When discussing health problems in New York City, it is easy to target unhealthy products such as fast food and tobacco because consumption of these goods is proven to be detrimental to a person’s health. However, the same can be said for alcohol even though there is not a large movement in place to reduce that (with the exception of drinking and driving). Rather than focus on these problems (which can be drastically reduced by people simply having more self control) I would like to focus on unavoidable health issues for many New Yorkers. The first being the fact that lead content is still found in paint in many old homes. The old homes that contain this harmful paint often belong to low income families who cannot afford to test the walls themselves. As a result, many families (and especially children) have suffered from lead poisoning. It is so common that personal injury attorneys often advertise on trains their success winning money for injuries caused by lead paint. I even went to middle school with a student who suffers from mental retardation because of lead paint. A second issue is food deserts. Approximately 750,000 New Yorkers live in designated food deserts while 3 million live near few or far away from affordable healthy food options. The locations of these food deserts are Central/East Harlem and North/Central Brooklyn. These locations pose a serious health risk to the people living there, removing the previously discussed will power associated with choosing healthy food over fast food; people living in food deserts are often forced to eat unhealthy fast food due to financial reasons. Thirdly, I would like to discuss the related problem of unhealthy public school lunches. As a student in the public school system since pre-kindergarten, I have seen the awful food provided to students. It sets them up for failure. The DOE preaches that students should stay healthy but do not back it up with actions. While they state “gym” class is just as important as math and science classes, shown by gym teachers making the same amount of money as any other teacher, they completely ignore the fact that nutrition is half the battle. While I was fortunate enough to bring lunch from home every day, many families at my school could not and the city forced poor nutrition on their children.

An important change to school lunches is to increase the requirements of a “healthy meal.” Currently, 30 million students nationwide are few by The National School Lunch Program. In 1946, Harry Truman signed this program into law and the guidelines appear just as old: “No more than 30 percent of the meal’s calories may come from fat,” “Less than 10 percent of the meal’s calories may come from saturated fat,” and “Meals must provide one-third of the Recommended Dietary Allowances (RDA) of protein, Vitamin A, Vitamin C, iron, calcium and calories.” Many experts have said that these requirements make school lunch not any better than fasts food and President Obama’s White House chef has stated that the meals are high in fat, preservatives and high fructose corn syrup. In order to improve the school lunches, and health, of young children, the requirements must be updated based upon our better knowledge of nutrition since 1946.

[1] http://recipes.howstuffworks.com/menus/who-decides-lunch-plans.htm

[2] http://www.schoolfoodnyc.org/public1/default.aspx?logout=1

[3] http://www.foodispower.org/food-deserts/

As a receptionist in a doctor’s office, I’ve seen various problems regarding health and healthcare. Especially, I saw a drastic rise in cost of healthcare plans and decrease in number of patients as well as doctors. Also, there is a great issue of obesity in New York, as well as throughout the other States. Therefore, in this post I will discuss the aspects of these issues and possible solutions that can be implemented to address these problems.

One of the most dramatic changes I’ve seen throughout my job as a receptionist is the cost of insurance. Because I became more knowledgeable about insurances and its expenses, I realized that there are way too many healthcare plans and their prices were high rocketing. According to The New York Times, with the increase in cost of insurances and deductible, many people cut back in visiting doctors. For example, Medicare patients have to pay off deductible every year in order for doctors to bill their services. However, I’ve seen numerous patients that are unable to pay their deductibles because it is expensive. Also, there is a significant number of different insurances. For example, Amerigroup insurance includes plans such as Medicare advantage, Healthplus, Community plan and more. This multitude of insurance plans is ineffective because doctors take certain number of insurances and this variance leads to confusion. Therefore, the number of insurances and their cost gives both patients and doctors hard time.

Furthermore, there is a decrease in number of doctors and patients throughout the years. The United States Census Bureau stated that, “In 2010, working-age adults made an average of 3.9 visits to doctors, nurses or other medical providers, down from 4.8 in 2001.” This decrease in number of patients can be reasoned with the cost of insurance. In addition, there is a shortage of doctors because of the recent health care law. This decline in patients and doctors is problematic because it does not insure health of patients. If patients delay office visits because of the cost, it may delay diagnosis of diseases. Late diagnosis can lead to late treatments and by that time, certain problems might be too late to cure. Moreover, obesity is an issue in New York as well as all throughout America. Although New York is not ranked as the state with the highest obesity rate, the rate of obesity in adult is 25.4%, which is still a high number. Obesity is a problem in today’s world because the rate has been increasing throughout the years. Quick and easy access to food can be harmful if the rate continues to rise. Also, New York lacks certain public policies that address obesity. For example, NY does not follow the Menu Labeling Law that requires nutrient content on menus. By not implementing such policy, people are not being thoroughly aware of what they are eating.

From these three problems I have addressed, I found the cost of insurance to be the most important topic to discuss. For example, President Obama tried to tackle the problem of cost of insurance by enacting the Affordable Care Act. Although this act’s effectiveness is still debated, data have shown that it has helped in significantly decreasing the number of uninsured people. Such policy is one way of solving the issue of cost of insurance.

Also, to address the problem of declining patients and doctors, there should be a way to enforce communication between the patient and the doctors. It is crucial for patients to be aware of their rights as a patient and should feel at ease in visiting doctors. Also, better communication between these two parties can ease the environment within the office and convince patients to regularly visit doctors.

Furthermore, I believe it is crucial to increase awareness of health issues within society. As mentioned above, rise in rate of obesity is an issue that could be solved with more awareness. If the policy of Menu Labeling Law was implemented in New York, more people would be aware of what they are consuming and would be conscious of its effect. Therefore, by implementing awareness and educating people about health issues, more people would be keen to their health. In order to educate people, schools should be the first step in teaching the problems. Health education class should not solely focus on problems of drugs or sexual diseases, but also on rights of patients and the problems of health in today’s society. Therefore, with increase education and awareness, these issues could be addressed and solved.

http://www.nytimes.com/2012/10/02/health/doctor-visits-drop-census-finds.html
http://www.nytimes.com/2012/07/29/health/policy/too-few-doctors-in-many-us-communities.html
https://www.census.gov/newsroom/releases/archives/health_care_insurance/cb12-185.html
online.citibank.com/US/JPS/portal/Home.do
http://obamacarefacts.com/obamacare-pros-and-cons/
http://stateofobesity.org/states/ny/

In a city with many people like New York City, public health is an important matter that widely affects both the present and future generations of citizens. Given the country’s current stance on healthcare, New York City faces many issues of public health that unfortunately cannot be solved easily with policy change or federal government intervention. One of these public health problems is the presence of food deserts, or areas in the city with little to no access to affordable, healthy produce for miles. Science direct suggests that obesity is most common in New York City’s poor, low-income neighborhoods. According to the site “21% to 30% among adults living in East and Central Harlem and North and Central Brooklyn; some of New York City’s lowest income neighborhoods” (Sci_Direct). According to this information, these specific neighborhoods with the largest percentages of obesity have the lowest access to health produce and groceries in the city, and have the most sizeable concentration of fast-food restaurants than more wealthy neighborhoods. This is a problem because the obesity that occurs from food deserts are mainly contributing to the mal-nourishment of New York’s poor population, who are the citizens with the worst healthcare options.

A solution to this problem would be to potentially encourage citizens in these communities to eat locally grown produce. This would require the help of local New York farmers to sell their foods in affordable farmer’s markets or farm shares. With many available farmers markets in low-income neighborhoods, people forced to live in food deserts will be granted access to cheap but natural fruits, vegetables and meats they normally would not be able to find in local delis or fast-food restaurants in these areas.

A similar health related issue affecting New York City’s poorer areas is childhood obesity. According to the New York Times article “Obesity & School Lunches” school lunches are a major factor in childhood obesity for New York’s inner city children. The Times states “most school lunches rely heavily on high-energy, low-nutrient-value food, because its cheaper” (NYTimes). Because of this many children who attend public schools are not provided with balanced diets and therefore are more likely to become overweight. Though the department of education and the health department attempt to impart regulations on the number of vegetables and fruits that is offered to students, many schools either do not meet the minimum or substitute other foods for proper vegetables. For example, one school makes potato-based foods fulfill all the vegetable requirements in school (NYTimes). This is unhealthy and sets a potentially dangerous example of what a proper diet is to children, who then continue to eat badly as adults.

The last problem in public health that is common in New York City is the recent increases in HIV and other STDs in certain neighborhoods. According to a CBS report, approximately “19 ZIP codes with high rates of poverty in the South Bronx, north-central Brooklyn and northern Manhattan saw top-quintile rates of HIV/AIDS, chlamydia and gonorrhea” (_CBS). The report states as well that the highest rates of STDs were found in “the Bronx, where rates of hepatitis C, chlamydia, gonorrhea and HIV/AIDS all ranked in the top 20 percent of all New York City ZIP codes” (CBS-). Therefore, here we see again that public health problems seem to be most widely seen in low-income neighborhoods. Without proper access to contraception, education in schools about STD and HIV, and with an inadequate number of health clinics in these places, citizens in these locations are prone to spread STDs and HIV in New York.

http://www.sciencedirect.com/science/article/pii/S1353829210001905

http://www.nytimes.com/2011/02/08/health/research/08childhood.html

http://newyork.cbslocal.com/2012/12/10/study-shows-soaring-std-rates-in-many-areas-of-new-york-city/

A city cannot thrive if its people cannot. Therefore, it is the job of the city to do its best to keep its citizens healthy and happy, so that they can be fully functioning members of society. For New York City, keeping a population of over 8 million people healthy is a challenge, and here are some of the reasons.

First and foremost, the role of primary care doctors is to maintain the public health of the city that they provide for. The problem is that there are not nearly enough primary care physicians. In fact, if the primary care system remains the same as today, it is estimated that there would be shortage of over 20,000 primary care physicians by 2020 [1]. For a medical student with insurmountable debt, the financial appeal of specialization is obvious, but unfortunately a lack of primary care doctors could lead not only to overcrowded offices, but a situation where the quality of primary healthcare is compromised.

Aside from the accessibility of doctors, accessibility of affordable, fresh food is another huge issue in the United States. According the the USDA, 23.5 million people live in “food deserts”, defined as low-income areas in which the closest supermarket is, in urban areas, a mile away. One might think that in a city as dense as New York, this isn’t possible. However, it is estimated that 750,000 New Yorkers currently live in food deserts [2]. When the most affordable way to get your daily caloric intake is sugary drinks, snacks and hearty New York City bagels, it is no surprise that a lack of supermarkets around their home makes citizens 25% more likely not to follow a healthy diet [3]. In turn, this lack of availability of food has been repeatedly correlated to development of type-2 diabetes [3].

There is no question that reforms need to be made in each of these areas, but I think food deserts can be addressed most immediately. While the city has implemented Green Carts [2], and Green Markets which bring affordable produce to the city’s food deserts, they are still few and far-between. While starting ones own garden, as Dr. Thomas Blaine suggests [3], may not be feasible in the typical New York City apartment life-style, community gardens and even school green-houses could be implemented in these areas. In this way, residents would not have to wait for the produce trucks or farmers markets to appear. I also think that it is important to promote these trucks and gardens, providing community outreach to teach about the benefits of fresh food, and possibly even holding free lessons in cooking and gardening to show residents how to get the most out of this produce for their family.

Another option would be to put a tax on hyper-processed snacks, to promote the healthier foods that are available. Ideally, this would reduce consumption of these more unhealthy food and drinks, and in turn provide the funds to subsidize the healthier food that is currently unaffordable to many. In short it would create a system where the economy was “profiting from the foods that make us sick and use the money to make us healthy” [4].

[1] http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/

[2] http://www.foodispower.org/food-deserts/

[3] http://www.diabetesforecast.org/2013/sep/food-deserts-mar-the-land-of-plenty.html

[4] http://www.nytimes.com/2011/07/24/opinion/sunday/24bittman.html?_r=1

The United States health care system is very inefficient at keeping the population healthy. It ranks 46th in a survey of 48 countries and it is currently the fattest country in the world, just ahead of Mexico. Health care isn’t making us healthy, it’s just keeping everyone on life support. Furthermore cigarette company Philip Morris International ranks at #2 in lobbying Congress at 9.83 million dollars in 2012. Likewise pharmaceutical entities Merck, Johnson & Johnson, and Proctor & Gamble saw large increases in lobbying where they combined for just under 20 million dollars in 2012. Simply put, the United States health care system is unwilling to change because multimillion dollar corporations are influencing the decisions of Congress. We are unable to have a successful health care system like the one in Canada (which is ranked #1 in the world based on Canadian citizen satisfaction with the system) because the true motive is money, not health.

In terms of developed countries, the United States ranks at the bottom of every measurable statistic found in a Business Insider report. These include highest mortality rate, second worst rate of respiratory disease, and highest health care cost per capita. These high health care costs come from the fact that health care is a largely private owned industry in the United States. Insurance companies average about 25% overhead which is a major contributor to high healthcare costs in the United States. On the other hand, the state sponsored Medicare has an overhead of just 1%. When comparing these percentages in the sense of millions of dollars, the disparity is visible and the savings are huge for the consumer.

In order to create a better health care system, I propose that insurance become a fully state sponsored industry. Instead of having hundreds of health providers to choose from there will just be one provider that is paid for with taxpayer money and everyone will be able to benefit. This solves the issue of hospitals having to overcharge for certain procedures and doing unnecessary procedures just to milk insurance companies for compensation. People will no longer be faced with huge debts to hospitals for that one in a million injury/disease they get when they would otherwise be healthy. It solves the problem of millions of healthy people paying large amounts of money per month to go towards health insurance coverage when they don’t get any expensive procedures done.

The only way to solve the issue of expensive and ineffective health care coverage is to attack it at its source; private health insurance companies. They don’t provide benefits to the consumer and they lobby Congress to go against the health issues in our country. A fully state sponsored health insurance plan as seen effective in other countries is the only tried and tested system that we should move to in order to provide useful health care coverage to the people of the United States.

Source:

• http://www.healthline.com/health-news/policy-eight-healthcare-statistics-that-may-surprise-you-090113#2
• http://www.bloomberg.com/visual-data/best-and-worst/biggest-increases-in-lobbying-in-u-dot-s-companies
• http://www.businessinsider.com/us-health-lags-the-developed-world-2013-1

One health problem that New York City faces is the lack of healthy food options available in poor, inner-city neighborhoods. As of 2009, an estimated 750,000 New Yorkers lived in food deserts, or areas where it is difficult to obtain fresh, affordable, raw produce within walking distance (“Fresh Food for Urban Deserts”). This inaccessibility has caused the rates of diabetes and obesity to soar in New York. According to the New York City Department of Health and Mental Hygiene, between 2002 and 2004, the rates of obesity and diabetes both increased by 17% in the city, whereas the rest of the country only saw a 6% increase during the same two-year period (Scaperotti). Dr. Thomas R. Frieden, the city’s former health commissioner, cited the lack of access to affordable, healthy food in some New York City neighborhoods as a cause of the steep increase in obesity and diabetes (Scaperotti). Although residents of wealthier neighborhoods also contributed to the rising numbers, the Department of Health and Mental Hygiene states that the highest rates were found among racial minorities and residents of low-income neighborhoods (Scaperotti).

Because neighborhoods that are deemed food deserts are more populated with bodegas/delis than supermarkets and farmer’s markets, a possible solution to this problem would be to have supermarkets and farmer’s markets sell their unsold, still edible, slightly-past-the-expiration-date produce to bodegas at discount rates so that these products are more readily and cheaply available to residents of such neighborhoods. A lot of produce that isn’t sold by its expiration date is thrown out by markets, even though in many cases that produce is still perfectly edible. Instead of throwing it out and losing money, food markets can make money off of technically expired but still edible goods while providing food deserts with the nutritional resources they lack.

Another health problem that will continue to become increasingly prevalent in New York City is the shortage of primary care physicians. The US Department of Health and Human Resources found that the demand for primary care services will increase throughout the nation through 2020 for two key reasons: an aging and growing population and an expansion of health care coverage under the Affordable Care Act (“Projecting the Supple and Demand”). The aging and growth of the nation’s population is especially important because the Department of Health and Human Services predicts that 81% of the increase in demand for primary care will result from this factor (“Projecting the Supply and Demand”). New York City’s population is expected to increase a total of 13.9% between 2000 and 2030 and the number of city’s residents who are 65 and over is expected to increase by 44.2% over the same time period (“New York City Population Projections”). Therefore, the nationwide increase in demand for primary care and the resulting shortage of primary care physicians will affect New York City as well. This means that the number of patients per physician will increase, causing longer wait times between appointments, less personalized care for patients, and overworked doctors who will be more prone to making mistakes.

In addition to creating an increased demand for and shortage of primary care physicians, the aging of New York City’s population will also cause other public health issues. As the city’s baby boomers approach old age, life expectancy increases, and fertility rates decline, the number of elderly people in need of caregivers will outpace the number of people who can provide care for these aging city residents (“New York City Population Projections”). This means that the city will have to assume responsibility for providing care to elderly residents without family members or those whose families are financially incapable or unwilling to care for them. This will likely entail an increase in senior residence facilities, Medicaid, visiting nurse services, food stamps, etc., which will be financially taxing for the city.

Works Cited

“Fresh Food for Urban Deserts.” The New York Times. The New York Times, 20 Mar. 2009. Web. 28 Apr. 2015.

New York City Population Projections by Age/Sex & Borough 2000-2030 (Briefing Booklet) (n.d.): n. pag. New York City Department of Planning, Dec. 2006. Web. 28 Apr. 2015. <http://www.nyc.gov/html/dcp/pdf/census/projections_briefing_booklet.pdf>.

“Projecting the Supply and Demand for Primary Care Practitioners Through 2020.” Projecting the Supply and Demand for Primary Care Practitioners Through 2020. N.p., Nov. 2013. Web. 28 Apr. 2015.

Scaperotti, Jessica, Sara Markt, and Celina De Leon. “OBESITY AND DIABETES RISING FASTER IN NYC THAN NATIONALLY.” NYC.gov. The City of New York, 26 Mar. 2008. Web. 28 Apr. 2015.

Policies regarding public health affect our lives as closely as the other three topics we had discussed in this class.

One of the main problems regarding public health is antibiotic resistances in human. Antibiotic is widely used around to world to attack common infections found in humans and animals. These antibiotics, when taken correctly, get rid of the specific infections; however, this is usually not the case. People either do not finish the complete supplement or take a few to immediately combat the infections/diseases. With this in mind, the problem is that these bacteria in our bodies will be weakened and not completely killed off. This will give a chance for them to rejuvenate and evolve to attack again. Another way humans obtain other antibiotics in their bodies is through the consumption of farm animals. They are sometimes treated with antibiotic that have no effects in human bodies but can affect the bacteria found inside our bodies.

Another problem relates to the scarcity of primary care doctors which correlates to expensive primary care. Many of our peers or colleagues have a desire to be a doctor and often tend to choose become a specialist either for interest or money. The reason doesn’t matter, but it’s the fact that very few goes into primary care and this is what we need more of in order to take care of the United States population. The raise of primary care also causes health care to be really expensive and hard to acquire for residents in the United States. It’s worse for people who are too rich to be considered to be poor to acquire health care services to help.

Last problem relates to the country’s slow but steady acceptance of marijuana. It has been created legal in several states over the past half of a decade. While it has held the title of either the most commonly used illicit drug or for medicinal uses, it always held a bad connotation.  In comparison to alcohol consumption, marijuana is said to be less lethal in many sources; of course, it also depend on the users. The drug is so commonly used that over 45% of the people in the United States have used it before with a certain percentage continue to be frequent users. With the legalization, the sales can be taxed and put towards medical care for either homeless or poor families.

The problem of antibiotic resistance is impossible to tackle, but the others can be simplified. We already have a ton of students in the medical field hoping to become doctors. We should raise the amount of incentive for those who want to pursue a career in the primary care rather than specialization in some fields. Alter the wage differences between specialization and primary care; show that there is the same amount of importance in both sides. One innovative way to also incorporate more people into primary care is to show them the effects they provide with every patient they care. Show them the pathos aspect of the field and let them understand the satisfaction when saving lives. With the abundance of primary care doctors, we will have reduced health care costs for those who do not qualify.