1

Bronx Community Health Dashboard: Diabetes Last Updated: 4/19/2019 See last slide for more information about this project.

2 Data source: Centers for Disease Control and Prevention. Division of Diabetes Translation At A Glance

Diabetes exerts a tremendous economic & health toll

From 0.93% to 7.40%

+796% increase in prevalence of diabetes from late 1950s to 2014

Statistics for the entire United States

3

+1.5%

-3% -2% -1% 0% 1% 2% 3%

Ischemic heart disease

Neonatal disorders

Road injuries

Colon and rectum cancer

Lower respiratory infections

Stroke

Lung cancer

Falls

Depressive disorders

Headache disorders

Anxiety disorders

Low back pain

Hearing loss

Oth. musculoskeletal disord

COPD

Neck pain

Alzheimer's/dementia

Chronic kidney disease

Diabetes mellitus

Drug use disorders

Annual % Change in DALYs

4.0%

0%

2%

4%

6%

8%

10%Is

chem

ic h

eart

dise

ase

Dru

g us

e di

sord

ers

Low

bac

k pa

in

CO

PD

Dia

bete

s m

ellit

us

Lung

can

cer

Hea

dach

e di

sord

ers

Stro

ke

Dep

ress

ive

diso

rder

s

Alz

heim

er's

/dem

entia

Oth

. mus

culo

skel

etal

dis

ord

Nec

k pa

in

Anx

iety

dis

orde

rs

Falls

Neo

nata

l dis

orde

rs

Hea

ring

loss

Roa

d in

jurie

s

Chr

onic

kid

ney

dise

ase

Col

on a

nd re

ctum

can

cer

Low

er re

spira

tory

infe

ctio

ns

% o

f tot

al D

ALYs

Diabetes is a leading cause of morbidity & mortality in New York State

In New York State in 2017, diabetes was the fifth leading cause of morbidity + mortality.

Data source: 2017 Global Burden of Disease Project. DALY = Disability Adjusted Life Years and is a measure that captures the impact of a risk factor or condition on total health, including both morbidity (i.e., disability) and mortality. Analysis limited to top 20 causes.

Diabetes has experienced the 2nd highest annual increase in morbidity + mortality in New York State since 1990, trailing only drug use disorders

Burden increasing

Burden decreasing

4

The Bronx has the highest prevalence of diabetes in NYC and it continues to increase

Data source: New York City Community Health Survey, 2002-2017.

11.9

17.5

0

2

4

6

8

10

12

14

16

18

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

pre

vale

nce

of d

iabe

tes

Bronx Brooklyn Manhattan Queens Staten Island

5

Older residents, women, Hispanic and non-Hispanic black populations and those with less education have the highest burden of diabetes

Data source: New York City Community Health Survey, 2017. NHB: non-Hispanic black; NHW: non-Hispanic white

Not age-adjusted

1.4*

7.6

24.4

41.0

14.8

19.5 19.6 18.8

7.1

23.7

15.7 16.7

12.0

0

10

20

30

40

Age-

adju

sted

pre

vale

nce

of d

iagn

osed

dia

bete

s

6

Adults with the least education have the highest prevalence of diabetes and disparities are increasing

Data source: New York City Community Health Survey, 2002-2017.

9.8 12.0

14.9

23.7

0

5

10

15

20

25

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

pre

vale

nce

of d

iabe

tes

College graduate Some college HS <HS

7

8 out of 10 Community Districts with the highest prevalence of diabetes are in the Bronx

201 202

203 204 206

207 208

209 210

211

212

205

201 Mott Haven & Melrose

202 Hunts Point & Longwood

203 Morrisania & Crotona

204 Highbridge & Concourse

205 Fordham & University Heights

206 Belmont & East Tremont 207 Kingsbridge Heights & Bedford

208 Riverdale & Fieldston

209 Parkchester & Soundview

210 Throgs Neck & Co-op City

211 Morris Park & Bronxdale

212 Williamsbridge & Baychester

Data source: NYC Community Health Profiles.

22 22 20 20

19 17

16 16 14 14

13 12

17

0

5

10

15

20

25

Mor

risan

ia &

Cro

tona

(203

)

Bel

mon

t & E

ast T

rem

ont (

206)

Mot

t Hav

en &

Mel

rose

(201

)

Hun

ts P

oint

& L

ongw

ood

(202

)

Kin

gsbr

idge

Hei

ghts

& B

edfo

rd (2

07)

Hig

hbrid

ge &

Con

cour

se (2

04)

Ford

ham

& U

nive

rsity

Hei

ghts

(205

)

Par

kche

ster

& S

ound

view

(209

)

Mor

ris P

ark

& B

ronx

dale

(211

)

Willi

amsb

ridge

& B

aych

este

r (21

2)

Thro

gs N

eck

& C

o-op

City

(210

)

Riv

erda

le &

Fie

ldst

on (2

08)

NY

C O

vera

ll

8

Poor diabetes control is clustered in the Bronx and Central Brooklyn

Data source: NYC A1C Registry, 2014

Data is by Neighborhood Tabulation Area (NTA)

9

Diabetes Hospitalizations

10

Preventable diabetes hospitalizations are highest in the South Bronx

Includes principal or other diagnosis of ICD-9 codes 250.10-250.33, 250.40-250.93, 250.02-250.03, 841.0-841.9, or 250.00-250.93.

Data source: SPARCS, 2012-2014. Data are age-adjusted.

Data is by Neighborhood Tabulation Area (NTA)

11

Diabetes Mortality

12

The diabetes mortality rate has fallen by 38% over the last 17 years in the Bronx, but remains higher than NYC

Data source: Underlying Cause of Death, 2000-2017.

36.8

22.9 20.2

17.5

0

5

10

15

20

25

30

35

40

45

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

dia

bete

s m

orta

lity

rate

s pe

r 100

,000

Bronx NYC, excluding the Bronx

13

Diabetes mortality has declined among both sexes, but the drop is larger for women

43.0

29.9 33.0

18.1

0

5

10

15

20

25

30

35

40

45

50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

mor

talit

y ra

te p

er 1

00,0

00

Male Female

Data source: Underlying Cause of Death, 2000-2017.

14

Racial/ethnic disparities in diabetes mortality have declined in the Bronx, but remain highest for non-Hispanic black residents

43.9

22.8

48.2

28.1

24.4

14.1

0

10

20

30

40

50

60

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Age-

adju

sted

mor

talit

y ra

te p

er 1

00,0

00

Hispanic NHB NHW

Data source: Underlying Cause of Death, 2000-2017. NHB is non-Hispanic black; NHW is non-Hispanic white.

15

Among all age groups, the diabetes mortality rate has declined in the Bronx

55.7 39.9

166.6

69.0

248.7

173.1

384.0

234.3

0

50

100

150

200

250

300

350

400

450

500

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Dia

bete

s m

orta

lity

rate

per

100

,000

55-64 65-74 75-84 85+

Data source: Underlying Cause of Death, 2000-2017. Data are not age-adjusted.

16

Out of 59 Community Districts, the Bronx has 2 of 5 highest diabetes mortality rates

Data source: NYC Mortality Data, 2016.

41.7 38.8

32.7 29.3 29.1 27.9 27.8 27.6

25.3 23.6 23.4

16.7 19.2

0

5

10

15

20

25

30

35

40

45

201 Mott Haven & Melrose

202 Hunts Point & Longwood

203 Morrisania & Crotona

204 Highbridge & Concourse

205 Fordham & University Heights

206 Belmont & East Tremont 207 Kingsbridge Heights & Bedford

208 Riverdale & Fieldston

209 Parkchester & Soundview

210 Throgs Neck & Co-op City

211 Morris Park & Bronxdale

212 Williamsbridge & Baychester

17

About the Community Health Dashboard Project

The goal of the project is to provide Bronx-specific data on risk factors and health outcomes with an emphasis on presenting data on trends, socio-demographic differences (e.g., by age, sex, race/ethnicity, etc.) and sub-county/neighborhood level data

Dashboards will be periodically updated as new data becomes available.

Produced by Montefiore’s Office of Community & Population Health using publicly-available data sources

For more information please contact us at OCPHDept@montefiore.org