Transcript Healthy Camden 2010

Summation of Recent
Camden City Health
Studies
Joan M. Gray-UMDNJ Fieldwork Project
Presentation to
Camden City Healthy Futures Committee
September 28, 2006
Purpose of the Report


Combine some of the recent Camden studies
into a usable format for setting health
initiatives
Benchmark Camden City objectively against
New Jersey health targets
Acknowledgments
This report has been made possible through the support of:
 The Camden City Healthy Futures Committee
 Mitchell Berger, MPH
Camden County Department of Health and Human Services
 Dr. Jung H. Cho
Camden County Department of Health and Human Services
 Hilary Colbert MPA
CPAC: Community Planning and Advocacy Council
 Jean F. Mouch, MD, MPH
Camden County Cancer Coalition
 Derek Ziegler
CAMConnect
Acknowledgements
University of Medicine and Dentistry of New Jersey



Mark Fulchomer, Ph.D
Marcia Sass, Sc.D., MSN.
Bernadette West, Ph.D., MA.,
University of Medicine and Dentistry-School of Public Health Students


Ann Jones, MBA, BS, MPH
Maribeth Robenolt, BA
Studies Included


New Jersey Department of Health and Senior Services, Center
for Health Statistics
Behavioral Risk Factor Surveillance Survey-BRFSS Camden City
Breakdown-2006
UMDNJ MPH Fieldwork Project

Camden City Community Health Assessment Focus Group
Project-2005
UMDNJ MPH Class Project

Camden City Community Health Assessment Focus Group In
Depth Analysis Using Atlas.ti-2006
UMDNJ MPH Fieldwork Project

Healthy Camden City 2010-Update 2005
UMDNJ MPH Fieldwork Project
Studies Reviewed

Camden Hospital and Emergency Room Health Data June 2006
Camden Coalition of Healthcare Providers and CAMConnect

Camden Kids Count 2004
Association for Children of NJ and CAMConnect

Camden Waterfront South Air Toxics Pilot Project 2005
NJ Dept of Environmental Protection

From Data to Strategy: Information for Planning a Smoking
Cessation Program-2005
Camden County Cancer Coalition

Health Report Card Survey-2005
Center for Children & Childhood Studies at Rutger’s Camden, Cooper University
Hospital Department of Family Medicine, and CAMConnect
Access to Health Care
Percentage of adults
who report they have a
source or primary care
96
94
Camden
City
Camden
County
New
Jersey
NJ Target
92
Sources:

NJDHSS, Center for Health Statistics,,
Behavioral Risk Factor Survey

Healthy New Jersey 2010: Update 2005

Camden City and Camden County Data from
Behavioral Risk Factor Survey BreakdownUMDNJ Graduate Student Project. 2006

Healthy Camden City 2010: Update 2005
90
88
86
84
Preferred
Endpoint
82
80
2001
2001
Fundamentals of Good Health
Healthy Mothers and Young Children
Rate of infant
mortality per
1,000 live births
Sources:

NJDHSS, Center for Health
Statistics

Healthy New Jersey 2010:
Update 2005

Camden Kids Count 2004

Healthy Camden City 2010:
Update 2005
18
16
Camden City
14
12
Camden County
10
NJ
8
Target NJ White
6
Target NJ Black
4
TargetNJ Hispanic
2
Target NJ Asian/PI
0
Target NJ
2001
Targets
Fundamentals of Good Health
Healthy Mothers and Young Children
Percentage of
infants with birth
weights less than
2,500 grams
14
12
Camden City
Camden County
NJ
Target-NJ White
Target-NJ Black
Target-NJ Hispanic
Target-NJ Asian/PI
Target NJ
10
8
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update
2005

Camden Kids Count 2004

Healthy Camden City 2010: Update
2005
6
4
2
0
2002
Target
Fundamentals of Good Health
Healthy Mothers and Young Children
Percentage of live
births whose mothers
receive prenatal care in
the first trimester
90
80
Camden City
Camden County
NJ
Target NJ White
Target NJ Black
Target NJ Hispanic
Target Asian/PI
Target NJ
70
60
50
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update 2005

Camden Kids Count 2004

Healthy Camden City 2010: Update 2005
40
30
20
10
0
2002
Target
Fundamentals of Good Health
Healthy Mothers and Young Children
Percentage of live
births whose
mothers receive no
prenatal care
3
2.5
Camden City
Camden County
NJ
Target-NJ White
Target-NJ Black
Target-NJ Hispanic
Healthy NJ Target
Preferred Endpoint
2
1.5
1
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update 2005

Camden Kids Count

Healthy Camden City 2010: Update 2005
0.5
0
2002
Target
Fundamentals of Good Health
Healthy Mothers and Young Children
Percentage of
women who abstain
from any tobacco
product during
pregnancy
96
94
Camden City
Camden County
NJ
Target-NJ White
Target-NJ Black
Target-NJ Hispanic
Healthy NJ Target
Preferred endpoint
92
90
88
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update 2005

Camden Kids Count

Healthy Camden City 2010: Update 2005
86
84
82
80
78
2002
Target
Fundamentals of Good Health
Healthy Behaviors-Adolescents
Total number of births
per 1000 females aged
10 through 14
4.5
4
3.5
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

National Center for Health Statistics and U.S.
Census Bureau

Healthy Camden City 2010: Update 2005
3
Camden City
Target black
Target Hispanic
NJ Target
2.5
2
1.5
1
0.5
0
2000
2001
2002
2003 Target
Fundamentals of Good Health
Healthy Behaviors-Adolescents
Total number of
births per 1000
females aged 15
through 17
90
80
70
60
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update
2005

National Center for Health Statistics
and U.S. Census Bureau

Healthy Camden City 2010: Update
2005
Camden City
Target White
Target Black
Target Hispanic
NJ Target
50
40
30
20
10
0
2000
2001
2002
2003 Target
Fundamentals of Good Health
Health Behaviors-Adolescents
Total number of
births per 1000
females aged 18
through 19
Sources:

NJDHSS, Center for Health Statistics.
US Census Bureau

Healthy New Jersey 2010-Update 2005

National Center for Health Statistics and
US census Bureau

Healthy Camden City 2010: Update 2005
200
180
160
140
120
100
80
60
40
20
0
Camden City
Target White
Target Black
Target Hispanic
NJ Target
2000
2001
2002
2003 Target
Fundamentals of Good Health
Healthy Behaviors: Adult
Percentage of persons
aged 18 and over who
are overweight but not
obese
Sources:

NJDHSS, Center for Health Statistics,
Behavioral Risk Factor Surveillance System.

Camden City and Camden County Data from
Behavioral Risk Factor Survey BreakdownUMDNJ Graduate Student Project. 2006

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
80
70
60
50
Camden City
Camden County
Target neither
NJ Target-overweight
40
30
20
10
0
neither
overweight
obese
Fundamentals of Good Health
Preserving Good Health for Seniors
Percentage of persons
65 years and older who
have received influenza
vaccinations in the
previous 12 months
70
60
50
40
Camden City
Camden County
30
Sources:

NJDHSS, Center for Health Statistics,
Behavioral Risk Factor Surveillance System

Camden City and Camden County Data from
Behavioral Risk Factor Survey BreakdownUMDNJ Graduate Student Project. 2006

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
Data not precisely comparable as Camden City and
Camden County Data include all ages
20
10
0
2005
Preventing Major Diseases
Heart Disease and Stroke
Age-adjusted mortality
rate from coronary
heart disease per
100,000 standard
population
Sources:

NJDHSS, Center for Health Statistics,

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
250
200
150
Camden City
New Jersey
NJ Target
100
50
0
1999 2000 2001 2002 2003 Target
Preventing Major Diseases
Heart Disease and Stroke
Age-adjusted mortality
rate from cerebrovascular
diseases per 100,000
standard population
60
50
40
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
Camden City
New Jersey
NJ Target
30
20
10
0
1999 2000 2001 2002 2003 Target
Preventing Major Diseases
Heart Disease and Stroke
Percentage of persons
18 years of age and over
who have had their blood
cholesterol checked by a
health professional within
the past five years
Sources:

NJDHSS, Center for Health Statistics, Behavioral
Risk Factor Survey

Healthy New Jersey 2010: Update 2005

Camden City and Camden County Data from
Behavioral Risk Factor Survey Breakdown-UMDNJ
Graduate Student Project. 2006

Healthy Camden City 2010: Update 2005
90
88
86
84
82
80
78
76
74
72
70
Camden City
Camden County
New Jersey
Target
Preferred Endpoint
2003 Camden
Data
Target
Preventing/Reducing Major Diseases
Cancer
Age-adjusted mortality
rate from female breast 30
cancer per 100,000
25
standard female
20
population
Camden City
NJ
NJ Target
15
Sources:

NJDHSS, Center for Health Statistics.

US Census Bureau

Healthy New Jersey 2010-Update 2005

Healthy Camden City 2010: Update 2005
10
5
0
2002
2003
Target
Preventing/Reducing Major Diseases
Cancer
Age-adjusted
incidence rate of
invasive cervical
cancer in females per
100,000 standard
population
Sources:

NJDHSS, Cancer Epidemiology Services.

Camden County Cancer Coalition, February
2006

Healthy New Jersey 2010-Update 2005

Healthy Camden City 2010: Update 2005
25
20
15
Camden City
Camden County
NJ Target
10
5
0
Average
1998-2002
target
Preventing/Reducing Major Diseases
Cancer
Age-adjusted mortality
rate from colorectal
cancer per 100,000
standard population
30
25
20
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
Camden City
NJ
NJ Target
15
10
5
0
2003
2002
Target
Preventing/Reducing Major Diseases
Cancer
Age-adjusted mortality
rate from lung cancer
among persons 65
years of age and over
per 100,000 population
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Camden Demographics, Camden Reports
2006, CAMConnect

Healthy Camden City 2010: Update 2005

Not graphed as comparison due to skewing of
data due to Camden’s age spread in population
with 37% under 18yrs of age.
35
30
25
20
Camden City
15
10
5
0
1999
2000
2001
2002
2003
Preventing/Reducing Major Diseases
Mental Health
Mortality rate from
suicide per 100,000
male population
\
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
****Camden City data indicate age group of concern
is 25-34 years of age. Different age group than
Healthy New Jersey 2010 (15-19)
50
45
40
35
30
25
20
15
10
5
0
Camden City males
25-34 rate/100,000
NJ Target 15-19
1999- 20002001 2002
NJ
Target
15-19
Preventing/Reducing Major Diseases
Mental Health
Additional Information

1 in 45 Camden Residents visited the ER in 2004 with a
diagnosis of drug abuse.
Camden Hospital and Emergency Room Health Data 2003, Camden Coalition of
Health Care Providers, CAMConnect June 2006


24% of residents in Camden report their mental health was
not good more than 2 days during the past 30 days.
14% of residents in Camden report their mental health was
not good 15-30 days of the last 30 days.
Healthy NJ benchmark-Mental health good average of 28 days out of last
30.
Camden City and Camden County Data from Behavioral Risk Factor Survey
Breakdown-UMDNJ Graduate Student Project. 2006
Healthy NJ 2010-2005 Update
Preventing/Reducing Major Diseases
Addictions
Prevalence of cigarette
smoking among the
population aged 18 and
over
60
50
40
Sources:

NJDHSS, Center for Health Statistics, New
Jersey Behavioral Risk Factor Survey.

Healthy New Jersey 2010: Update-2005

Camden City and Camden County Data from
High Risk Area Behavioral Risk Factor Survey
Breakdown-UMDNJ Graduate Student Project.
2006

Healthy Camden City 2010: Update 2005
Camden City
Camden County
New Jersey
Target
30
20
10
0
2003
Camden
Data
Target
Fundamentals of Good Health
Healthy Mothers and Young Children
Percentage of
women who abstain
from any tobacco
product during
pregnancy
Sources:

NJDHSS, Center for Health Statistics

Healthy New Jersey 2010: Update 2005

Camden Kids Count

Healthy Camden City 2010: Update 2005
96
94
Camden City
Camden County
NJ
Target-NJ White
Target-NJ Black
Target-NJ Hispanic
Healthy NJ Target
Preferred endpoint
92
90
88
86
84
82
80
78
2002
Target
Preventing/Reducing Major Diseases
Cancer
Age-adjusted mortality
rate from lung cancer
among persons 65
years of age and over
per 100,000 population
35
30
25
20
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Camden Demographics, Camden Reports
2006, CAMConnect

Healthy Camden City 2010: Update 2005
Not graphed as comparison due to skewing of data
due to Camden’s age spread in population with
37% under 18yrs of age.
Camden City
15
10
5
0
1999
2000
2001
2002
2003
Preventing/Reducing Major Diseases
Asthma
Annual hospital
admission rate due to
asthma per 100,000
population
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Camden City data source-Camden Hospital
and Emergency Room Health Data 2003,
Camden Coalition of Health Care Providers,
CAMConnect June 2006

Healthy Camden City 2010: Update 2005
700
600
500
Camden City
Target NJ
Target NJ White
Target NJ Black
Target NJ Hispanic
400
300
200
100
0
2003
Targets
Preventing/Reducing Major Diseases
HIV/AIDS
Age-adjusted mortality
rate from HIV disease
per 100,000 population
30
25
20
Sources:

NJDHSS, Center for Health Statistics.

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
Camden City
New Jersey
NJ Target
15
10
5
0
1999 2000 2001 2002 2003 Target
Preventing/Reducing Major Diseases
Infectious Diseases
Tuberculosis incidence
rate per 100,000
12
population
10
Sources:

NJDHSS, Communicable Disease Service.

Healthy New Jersey 2010: Update 2005

Healthy Camden City 2010: Update 2005
Camden City
New Jersey
Target White
Target Black
Target Hispanic
Target Asian/PI
Target NJ
8
6
4
2
0
2000
Target
Preventing/Reducing Major Diseases
Sexually Transmitted Diseases
Incidence of chlamydia
trachomatis infections
among females aged 1519 years per 100,000
population
2,500
2,000
1,500
Sources:
NJDHSS, Communicable Disease Service.
Healthy New Jersey 2010: Update 2005
U.S. Census Bureau
Healthy Camden City 2010: Update 2005
Recent Data-not exactly comparable as
Camden data includes all ages however this
is age group with highest target rate.
Camden City
New Jersey
Target NJ
1,000
500
0
2004
Target 950
Top Priorities Identified in
Community Focus Groups




Issues of poverty and the working poor, lack of housing,
jobs, education
Healthcare concerns (particularly men’s health,
mental health, exercise, and affordability)
Concerns regarding safety, drugs, domestic violence,
and after school safety
Concerns related to families and children, parenting
skills
Focus Group In-Depth Analysis
Topics Most
Frequently Discussed
Health Care Access
#1 Most Frequently Discussed
Comments

No coverage for prescriptions
Negative effect of poverty on ability to maintain good health practices
Lack of access to specialists, dentists, psychologists, psychiatrists,
and substance abuse programs
Lack cars or money for bus transportation especially to specialists
“Difficult to get appointments at WIC”, “Difficult to fill out Family Care
applications”
Long waits

No insurance if working poor-2 part time jobs





Children/Families
#2 Most Frequently Discussed





Comments
“The family structure is failing”
“Poverty causes parents to participate in illegal activities to
provide for their families”
“Unsafe to let children go out and play”
“Children are not eating properly.” “ Many children eat potato
chips or pretzels for breakfast”
“Children look up to drug dealers. They are the ones with the
gold jewelry and BMWs”
Children/Families
#2 Most Frequently Discussed (cont.)



Comments (continued)
“We are losing a generation of boys” to the terrible drug thing.
“Children buying drugs are more often arrested than the people
dealing drugs.”
“Children no longer go to church or attend Bible School.”
Schools and Education
#3 most frequently discussed



Comments
“Many children move from school to school
during the year and from year to year.”
“There is too much violence in the schools.”
“Schools should provide extensive sex
education. They should show them how
babies are born and how demanding it is to
take care of a baby.”
Schools and Education
#3 most frequently discussed



“School supplies are always late.”
“Teachers are no longer just educators. They have
to deal with all of society’s problems. There are so
many disruptive children that it is difficult to teach.”
“People also need to be educated how to manage
their money. They need to make their paycheck last
till the next one and not spend it all right away.”
Schools and Education
#3 most frequently discussed





“Kids need to walk 2-3 miles to get to school. They
need to reevaluate the bus pass situation.”
“The schools never follow up to see if the parent has
received the report card. They give no warning if your
child is failing- bad communication.”
“Child misses a lot of school due to health problems
(asthma).”
“Some schools are so big that the children get lost.”
“There should be education programs for people
wanting to start-up businesses in Camden-things like
the legalities of incorporating and financing.”
Violence/Safety
#4 most frequently discussed




Comments
Violence and safety for children “at school and on the way to
school.”
“Young mothers are not monitored and the safety of their infants
could be jeopardized.”
“Police need to learn to differentiate between individuals who are
truly violent versus those who are acting out due to mental
illness.”
“Seniors are afraid to leave their homes. They are disrespected
by the youth.”
Violence/Safety
#4 most frequently discussed





“The drug dealers are responsible for most of the
murders and drive-by shootings”
“Guns are too readily available and there is little the
police do to get rid of the guns”
“In Camden children can’t run if confronted. If you run
away you’re punk and everyone beats you up. You
need to be prepared to be violent to protect yourself.”
“It is dangerous outside of the business district”
“People working at agencies where client visits are
necessary are often afraid to leave the office.”
Violence/Safety
#4 most frequently discussed





“Inadequate employment and housing for ex-cons has led to
a high recidivism and incarceration rate. People convicted of
crimes are not eligible for a lot of the programs out there.”
“There is actually a war going on outside that you can’t run
from and no one is safe from.”
“There are a lot of gangs. The gangs are becoming more
organized.”
“Very rarely do individuals come out of prison changed for the
better.”
“There is physical and verbal violence on the street and at
home. Many sexual assaults occur in the home.”
Violence/Safety
#4 most frequently discussed




“The drug activity is escalating during the day and
even moving into the medical and academic areas.”
“Some in law enforcement will accept being paid off by
the drug dealers.”
“They are doing a lot to beautify the parks but not
secure them. The parks are now nicer for the drug
dealers and prostitutes.”
“Many have just accepted the violence in Camden.”
“Oh well, Camden is violent….This is not acceptable
though. It would not be accepted in any other
community.”
Environmental
#5 most frequently discussed






Comments
“The water quality is terrible.”
“I wouldn’t drink it or wash my children in it. I bathe them in
bottled water”
“The water is brown coming out of the spigot and the toilets
always look dirty, but it’s the water color.”
“The air is not clean and we still have problems with lead.”
“Unsanitary conditions cause many health problems like asthma.”
“There are infestations of water bugs.”
Results of Environmental Studies
Camden Waterfront South
Air Toxics Pilot Project 2005
NJ Dept of Environmental Protection
Waterfront South Air Pollutants
Currently above Health Benchmarks
Pollutants with risk ratios greater than one
Currently above Health Benchmarks
Arsenic, Cadmium, Dioxin, Nickel- cancer the health effect of
concern
Lead-irreversible neurological and behavioral deficits in
children, cancer
Hydrogen sulfide-adverse effects of nasal tract, headache and
nausea
Manganese-visual reaction, eye-hand coordination, hand
steadiness
Camden Waterfront South Air Toxics Pilot Project 2005
NJ Dept of Environmental Protection
Waterfront South Air Pollutants
Currently above Health Benchmarks



Fine Particulate Matter PM25
risk ratio 1.5
Inhalable Particulate Matter PM10 risk ratio 1.2
Diesel Particulate Matter
risk ratio 1.4
Camden Waterfront South Air Toxics Pilot Project 2005
NJ Dept of Environmental Protection
Summary of Challenges
Camden City







High Utilization of Emergency Departments versus primary care
Infant mortality, prenatal care, and teen pregnancies in Camden
City
Obesity
Heart Disease, Asthma, Diabetes
Cancer particularly breast, colorectal, invasive cervical, and lung
mortality. Oral and prostate incidence levels.*
Mental Health
Infectious Disease
*From Data to Strategy: Information for Planning a Smoking Cessation Program-2005
Camden County Cancer Coalition
Summary (continued)








Cigarette smoking
Dental care
Poverty, housing, jobs, education, working poor
Healthcare (particularly men’s health,
mental health, exercise, and affordability)
Safety, drugs, domestic violence, and after school safety
Schools and education
Lack of specialists, money for transportation to specialists out of
area, money for prescriptions
Environmental-air, water, infestations
Next Steps
1. Ranking Priorities
2. Developing Action Plans to
Address Priorities