Public Health Problems + Solutions
One of the most fast-paced cities in the world, New York City is famous for being the “city that never sleeps.” As NYC residents, we know that this is not a misleading statement. Rushing people, crowded streets and trains, blaring horns – these are all a part of our daily routine. Not to mention the long commute, long work days, and high cost of living [1]. As a result, New York City dwellers experience some of the highest levels of stress in the world. Stress can lead to various health conditions, such as heart disease, asthma, obesity, diabetes, headaches, depression, Alzheimer’s disease and more [2]. In fact, the rate at which people die of heart attacks in New York is 55 percent higher than the national average [3].
Unfortunately, there is not much we can do to change the overall fast-paced nature of the city. The one thing we do have control over, however, is our own individual perception of stress/how we respond to stress. The attached video explains the biological effect that stress has on your body and offers ways to alleviate it. As mentioned in the video, it is important to put aside some time to spend with family and friends, or to engage in a relaxing physical activity such as yoga or meditation. Sometimes we get so caught up with our own work that we unknowingly neglect any rest time. With the impending finals, don’t forget to take a break from your studies every now and then to let your mind relax. (Hopefully I can follow my own advice.)
Another essential problem in public health is the significant health disparities present among New Yorkers of various economic and racial groups. Looking at the trend diagrams on the America’s Health Rankings website, we see that the rates for diabetes and obesity have been increasing steadily for the past two decades [4]. It is estimated that about 25.4% of adults living in New York are obese and that 8.9% suffer from diabetes. However, studies show that stress and health levels are especially bad for minorities living in the city. According to a report conducted by the New York City Department of Health and Mental Hygiene, the poorest New Yorkers are 4 times more likely to report poor overall health than the wealthiest [5]. Processed fast food is both readily available and inexpensive, which often makes it the only choice for those living in poor conditions [6]. Since the poorest city neighborhoods are comprised mainly of minority groups, these individuals are more likely to eat these foods, which plays a key factor in the detriment of their health.
The best way to combat obesity, especially within minority groups, is through preventative measures within the public education system. For many children from poor backgrounds, school breakfast and lunch are the biggest – and sometimes the only – meals that they have all day. Eating healthier as a child significantly reduces his or her chance of heart disease in the future. It is vital that parents band together within the Parent-Teacher Association at their child’s school to demand a healthier school lunch menu for their children. This may be difficult, especially for parents working long hours, so an alternative solution to encourage involvement is to allow online communication about these issues so that everyone can have a say in each matter regardless of whether or not they can attend the meetings.
References:
[1] http://money.cnn.com/gallery/pf/2014/06/25/most-stressed-out-cities/
[2]http://www.webmd.com/balance/stress-management/features/10-fixable-stress-related-health-problems
[3]http://nymag.com/nymetro/urban/features/stress/10888/
[4] http://www.americashealthrankings.org/NY
[5] Karpati A, Kerker B, Mostashari F, Singh T, Hajat A, Thorpe L, Bassett M, Henning K, Frieden T. Health Disparities in New York City. New York: New York City Department of Health and Mental Hygiene, 2004.
[6] http://www.nytimes.com/2011/07/24/opinion/sunday/24bittman.html?_r=0
The Health Problem Facing the Nation: Obesity
New York City, and America in general, are facing one of the most serious health issues that affects the whole nation. This health issue is so bad, that when stereotyped, this is almost always a description that is associated with Americans. This problem is obesity.
Obesity is a real epidemic. According to the New York Times article, “Obesity Around the Nation” by Anahad O’Connor, 1 out of every 5 adults in every state is obese.In two states, Mississippi and Arizona, the rate of obesity has gone over 35%. O1 out of every 10 children, ages 1-5, also have problems with obesity. This is a major factor, as obesity increases the risk of heart disease and stroke, and lowers one’s life expectancy. O’Conor also points out that obesity rates are highest in minorities, specifically the hispanic and black communities, with whites having the lowest rates. She says that this: “showed an economic divide, with people in the lowest income brackets having disproportionately higher rates” (O’Connor 1).
The issue with obesity is known nation wide. So much so in fact, that national entities and private corporations are sponsoring active campaigns, in order to get kids to live more active lifestyles and avoid a sedentary one, leading to higher rates of obesity. These include instances like Michelle Obama’s “Let’s Move” campaign, and the NFL’s “play 60” campaign. However, as O’Connor pointed out, this goes beyond just getting children to be active, this has to do with an economic divide. The best way to deal with that, is policy revision.
Mark Bitterman’s Article, “Bad Food? Tax it, and Subsidize Vegetables,” advocates one of the best ways to combat obesity. Bitterman states that a lot of the unhealthy processed foods are subsidized, making it cheaper to produce, sell, and even consume. The problem is that these processed foods are highly unhealthy; they are high in sugars, fats, and sodium. Bitterman advocates to change the policy around, subsidize fresh food and fresh vegetables instead of the processed food. He states that we could start by subsidizing staple foods, like seasonal greens, whole grain, and fruit, and sell this locally, at drug stores, street corners, convenience stores, etc. This would work perfectly for New York City, where the city itself thrives on local businesses.
However, we can take this policy one step further, changing school lunches. Children, the next generation, are unfortunately the ones overly susceptible to processed foods. During school, the main responsibility of children for the first 18 years of their life, the lunch program which many kids depend on is full of processed and unhealthy foods. In Lucy Komisar’s article, “How the Food Industry Eats Your Kids Lunch,” Komisar explains that the processed food industry is subsidized, and is more cost effectient in providing cheap, unhealthy foods. However, Komisar explains that this isn’t the actual case. Schools may believe that they are saving money by using a private corporation for school lunches, but the reality is that the money they “save” is wasted through bureaucratic issues. There should be a policy change, and advocacy from the federal government to get rid of privatization of school cafeterias. The schools should use their funds, and be helped by the federal government, to hire their own kitchen workforce to prepare fresh food for the children. In this system as it stands, the only ones that stand to profit are the companies providing the fast food. As Komisar states, in this system: “Unfortunately, profit, not health, is the priority of the food service management companies, food processors and even elected officials. Until more parents demand reform of the school lunch system, children will continue to suffer” (Komisar 1). With such high officials like the first lady recognizing and acknowledging the problem, a push to publicizing the school cafeteria, put that into the hands of the schools themselves and provide schools with all the same funding to have their own kitchens, all these policy changes should at least have some support. If this is put into place, the obesity epidemic will take a major blow.
Sources:
http://www.nytimes.com/2011/12/04/opinion/sunday/school-lunches-and-the-food-industry.html
http://well.blogs.nytimes.com/2014/09/08/obesity-around-the-nation/
http://www.nytimes.com/2011/04/20/nyregion/college-cafeterias-get-bad-grades-from-new-york-city-health-department.html
http://www.nytimes.com/2011/07/24/opinion/sunday/24bittman.html?_r=0
Public Health Problems and Solutions
It is no question that New York City faces many health problems, the least of which is the issue of obesity. Currently 29% of adults in the five boroughs are either overweight or obese according to a NYC Health study. Even more shocking is that 20% of NYC kindergarteners are obese as well! Every fifth child aged 5-6 years old is obese. To me that is an incredibly troubling statistic. Obesity obviously causes many health issues later on in life as many children find it difficult to drop the unhealthy lifestyle habits as teenagers and adults. Childhood obesity makes hypertension and diabetes nearly inevitable for our city’s growing youth and also increases their risk for heart disease, stroke and cancer. Clearly we are depriving New Yorkers of easier lifestyles and even years off their lives with the cheap and convenient food NYC offers and promotes.
Another major issue we as New Yorkers face is sexually transmitted diseases. In 2014 it was estimated that 5,273 adult and adolescent New Yorkers were diagnosed with HIV and New York as a state ranks 5th among states with the number of HIV diagnoses. These statistics are alarming considering the nature of sex in NYC as a whole where virtually every adult is sexually active. Another statistic of concern is that 40% of teenagers who are sexually active are not wearing condoms or on birth control. This only serves to add fuel to the STD ‘wild fire’ that runs rampant through NYC. Sexually transmitted diseases, like obesity, can cause destruction to many people’s lives as their bodies begin to deteriorate if the disease is not treated in time or is untreatable all together. While STD’s are serious issue that affects our city, I believe there is a rather simple solution that would address both STD’s and obesity.
Obviously the more we as a population know, the better we can prepare for what we might encounter. This is why my solution to these two societal problems is increased health education. I went to public school through junior high school and I can’t recall a health class I was required to take. Even in high school my health class was an elective taken only by seniors. Clearly at the age of 18 or 19, seniors in high school have established and grown accustomed to a certain type of lifestyle with regard to diet, exercise and maybe even a sex life. Increased education is clearly the way to disseminate information to the public and allow them to make more educated decisions for themselves. We need to increase education elementary school students about diet and exercise because clearly the existing health ‘suggestions’ schools impose on students doesn’t stick with them. Public schools should add a health class to their curricula, perhaps only once or twice a week that would test the children’s decision making and assure that they are well informed as to the dangers of unhealthy food and a immobile, sedentary lifestyle. By starting to inform NYC students from a young age, this will no doubt promote healthier lifestyles later on in life. The current ‘food pyramid’ and ’30 minutes of exercise a day’ posters that hang in school hallways just aren’t cutting it as we as New Yorkers boast a 17% obesity rate among 10 to 17 year olds. We see that with increased education, the students have improved their scores on standardized tests, so why would we not expect the same kind of improvement when analyzing mandatory health classes. With regard to STD’s, clearly even the increased availability and convenience of NYC Condoms hasn’t had the tremendous impact we expected at its launch. This is why we must expose our teens and adults to the risks and dangers of unprotected sex. Sexual health classes must be more available and possibly even required for NYC’s teenagers and adults in high schools and at the workplace. I believe this would increase awareness and maybe serve as a scare tactic that would eventually decrease the STD rate in NYC.
http://www.nyc.gov/html/doh/html/living/obesity.shtml
http://www.cdc.gov/nchhstp/stateprofiles/pdf/new_york_profile.pdf
https://www.nycptc.org
Health Problems and Solution
When making health decisions as an adult, we often call upon the knowledge and skills we were taught as teens. The skills we are taught in our youth are essential for ensuring we make thoughtful decisions as we grow up. New York City law states that all teens must take a health class before graduating high school. However, due to budget cuts and staff shortages, some teens are left without a comprehensive health education. Studies show that substance abuse, untreated mental illness, and teen pregnancy all lead to low performance, high school dropouts, and other overall lower qualities of life. The need for education is clearly there – 1 in 3 teenagers are having sex (40% without the use of a condom), 1 in 4 teenagers use marijuana, 1 in 6 teenagers have seriously considered suicide, and 1 in 5 teenagers binge drink. Without a health education, teenagers are put at risk for making uninformed health choices.
Food deserts, a term I had only heard of recently, is defined as an area without access to fresh, healthy, and affordable food. Instead, the residents in these neighborhoods rely on fast food and convenience stores, which offer few healthy options. As a result, these communities are at a higher risk for obesity, diabetes, heart disease, and other diet related illnesses. In American, it is estimated that about 23.5 million people live in food deserts! More than half of that number is people residing in low-income neighborhoods.
Another issue, not only in NYC, but across the US, is doctor shortages. This issue confused me at first – how do we have doctor shortages when it is so hard to get into medical school? The problem is that many med school students do not go into primary care. Currently about half of our nations 830 thousand physicians are over the age of 50. These doctors, now older and on the brink of retirement, are seeing fewer patients, yet, the patient population is growing. We have a larger elderly population then ever before and under the Affordable Care Act, people who were once not insured, are now insured. There are about 30 million people being absorbed into the system with a shortage of 16,000 doctors.
As mentioned, health education is a serious concern for many teens in NYC (especially those in low income neighborhoods). Educating our youth can prevent them from making a series of dangerous decisions regarding their health. About a year ago I joined a club called Peer Health Exchange (PHE), whose mission to give all teens a proper health education. PHE recruits volunteers (like myself) to go into various high schools around NYC that are lacking comprehensive health curriculums. Each week, college students teach ninth graders one of twelve workshops. These workshops are designed to teach the students both knowledge and skills. The skills part, in my opinion, is the most important. We tell students that everyone’s definition of “healthy” is different and because of that they need to develop the proper decision-making, communication, and advocacy skills to decide for themselves what the best choices are regarding their health. In a perfect world, Peer Health Exchange wouldn’t have to exist (and it is my hope that one day it won’t). But for now, we need organizations like PHE to pick up the slack and ensure all teens are exposed to health education.
Sources:
http://www.peerhealthexchange.org/
http://apps.ams.usda.gov/fooddeserts/fooddeserts.aspx
http://www.aarp.org/health/medicare-insurance/info-03-2013/how-to-beat-doctor-shortage.html
http://www.cnn.com/2015/01/02/opinion/gupta-health-challenges-2015/
Public Health Problems/Solution
In present-day New York City, public health has been a growing area of concern. Despite New York State being ranked as the 14th healthiest state in America, there are still several problems that can be associated with the public health of NYC. Three problems that I have pinpointed are physical inactivity, the work-life balance, and food deserts.
Physical inactivity in NYC was reported at 25.7% for 2013. A person was defined as physically inactive if, during the 30 days prior to taking the questionnaire, they had NOT at any point participated in any physical activities or exercises, such as running, calisthenics, golf, gardening, or walking for exercise. This is shocking to me. For more than one in every four New Yorkers to not perform ANY physical activity for a month obviously has its adverse effects. The effects associated with physical inactivity as per a study conducted by Johns Hopkins University are: a greater risk of developing high blood pressure, heart problems, anxiety and depression, and certain cancers.
As for the work-life balance, we live in the financial capital of the world. This title comes at a price. In a 2014 New York Times article titled, “Why You Hate Work,” a successful chief executive of a multibillion-dollar company was quoted saying, “It seemed like I was always cheating someone — my company, my family, myself. I couldn’t truly focus on anything.” I think that this quote speaks volumes of our current state as a society. In order to be a successful employer, we often have to make sacrifices in our personal life. In order to be a good family member, we are often forced to make sacrifices on the job. This demanding lifestyle is unhealthy and unsustainable. According to statistics provided by the Organization for Economic Cooperation and Development (OECD), Americans spend 10-20% of their time on unpaid work. Additionally, 14.3 hours of our day on average are devoted to leisure and personal care, including sleeping and eating. The Untied States ranks 32nd of 36 among OECD countries in this category. While this website only provides national statistics, one can only assume that the percentage of time on unpaid work increases in NYC while leisure and personal care time decreases.
Lastly, I’d like to touch upon food deserts in New York City and why they are such a problem affecting public health and wellbeing of New Yorkers. A food desert can be defined as a geographic area where members of the community have little or no access to affordable, healthy produce. In a report prepared by the Economic Research Service of the US Department of Agriculture, we learn that roughly 2.3 million Americans live more than a mile away from a supermarket and do not own a car. In New York City specifically, approximately 750,000 residents live in food deserts. In recent years, many supermarkets and food providers have closed down or relocated due to increased rent and/or little or no profits recorded. Food deserts are most prevalent in low-income neighborhoods.
While the three problems described above are all serious predicaments that need addressing, I’m going to take this time to discuss a possible solution to food deserts in NYC. Food is a necessity of life. With supermarkets and other food suppliers unable to stay open, we need to discover a new way of getting affordable produce to those in areas labeled as food deserts. After doing research on how other cities have approached this problem, I think a viable solution to this ever-growing concern can be for the twelfth wealthiest university in the world, Columbia University, to fund a non-profit produce truck that goes around NYC selling affordable goods to New Yorkers. Because of the fact that some areas surrounding Columbia University can be labeled as food deserts, it would be a nice, innovative way for the prestigious university to give back to the community. The produce truck would go around NYC to areas proven to have minimal access to fresh fruits and vegetables. It would accept food stamps and be reasonably priced so that even lower-income families would be able to rely on the truck. There is no reason that Columbia shouldn’t be able to fund this project, being that school’s endowment is currently $9.2 billion. I believe that if this produce truck were to be implemented, we would certainly see over time a decline in the percentage of people with limited access to affordable, healthy food options.
References:
- http://a816-dohbesp.nyc.gov/IndicatorPublic/publictracking.aspx
- http://www.hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/risks_of_physical_inactivity_85,P00218/
- http://www.nytimes.com/2014/06/01/opinion/sunday/why-you-hate-work.html?_r=0
- http://www.oecdbetterlifeindex.org/topics/work-life-balance/
- http://www.foodispower.org/food-deserts/
- http://www.nonprofitcollegesonline.com/wealthiest-universities-in-the-world/
