Angel Mendoza, MD, the Academy’s director of Health Policy and Programs, on a new research about how to make cities healthier places to live, work and play.
Life expectancy among New Yorkers is way up. A dramatic improvement for a metropolitan area that once lagged behind much of the United States. Many of the New York Region’s 20 million plus residents now live longer than the average American.
All counties in the region saw an increase since 2010, according to the new report, The State of the Region’s Health, published this week by the New York Regional Plan Association (RPA). For women, life expectancy rose to age 83, up from 78; for men the increase was from age 71 to age 78, with the largest gains (more than 10 years for men in Brooklyn, Manhattan and the Bronx) occurring in New York City.
The RPA launched the new report to underscore the central role of innovative urban planning in creating a culture of health at an event that brought together a range of experts on urban health, including Academy President Jo Ivey Boufford, MD, on a panel with Daniel Hernandez, the deputy commissioner for neighborhood strategies at the city’s Department of Housing Preservation and Development, and Walter Barrientos, a lead organizer with Make the Road New York, an immigrant and worker advocacy group.
Bridging the Disparities Gap
While noting health gains across counties, event speakers and report author Mandu Sen also highlighted the striking differences in health in between many communities, even those that are only a few blocks apart. Residents of the Upper East Side of Manhattan, for example, live 10 years longer than their nearby neighbors in East Harlem.
In many cases, these dramatic inequities may be resolved by changing the way the city’s resources are used, Dr. Boufford said. “Expanding the role of community health workers, for example, could help to solve persistent economic disparities in health care in the New York region. Currently, those health workers spend more time helping patients navigate the health care system and keep their appointments. But in the future, their responsibilities might expand to include such activities as conducting environmental assessments of clients' homes to detect pollutants that might aggravate asthma—work that might have previously fallen to a city agency.”
Citing a potential opportunity for urban planners to maximize the impact of new investments in the city’s communities, Boufford also called on policy makers to increase “financial incentives that would encourage hospitals to pour more resources into prevention activities and community health. She said the nature of fee-for-service payment has led hospitals to focus on inpatient care.”
Other Highlights from “The State of the Region’s Health”:
• Cities offer great Health Advantages: Residential density, walkable streets, extensive public transportation systems and access to large networks of health care professionals, supermarkets and open space are all urban resources that can be improved to support resident’s health.
• Diversity has not resolved segregation: Urban areas bring together people from all over the world, but income inequality, unequal opportunities for education and other benefits, as well as economic and racial segregation contribute to the great differences in health outcomes among city residents.
• Linking Health and Urban Planning is key: Creating a culture of health that supports all residents means integrating planning for improved health with planning for other aspects of the physical environment, including transportation, housing, school districts, hospitals and outdoor spaces, and integrating the work across health departments and government agencies.
The State of the Region’s health research was conducted with support from the Robert Wood Johnson Foundation and advisors from the Academy and other organizations. It is the first step toward incorporating health goals into all elements of the organizations 25-year planning blueprint for New York, A Region Transformed, to be released in 2017.
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