: Community Food Programs and Hospital Partnerships in New York

DASHNY Clinical and Community Linkages, Food Policy, HOMEPAGE LATEST NEWS, Prevent Chronic Disease 0 Comments

Heart disease, diabetes, and obesity are among the serious conditions that can result from a poor diet. Creating healthy food environments is vital to preventing these serious conditions and promoting the well-being of our communities.

Hospitals and community-based organizations play a critical part in promoting food environments that support healthy eating. This is why, on May 15, 2017 from 10 am – 4 pm, the New York Academy of Medicine, in partnership with the Community Food Funders, hosted the Partners in Health: Community Food Programs and Hospital Partnerships in New York convening. This event created a place for CBOs working to improve the food system and hospital/health system leaders across New York State to come together, share information, and explore potential partnerships.

It is our hope that by bringing hospital/health system leaders and community-based organizations together, we can help foster potential partnerships that will promote greater access to healthy food across our state’s communities.

The convening included a keynote speech on The Good Food Purchasing Policy: A Holistic Approach to Food as a Determinant of Health by Paula Daniels, J.D., co-founder and Chair of the Center for Good Food Purchasing. There were also panels on the following topics:

  • Health Care: What value can CBOs bring to population health?
  • Food: How and why to partner with a hospital?
  • Hospital-CBO Partnerships that address food and nutrition

Following our panelists, the convening participants gathered together in small group breakout sessions around topics like emergency food, local procurement, and hospital food environment.

A huge thank you to everyone who joined us on May 15, 2017 for this important work!

Supervised Injection Facilities: A Controversial but Proven Solution to a Deadly Epidemic

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By Amanda Li and Michele Calvo

In 1995, at the peak of the United States’ HIV/AIDS epidemic, 43,115 people died from the disease within that one year alone. Now, in 2017, we are facing an even deadlier epidemic: the opioid crisis. Drug overdoses are currently taking more lives than the HIV/AIDS epidemic did at its peak; in 2015 alone, over 52,400 people died from a drug overdose in the U.S., with almost two-third of those deaths related to opioid use.

How do we confront this growing crisis that is now outpacing some of the current leading causes of death? Although controversial in the U.S., supervised injection facilities (SIFs) have existed in Europe and Canada for decades as a tool in combatting overdose death and drug-related harms. SIFs are hygienic locations where people who use drugs can legally consume pre-acquired drugs under the supervision of trained professionals. Not only do SIFs provide medical supervision and a safe, sterile environment for injection, but they also provide linkage to primary health care, information on how to reduce the harmful effects of drugs, and treatment referrals among other valuable services.  In order to make them more inclusive to other kinds of drug use and not just limited to injection-based drugs, SIFs have also been referred to as supervised/safer consumption spaces (SCS).

There are currently no SIFs/SCSs present in the United States as the idea of providing legal spaces for illicit drug use is highly controversial. However, there are over 100 SIFs located around the globe across 60+ cities and ten countries. The great news is that across these 100+ SIFs, some of which been around for more than 30 years, no known overdose-related deaths have occurred in these facilities. In fact, studies show that these SIFs effectively promote safer conditions for injecting, improve access to health care and drug treatment, reduce overdose deaths, and decrease the frequency of public injections without increasing the rate of drug trafficking, injecting, or crime.  Further, people who use drugs often face tremendous social isolation and stigma, and SIFs help provide a place where these people can feel respected, valued, and cared for.

Knowing the potential public health benefits that SIFs can bring to New York City (which had about a 60% increase in fatal opioid overdoses in 2016), the New York Academy of Medicine is a proud member of SIF NYC, collaborating with the other members of the coalition to advocate for the implementation of SIFs/SCSs in the city. The Academy is also partnering with the New York Community Trust and the NYC Department of Health and Mental Hygiene on a feasibility study around using SIFs to help address the city’s opioid epidemic. A report of the study’s findings will be available this summer 2017.

Fortunately, the push to bring SIFs into New York has been gaining momentum. On April 25, 2017, the Safe Consumption Spaces Campaign Launch began with the release of a letter signed by more than 100 healthcare professionals across NYC declaring their support for SIFs as an evidence-based public health intervention to reduce overdose and blood-borne infections. The campaign continues with a 10-day Safe Shape tour that showcases a SCS model and documentary about public injection in the state. This campaign will hopefully help create the public awareness and dialogue needed to finally bring a much-needed resource into New York.