Skip to main content

Brooklyn's fractured demographics, as seen in a new report on health care

A report from the state Department of Health, At the Brink of Transformation: Restructuring the Healthcare Delivery System in Brooklyn (see Greater NY Hospital Association comments), aims to restructure Medicaid, but also offers some broader perspective on Brooklyn's fractured demographics and deep disparity between progress and need, a backdrop to the Atlantic Yards debate.

Brooklyn is the state's most populous county, and it has big problems. (Crain's is sponsoring a discussion 1/11/12 on Solving Brooklyn's Hospital Crisis.)

From the report's Executive Summary:
Today, Brooklyn is grappling with high rates of chronic disease and a healthcare delivery system that is, in many areas, ill-equipped to address them. High rates of preventable hospital admissions and avoidable emergency department visits indicate deficiencies in primary care and inefficient use of high-cost resources. Further, while there are several fine hospitals in Brooklyn that are well-managed and financially-stable, Interfaith Medical Center, Wyckoff Heights Medical Center and Brookdale Hospital Medical Center are experiencing financial crises. At the same time, great opportunity presents itself in new models of patient-centered care, focused on prevention, and supported by technology and appropriate reimbursement incentives... With Brooklyn’s high rates of obesity, high blood pressure and diabetes, and 1 million Medicaid beneficiaries among its [2.5 million] residents, the state has a strong interest in the quality, accessibility, efficiency and viability of healthcare in the borough.
Neighborhoods

The report draws a set of Brooklyn neighborhoods. To understand Atlantic Yards, consider the contrast between prosperous, mostly gentrified Northwest Brooklyn, and needier Central Brooklyn:
To describe geographic variation in health and socioeconomic status and access to care in Brooklyn, this report uses the neighborhoods defined by the United Hospital Fund for the purpose of research and planning studies. UHF drew 42 neighborhoods across New York City based on boundaries consisting of adjoining zip code areas. These neighborhood designations provide clear and consistent boundaries for the unique demographic, economic, health and delivery system characteristics of small geographic areas. In Brooklyn, the UHF neighborhoods are: Greenpoint, Northwest Brooklyn, Central Brooklyn, East New York-New Lots, Sunset Park, Borough Park, Flatbush, Canarsie-Flatlands, Southwest Brooklyn, Southern Brooklyn, and Bushwick-Williamsburg.
The demographic/health contrast between Northwest Brooklyn and Central Brooklyn


More demographics: race

From the report:
Nearly 20 percent of Brooklyn’s population is Hispanic or Latino, 36 percent is Non-Hispanic White, 32 percent is Non-Hispanic African American, and more than 10 percent is non-Hispanic Asian.9 Brooklyn’s neighborhoods vary based on the distribution of races and ethnicities among their residents. In Central Brooklyn, Bushwick-Williamsburg, Flatbush, and East New York- New Lots, for example, more than 85 percent of the residents are African-American or Hispanic. By comparison, in Greenpoint, Borough Park, and Southwest Brooklyn, more than 50 percent of the residents are White. Sunset Park has the highest percentage of Asian residents at 29 percent.

More demographics: economics

From the report:
Socioeconomic factors, such as income, health insurance, and education affect health needs and access. In 2010, 23 percent of Brooklyn residents had incomes below the federal poverty level ($22,350 for a family of four, or $11,100 for a single person). This compares to 20.1 percent citywide and 14.9 percent statewide.11 Nearly 15 percent of Brooklyn residents had no health insurance in 2010, compared to  nearly 12 percent statewide.12 Almost 1 million Brooklyn residents, or forty percent of the total, are covered by Medicaid. This compares with 4.7 million and 24 percent statewide.

The following are some additional key socioeconomic indicators for Brooklyn:
• Median household income for all of Brooklyn is $42,143 in 2010.
• The 2010 unemployment rate for Brooklyn was 10.5 percent, compared to 9.3 percent statewide.
• Of the total population 25 years and older, 12 percent has less than a 9th grade education, 29 percent has attained a high school diploma or equivalent and 29 percent has a Bachelor’s or higher degree.
The neighborhoods in Brooklyn with the highest poverty rates are: Greenpoint, Bushwick-Williamsburg, Central Brooklyn, and East New York-New Lots, where more than 30 percent of households live below the federal poverty level. By comparison, the poverty rate in Canarsie-Flatlands is 14 percent, in Southwest Brooklyn 16 percent, and Northwest Brooklyn 20 percent.
More demographics: language, area of origin

From the report:
Fully 38 percent of all current Brooklyn residents are foreign-born. Of those foreign-born residents, 45 percent are not US citizens.18 The majority of immigrants residing in Brooklyn are of Latin-American origin, with 52 percent from South American countries. European and Asian immigrants make up 20 percent and 25 percent of the remaining immigrant population respectively.

All of Brooklyn’s neighborhoods have high percentages of foreign-born residents. More than one-third of the residents are foreign born in Borough Park, Canarsie-Flatlands, East New York-New Lots, Greenpoint, Flatbush, Southern Brooklyn, Southwest Brooklyn, and Sunset Park.

The large foreign-born population in Brooklyn naturally leads to a significant percentage of residents with limited English proficiency and a wide variety of spoken languages. Of the total population living in Brooklyn over 5 years old, 46 percent speak a language other than English at home and 25 percent state they speak English ‘less than well.’
Health problems

From the report:
Brooklyn faces daunting population health challenges. High rates of chronic disease and premature death exact human and economic costs. On all of the following indices, Brooklyn residents exhibited worse results on health status indicators than New York City residents as a whole:
• 26 percent of adults in Brooklyn were obese in 2009;
• 11 percent of adults had diabetes in 2009;
• 31 percent of adults had high blood pressure in 2009.22
Likewise, rates of hospitalization and premature death were higher in Brooklyn than citywide. In Brooklyn, 47 percent of residents who died did so prematurely (before age 75) between 2007 and 2009, as compared to 45 percent citywide.
It's especially tough for black and Hispanic Brooklyn:
Specifically, Black non-Hispanic Brooklyn residents experience a disproportionately high rates of negative health outcomes, including:
• 62.3 percent of Black non-Hispanic residents who died did so prematurely (before age 75), between 2007and 2009 -- double the rates for White non-Hispanic Brooklyn residents;
• Black non-Hispanic residents experienced the highest rates of obesity (31.8%) and high blood pressure (35.0%) and second highest rate of diabetes (13.2%) as compared to other race/ethnic groups in Brooklyn during 2009;
• Black non-Hispanic children in Brooklyn were hospitalized for asthma at a rate of 70.0 per 10,000) -- almost ten time the rate of their White non-Hispanic (7.6 per 10,000) counterparts.
Hispanics also experiences a disproportionately poor health outcomes compared to other racial and ethnic groups residing in Brooklyn. Between 2007 and 2009, in comparison with other racial and ethnic groups residing in Brooklyn, Hispanic Brooklyn residents had the:
• Highest percentage of premature deaths (62.5%)
• Highest prevalence of diabetes (15.5%) and asthma (11.0%);
• Second highest rates of obesity (29.3%) and high blood pressure (31.3%).
Compounding the problem 

The report notes how health problems are compounded:
High rates of chronic disease are compounded by socioeconomic barriers to health care, such as lack of health insurance, limited English proficiency, and poverty. Large segments of the population in several neighborhoods live in extreme poverty, have low levels of educational attainment, and are linguistically isolated.39 Fully forty percent of Brooklyn residents are on Medicaid and 15 percent are uninsured.

The inpatient payer mix of Brooklyn hospitals is dominated by Medicaid, which paid for 42 percent of the discharges in 2010. Medicare covered 33 percent, and commercial insurance covered 17 percent. The remaining 8 percent are considered “self-pay” patients, who typically include primarily uninsured and charity care patients. With high percentages of patients covered by Medicare and Medicaid (75 percent in 2010), Brooklyn hospitals are particularly vulnerable to the effects of the state and federal budgets.
Wondering why the percentage of those using commercial insurance seems low? Because better-off Brooklynites go to Manhattan.

A map of health professional shortage areas

Comments

Popular posts from this blog

Barclays Center/Levy Restaurants hit with suit charging discrimination on disability, race; supervisors said to use vicious slurs, pursue retaliation

The Daily News has an article today, Barclays Center hit with $5M suit claiming discrimination against disabled, while the New York Post headlined its article Barclays Center sued over taunting disabled employees.

While that's part of the lawsuit, more prominent are claims of racial discrimination and retaliation, with black employees claiming repeated abuse by white supervisors, preferential treatment toward Hispanic colleagues, and retaliation in response to complaints.

Two individual supervisors, for example, are charged with  referring to black employees as “black motherfucker,” “dumb black bitch,” “black monkey,” “piece of shit” and “nigger.”

Two have referred to an employee blind in one eye as “cyclops,” and “the one-eyed guy,” and an employee with a nose disorder as “the nose guy.”

There's been no official response yet though arena spokesman Barry Baum told the Daily News they, but take “allegations of this kind very seriously” and have "a zero tolerance policy for…

Behind the "empty railyards": 40 years of ATURA, Baruch's plan, and the city's diffidence

To supporters of Forest City Ratner's Atlantic Yards project, it's a long-awaited plan for long-overlooked land. "The Atlantic Yards area has been available for any developer in America for over 100 years,” declared Borough President Marty Markowitz at a 5/26/05 City Council hearing.

Charles Gargano, chairman of the Empire State Development Corporation, mused on 11/15/05 to WNYC's Brian Lehrer, “Isn’t it interesting that these railyards have sat for decades and decades and decades, and no one has done a thing about them.” Forest City Ratner spokesman Joe DePlasco, in a 12/19/04 New York Times article ("In a War of Words, One Has the Power to Wound") described the railyards as "an empty scar dividing the community."

But why exactly has the Metropolitan Transportation Authority’s Vanderbilt Yard never been developed? Do public officials have some responsibility?

At a hearing yesterday of the Brooklyn Borough Board Atlantic Yards Committee, Kate Suisma…

No, security guards can't ban photos. Questions remain about visibility of ID/sticker system.

The bi-monthly Atlantic Yards/Pacific Park Community Update meeting June 14, held at 55 Hanson Place, addressed multiple issues, including delays in the project, a new detente with project neighbors,concerns about traffic congestion, upcoming sewer work and demolitions, and an explanation of how high winds caused debris to fly off the under-construction 38 Sixth Avenue building. I'll have more coverage.
Security issues came up several times at the meeting.
Wayne Bailey, a resident who regularly takes photos and videos (that I often use) of construction/operations issues that impact residents, asked representatives of Tishman Construction if the security guard at the sites they're building works for them.
After Tishman Senior VP Eric Reid said yes, Bailey asked why a guard told him not to shoot video of the site, even though he was on a public street.

"I will address it with principals for that security firm," Reid said.
Forest City Ratner executive Ashley Cotton, the …

Barclays Center event June 11 to protest plans to expand Israeli draft; questions about logistics

At right is a photo of a poster spotted in Hasidic Williamsburg right. Clearly there's an event scheduled at the Barclays Center aimed at the Haredi Jewish community (strict Orthodox Jews who reject secular culture), but the lack of English text makes it cryptic.

The website Matzav.com explains, Protest Against Israeli Draft of Bnei Yeshiva Rescheduled for Barclays Center:
A large asifa to protest the drafting of bnei yeshiva in Eretz Yisroel into the Israeli army that had been set to take place this month will instead be held on Sunday, 17 Sivan/June 11, at the Barclays Center in Downtown Brooklyn, NY. So attendees at a big gathering will protest an apparent change of policy that will make it much more difficult for traditional Orthodox Jewish students--both Hasidic (who follow a rebbe) and non-Hasidic (who don't)--to get deferments from the draft. Comments on the Yeshiva World website explain some of the debate.

The logistical questions

What's unclear is how large the ev…

Atlantic Yards/Pacific Park graphic: what's built/what might be coming (post-dated pinned post)

Click on graphic to enlarge. This is post-dated to stay at the top of the blog. It will be updated as announced configurations change and buildings launch. The August 2014 tentative configurations proposed by developer Greenland Forest City Partners will change, and the project is already well behind that tentative timetable.


Not quite the pattern: Greenland selling development sites, not completed condos

Real Estate Weekly, reporting on trends in Chinese investment in New York City, on 11/18/15 quoted Jim Costello, a senior vice president at research firm Real Capital Analytics:
“They’re typically building high-end condos, build it and sell it. Capital return is in a few years. That’s something that is ingrained in the companies that have been coming here because that’s how they’ve grown in the last 35 years. It’s always been a development game for them. So they’re just repeating their business model here,” he said. When I read that last November, I didn't think it necessarily applied to Atlantic Yards/Pacific Park, now 70% owned (outside of the Barclays Center and B2 modular apartment tower), by the Greenland Group, owned significantly by the Shanghai government.
A majority of the buildings will be rentals, some 100% market, some 100% affordable, and several--the last several built--are supposed to be 50% market/50% subsidized. (See tentative timetable below.)

Selling development …

Atlanta's Atlantic Yards moves ahead

First mentioned in April, the Atlantic Yards project in Atlanta is moving ahead--and has the potential to nudge Atlantic Yards in Brooklyn further down in Google searches.

According to a 5/30/17 press release, Hines and Invesco Real Estate Announce T3 West Midtown and Atlantic Yards:
Hines, the international real estate firm, and Invesco Real Estate, a global real estate investment manager, today announced a joint venture on behalf of one of Invesco Real Estate’s institutional clients to develop two progressive office projects in Atlanta totalling 700,000 square feet. T3 West Midtown will be a 200,000-square-foot heavy timber office development and Atlantic Yards will consist of 500,000 square feet of progressive office space in two buildings. Both projects are located on sites within Atlantic Station in the flourishing Midtown submarket.
Hines will work with Hartshorne Plunkard Architecture (HPA) as the design architect for both T3 West Midtown and Atlantic Yards. DLR Group will be t…