This paper assesses the community health status at Manhattan Borough in New York City. First, the windshield survey introduces the county in its statistical base and late discusses the survey findings based on the issues identified. The three main health problems of the community are identified as the key community diagnosis. The vulnerable population discussed in this paper include overweight and obese people.
Manhattan Island is located in the southern part of the NY County bordering Hudson and Harlem rivers taking up to 22.81 square miles (Lim & Harris, 2015). It is among the key global, cultural, and financial centers. The assessment of population demographics shows that the medium age is 39 years (Stephens, 2014). The range of 0-18 years comprise of 25%, 19-25 years is 9%, 36-44 years is 24%, and 45-64 years is 16% while the rest is above 64 years. In addition, 51% of the population is dominated by females while the rest are males (Stephens, 2014). According to Ogden, Carroll, and Flegal (2014), the majority of the population (95%) is occupied by white residents while the remaining 5% is comprised of Native Americans, Pacific Islanders, Hispanics, Asians, and African-Americans (Ogden et al., 2014). However, this situation can be different during the school months as students from other parts or outside the county attend the schools and colleges in the region.
The following estimations on the socio-economic statistics in terms of employment rates, income levels, education level and housing were identified in 2015. The median income level per family was $45,000 per annum compared to a median income of $32,000 per household, where males earned more with $27,000 while females earned $21,000 (Lim & Harris, 2015). The unemployment rate is 7%; education rate of high school level is 80% and college degrees at 18% (Lim & Harris, 2015).
Overall Condition of the Community
There are three major public housing agencies in Manhattan that include NYC Housing Auth, NYC Housing Development and Related Affordable Housing. Most of the houses are multi-family, and story buildings, and no single rooms identified during the survey. The majority of the houses are well-maintained despite being over five decades old. In general, the types of housing and environment show that the Manhattans’ residents are average income earners. There are notable differences in the quality of homes between the north and the southern part of the borough. In the north, the houses appeared to be more expensive/newer and spacious compared to the one from the southern region where the houses are less expensive and older.
Manhattan Island is more urbanized and built-up with less open spaces per square kilometer. There are minimal and restricted green spaces as the available open spaces are public playgrounds, fields for outdoor sports, town parks, road reserves or parking spaces. They include Central Park Zoo, Yankee Stadium, 5th Street Recreation Park, and NY botanical garden among others. The activities that take place in these spaces include recreation activities, people walking their dogs, car parks, or kids playing. The playing fields are well-groomed, and there is adequate lighting in recreation grounds and streets while some parking areas have surveillance cameras.
During the survey period, there were various forms of transport available in the area. The most common form of public transport was automobiles such as buses, cabs while private means included personal cars, motorbikes, and bicycles. Sidewalks and streets are well maintained with sufficient traffic light and directional signs.
Since the borough is densely populated in a planned urban environment, there were few security agencies observed per square kilometer. However, most homes and residential apartments were manned by private security personnel in addition to numerous surveillance cameras that helped in beefing up the security. In addition, the contacts for NWPD, private security companies, fire department, and ambulance were observed in some streets
There are several healthcare and health support institutions like hospitals, pharmacies, and emergency care services like ambulances among others. The observed care services include Manhattan Psychiatric center, Institute for Family Health WIC Clinic, Amsterdam Family Health Center, The Manhattan Institute, Mandl School of Allied health, New York College of Health Professions among others. Students from health schools in the region offer voluntary care services at the health institutions hence reducing the doctor-patient ratio. This means that Manhattan Island area has more healthcare professionals and health institutions compared to other regions such as East Village, Central Park, and Battery Park City. Notable Hospitals located in Manhattan include Bellevue Hospital Center, Lenox Hill Hospital, and Gracie Square Hospital
Vulnerable Population and Associated Health Risks
Obese and overweight residents represent the vulnerable population in this windshield survey. Overweight and obesity is the main health problem associated with inhabitants of this island. The prevalence of disorder continues to increase in children and adults as a result of unhealthy lifestyle. The problems are particularly attributed to risky health behaviors which are considered to be the main threat to good health. Obese people are posed to health risks of developing complicated disorders such as chronic diseases, coronary diseases, and psychosocial problems. For instance, arthritis, coronary artery diseases, hypertension, gallstones, and stroke.
The health risks emanating from obesity have been worsened by residents engaging in health risk behaviors such as poor eating habits, physical inactivity, availability of fast food, genes, and abuse of drugs such as insulin. According to CDC report, the average human weight in Manhattan is 81 (Stephens, 2014). The psychological, physical, and medical consequences of obesity in youth and children are severe and may lead to stress, low self-esteem, and trauma.
Principles of Obesity Prevention in Manhattan
Obesity is a serious medical condition, which is associated with life-threatening conditions and imposes a huge financial burden to the community and healthcare system. It develops over a long period until it becomes difficult to treat leading to limited success in managing personal healthcare. In Manhattan, this situation can be controlled by encouraging the young people to watch their diet and increase physical activities. People should be encouraged to use walkways or cycle to work, climb stairs instead of elevators as well as engaging in sports. Prevention of overweight in children should be considered the main priority to avoid a situation of high persistent in adulthood. Education in average weight of the community may imply better health status and less vulnerability to coronary diseases.
According to a report released in 2015 regarding the state of obesity in the USA, New York’s adult obesity rate is currently 25.0%, an increase from 17.1 % in 2000 and 9.3 % in 1990 (Lim & Harris, 2015). Childhood Obesity was at 13.1% in 2015, an increase of 2.3% from 10.8% in 2010 (Lim & Harris, 2015). In addition, there is a tremendous increase in obese people based on race, that is, White 24.9%; Black 32.3%; Latino 30.6%, an increase from 21.3%, 29.1%, and 28.7% respectively (Lim & Harris, 2015). The increase is attributed to lack of lack the efficient preventive interventions, assessments, psychological support, education, harmonization and integration of care, and medical support to the vulnerable patients, mostly those with genetic obesity. Other factors contributing to the changes include the overreliance on junk foods, abuse of alcohol, and use of antidepressants to overcome depression.
Epidemiological Concepts, Methods, and Tools
Generally, the BMI is the most renowned method of obesity diagnosis in adults. It is comprised of the relationship between the square individual’s height and the weight (Lovasi et al., 2015). Due to progressive changes in personal data, the use of BMI in classifying obesity may overestimate the adiposity in young adults. WHtR is another simple and fast tool for screening assessment in obesity (Lovasi et al., 2015). Values above 0.5 show increase in health risks of health problems. The meta-analysis results show that WHtR and BMI are effective methods of detecting cardiovascular risk factors in the population.
Health Disparities and Social Determinants of Health
Health disparities among the overweight and obese people in Manhattan Island emanates from inequality in access to health care and provision of quality care to patients based race, gender, ethnicity, religion, and socioeconomic status. In Manhattan, health disparities are common among the ethnic minorities that include, Latinos, Asian Americans, Native Americans, and African Americans (Witten, 2016). Compared with the white population, these people have a higher prevalence of obesity and overweight problems as a result of the difference in eating behavior, socioeconomic status, and lifestyle.
In addition, the social determinants of health that affect the prevalence of obesity among these groups of people include access to healthcare services, availability of healthy food, quality of education, accessibility of community-based resources, public safety, social support, and access to job opportunities.
In conclusion, the community diagnosis for Manhattan reveals a deteriorating health level among the residents, mostly the overweight and obese population. This inference is supported by the lack of open air market for raw foods and increased queues in fast food joints (Witten, 2016). Additionally, less preference to exercises, walking and climbing stairs have led to increasing in average weight and obese. This may result in chronic diseases such as coronary heart diseases, congestive heart failures, colorectal cancer, and cerebrovascular incidents. Through therapeutic interventions, it is possible to manage and control the health vulnerability caused by obesity.
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