The Health Disparities and Discrimination of East New York

The easternmost neighborhood in Brooklyn is East New York.  It is a neighborhood made predominantly of racial minorities.  It is a community stricken with poverty and some of the highest crime rates in Brooklyn.  These harsh conditions lead to racial health disparities in the community’s population.  The disparities in health this community faces are socio-economic in nature but are the result of a history of racist practices.

The racial makeup of East New York, according to a 2015 Community Health Report from the New York City Department of Health, is 52% Black, 37% Hispanic, 6% Asian, 3% White, and 2% other.  Key social and economic indicators are as follows: 24% of the population failed to graduate high school, and 32% of the population are poverty stricken with a 14% unemployment rate.  This community’s poverty rate is higher than that of Brooklyn and greater than the average of New York City.  Poverty results in health disparities in a community.  A key indicator of the health disparity in East New York is the life expectancy which is 77.7 years when compared with that of a white upper-middle class neighborhood such as Battery Park which is 85.9 years.  Social determinants of health are housing, crime rate, and food desert.  Chronic conditions such as infant mortality, HIV diagnoses, and substance abuse exemplify the problems of poor neighborhoods like East New York.

East New York is a neighborhood that is emblematic of the harmful discriminatory effects of blockbusting.  Blockbusting is the practice of persuading home owners to sell property cheaply because of fear of racial minorities moving into the area and profiting by reselling it at a higher price.  The fear of racial minorities resulted in white flight transforming a diverse neighborhood into a racial monolith.  The community is left jobless and deteriorates as racial minorities moved in due to higher unemployment rates.  This poverty results in socioeconomic disparities.

As noted by the 2015 report by the University of the State of New York Office of Postsecondary Access, East New York is a health manpower shortage area.  It suffers from a shortage of primary healthcare providers per capita.  Without the needed healthcare providers, chronic health conditions such as asthma, heart disease, and diabetes can’t be controlled, resulting in overcrowded emergency rooms which are the neighborhood’s only access to healthcare.  This can be seen in the increased number of avoidable hospitalizations for conditions like asthma and diabetes.  Characteristics of a health manpower shortage area are high poverty and infant mortality rates.  The infant mortality rate of East New York is 7.8 per 1,000 live births, higher than the borough of Brooklyn and the average New York City as a whole.  The leading contributor to infant mortality is premature birth.  Risk factors include cigarette and illicit drug use, chronic conditions like diabetes, being overweight, and stressful life events.  These are risk factors that are prevalent in East New York, as 17% of the population are current smokers, 31% of the population are overweight, and 18% have diabetes.  Preterm births make up 11.6% of all live births.

Food insecurity is a federal measurement of the lack of access to nutritionally adequate food.  Brooklyn has a higher food insecurity rate than any other borough in New York City.  Brooklyn, again has the highest meal gap rate when compared to the other boroughs.  In addition to lack of access to healthcare, East New York lacks stores that provide nutritionally adequate food.  It is a vicious cycle that will require years of work to overcome.

The health disparity faced in East New York is a multifactorial problem.  The solution will require action on all fronts.  Small successes can be seen as of late as East New York reports its lowest murder rate in decades and New York State’s Delivery System Reform Incentive Payment Program (DSRIP) will fundamentally restructure the healthcare delivery system with the primary goal of reducing avoidable hospital use.  Its focus is on Brooklyn’s poorest neighborhoods which include East New York.