New York City Department of Health and Mental Hygiene - Research Paper Example

Health Sciences and Medicine   December 14, New York Department of Health and Mental Hygiene The paper on “Women at Risk: The health of women in New York” compiled and published by the New York City Department of Health and Hygiene throws light on the various health related concerns and issues women of New York are facing. For this it takes help and guidance from the “Take Care New York” health journal regarding the various ways on how women treats themselves, and how public and community health providers along with the private health practitioners can take to improve the overall health of men and especially women in New York. Besides this, the report also tries to highlight some of the main factors or key personal and community traits like income group, ethnicity, age group, marital status and smoking pattern based on which the all the women in New York can be divided into subpopulation and the effect of these factors on their lifestyle habits and related health issues can be easily studied and understood. “It is important to note that race and ethnicity are primarily social characteristics much more than they are biologic categories. However, race and ethnicity can provide useful information to women's health care providers about environmental, cultural, behavioural, and medical factors that may affect their patients' health” (Racial and Ethnic Disparities in Women's Health para. 3, 2005). The New York Department of health and mental Hygiene’s report tries to highlight the health risks to women, major community factors and their influence on women health and also tries to suggest the various steps women can take on their own or through the community health care service providers. The reporter or group of people who have contributed to making this report have tried to collect data related to the following based on the key points mentioned in the “Take Care New York” article: First the varied health related risks have been considered and statistically evaluated. Secondly, the prevalence of health delimiting factors over the varied women subpopulations has been studied and; Finally, suggestions and recommendations for the women and community health care service providers have been laid. This can therefore help in making targeted group educating and socially friendly health campaigns and programs to benefit the women. From studying the above points, the authors of the report have made a choice to see the effect of community trait and related health risk prevalence as per the age groups of the women. The categorising factors considered in the report mainly include, the ethnic group to which the women belongs viz. Non-Hispanic white, Non-Hispanic black or Hispanic; also income group of the women has been used.) So, these are the two main baseline categories to which the women of New York have been divided and therefore the health risks analysed. “Differences based on race, ethnicity, or economics can be reduced. Reducing health disparities requires government policymakers, health professionals, researchers, and community groups to work together” (Health Disparities in New York City 1, 2010). Till date epidemiological studies have been focused on knowing the basic reasons or factors affecting a person’s health. But it has been observed and confirmed through varied controlled studies and surveys that even the socio economic factors like the married life, the economic status, societal factors also play an equal role in determining a person’s overall health. “Forty years of medical sociology have uncovered numerous examples of the social patterning of disease. Most obvious is the ubiquitous and often strong association between health and socioeconomic status” (Link & Phelan 81, 1995). Thus, like health is the state of physical, mental and social well-being; therefore effect of socio economic factors in one’s life is important to study and essential to manipulate in order to ensure complete health of the population. Thus, this publication by New York Department of Mental Health and Hygiene is a step forward towards highlighting the till dates much neglected individually important and affecting social factors. In the report, only women community and related health aspects have been studied comparing their occurrence probability with the socio-economic groups of varied women subpopulations. "Disparities in health behaviours, health outcome, and access to care exits among economics and racial/ethnic subgroups of women" ( Frieden) Women are the binding as well as promoting links of a society. A healthy women population of a nation is thus necessary to ensure a happy and healthy progress. Also while considering the social factors responsible for maintaining or harming the health of a person; healthy people of a nation would thus be referrals to health social frame of the place. “Persisting disparities in health violate widely shared U.S. norms of equality of opportunity and the dignity of each person. Eliminating health disparities is also important for the overall well-being of the entire U.S. society. First, diseases that are initially more prevalent in disadvantaged geographic areas eventually diffuse and spread into adjacent affluent communities.35 Second, the illnesses and disabilities associated with racial disparities limit the productive capacities and output of adults in their prime working years. This can negatively affect productivity at the local and national levels and can lead to declines in tax revenues and increased costs of social services” (Wiliams & Jackson 331, 2005). In this publication, the women population of New York City were chosen to observe. And following key findings could be found in this article: Though last five decades have seen a major improvement in the health of New York women, there still remain certain areas and issues which need to be addresses. New York City is inhabited by very little percentage of its native citizens but mostly by other like non -Hispanic White, Non-Hispanic black, Non-Hispanic Asians and Hispanics. All of these sub groups have and show a different attitude towards their own health and fitness also towards the medical care offered by various organisations and institutes. Considering the neighbourhoods of the city, the poor neighbourhoods have more incidence of ill health of the women there. Here the cases of AIDS mortality, deaths due to cancer, low birth weight of infants and deaths due to pregnancy related complications are on a high. Also the overall life expectancy is shorter for the women in these areas. Secondly, preventive care including, timely disease screening tests and examinations and vaccinations and immunizations are not available to all. The reason might be the lack of effort from the governing bodies plus the negligence from the patient’s as well. Women neglect taking preventive measure for themselves. Heart disease though has been the largest cause of mortality but has been known to be controlled with appropriate and timely measures. This is not true in case of New York women and thus, there is an increasing rate of deaths due to heart diseases among women than in men The following factors have been thought to affect the kind and extent to which the women of New York bother to take health care measures. And thus based on these various categories were formed as follows: “80% of black respondents in a US study reported experiencing racial discrimination at some time in their lives. Findings from the UK Fourth National Survey of ethnic Minorities suggested widespread experiences of racial harassment and discrimination among ethnic minority people in the United Kingdom” (Nazroo 281, 2003). To start with the study the inhabitants of the city are divided into easy to analyse subgroups. First noticed major groups included The Hispanic Black Non-Hispanics White non-Hispanics and Asians The natives inhabiting the city are very few and can thus be made into a category. The Non-Hispanic whites made the largest population with 38 % and were followed by Asians who are 24%. While analysis showed that black women have shorter lives than white women, the report also suggests that the Hispanics have higher life expectancy than the Non-Hispanics. Further analysis considered dividing the women age group wise and for this four age groups were considered as follows: 18-24 years (prone to smoking and cancer) 25-44 years (prone to smoking and cancer and AIDS) 45-64 years and (neglect health needs and avoid regular visits to the doctor, have highest prevalence of heart diseases) Older than 65 years Racial differences in socioeconomic status, neighbourhood “residential conditions, and medical care are important contributors to racial differences in disease. Socioeconomic-status whether measured by income, education, or occupation, socioeconomic status (SES) is a strong predictor of variations in health. Americans with low SES have levels of illness in their thirties and forties that are not seen in groups with higher SES until three decades of age later” (William & Jackson 327, 2005). While taking care of each of the above 10 analysis criteria the age groups of the women under study was diligently considered. In New York maximum women (42%) belonged to the age group of 25 to 44 years. Another major categorization criteria was the education of the women and following groups were formed: Did not complete high school Just completed high school Studied for some time in college Completed college degree Studied advance after college degree From all the above those who had to leave high school in between or who had just completed the high school formed the major portion of 25 to 28 % while those with a college degree were only 15 % and even had lesser chance to study further. The women without high school education are more prone to adapting smoking habits and neglecting health care campaigns while those with college or higher education tend to have better and positive perspective towards taking preventive healthcare measures and avoiding indulgence into practices like smoking. The women when grouped according to the yearly household income they have; following groups could be formed: Below 25,000 USD Between 25 and 50,000 USD Between 50 and 75,000 USD And above 75,000 USD Maximum women fall into the category of those having income below 25,000 USD i.e. 46% and minimum were those having above 50 or 75,000 USD (only 15%). Income group to which a woman belongs has been seen to have great impact on the women’s general behaviour and life style. "Women without health care coverage are 4 times more likely to report being able to obtain needed medical care than those with coverage. But, even among women with health care coverage, difficulty obtaining needed medical care is higher among low-income women" (p8, women at risk: The health of women in New York City). From the data, it can be seen that the ones falling in low income group were those to: Had shortest life expectancy (reported overall fair or poor quality of health); Experience pregnancy time complications Does not have medical insurance Do not take immunizations or undergo cancer screening tests Maximum cases of low infant birth rate and after birth complications While those falling in income group of about 45,000 USD or above were having better healthcare habits like regular medical check-ups, screenings, regular visit to healthcare provider. They also often have fixed family physician, medical insurance and therefore are less prone to pregnancy related diseases or complications and have healthy babies. Many of these people who falls under the income group of about 45,000 USD also shows interest in taking preventive measures to avoid heart troubles and were involved in regular exercising or gym routines, which was not true with those in the lower income group. The income group was found to have more profound effect on the health of the women, even more than the age group or the ethnic group. The New York women for the study purpose were also categorized as foreign born or US born and 43 and 57 % women belonging to two categories respectively were observed. For a long time, only physical factors or bodily traits have been related and studied to evaluate reasons or risks of having a disease for an individual. “There are pronounced gender differences in rates of various forms of cancer and mental disorder. African Americans have higher rates of overall mortality and infant mortality, renal failure, and stroke than do Whites, but lower rates of coronary heart disease cancer rates also differ by race and ethnicity” (Phelan et al. 82, 1995). But scientific views on epidemiological studies are changing now. Many scientist and researchers have started questioning and examining social and economic conditions of a person as the cause of a disease. If not a direct cause they might indirectly be involved into effecting the person’s health. These studies have now been given more importance and are being taken seriously. Where at one hand we cannot alter the physical conditions of a patient’s body, some social changes could be brought about to bring positive changes. These studies could thus be utilized to analyse the main societal causes posing health risks to the populations and thus can be fought against. The report “women at risk: The health of women in New York City” has pulled out an emphasis on the position of socio-economic status and traits present as an inherent part of a society; as the possible causes of posing health risks and also as key areas which can be worked upon by health care communities. Health care negligence is prevalent among women with low income group and the Hispanic women of the city. And this has been related to their negligence towards consulting a doctor on regular basis or getting medical insurance done. Regular medical check-ups also affect the chances of getting health screening tests done. “Having a regular provider is important to maintaining health. Women with a regular provider are less likely to report being able to obtain medical care, compared to those without a regular provider…Having a regular provider substantially increase the likelihood that woman receive screenings for colon (colonoscopy or sigmoidoscopy), breast (mammogram) and cervical (Pap test) cancers " (pg 9 Women at risk: The health of women in New York City) .So, those without medical claim policies or those who do not prefer to visit the primary healthcare provider regularly are more likely to avoid the cancer screenings, health examinations and immunizations and thus add to the increasing health risks to the women. Gender also plays a significant role. Or it can be said that everything is inter-related. While studying the women populations and comparing the data obtained with the prevelance rate of varied diseases among men a major gender effect had been noticed. "Social and biological theories would predict that of members of one sex were more vulnerable to disease and illness, that would lead to morbidity and mortality rates of the opposite sex" (Bird & Rieker 745-755, 1999). For various points like life expectancy, sexually transmitted diseases, smoking habits, cardiovascular health, routine check-ups and even medical claim policies; a huge gap and pattern had been noticed. Considering the complete population of New York, the study elaborates that men are more conscious towards their health than women. They like to remain active and indulge in exercising routines to keep themselves healthy. Also majority of them prefer to have regular health check-ups. While smoking rate is more in men, but on the other hand women have shorter life expectancy and more prevalence of deaths due to cancer and AIDS have been observed among women than men. Structural Analysis has been involved thoroughly in the Report: The author of the report, “Women at risk: The health of women in New York City” has taken a structural approach towards elaborating the various possible traits and characteristics of the women population in New York which is affecting their health. The structural approach of the author is prevalent from the report as: To start with the author has not blindly started to enumerate the health risks women are facing but has carefully tried to come up with the idea of various factors having prominent effect on a women’s choice of following particular health care regime which would involve having fixed doctor, visiting the physician regularly, setting self-targets and routines to remain healthy or having medical policies. A women’s social condition as per the author is a key ruler. It is the one which guides a woman’s steps she takes towards her health and the various habits she develops or forms during her lifetime. Similarly, the socio-economic status of the women also affects their health. Thus, in the report, the author has tried to elaborate all the socio economic factors having binding effect on a women’s life; major one being her income and the ethnic group. These have large emotional effect on the women’ thinking. For instance, while dealing with the smoking rate or deaths due to varied disease or life expectancy; the author has mentioned figures for both the men and women. He has at all points compared on the prevalence of various disease and lifestyle habits among the men and women population of New York. Another strong area which the author has considered uniformly throughout the report and the depictive of the author’s structural analytical ability is the history stances provided throughout the report. When dealing with any risk criteria the author has made sure to compare the present state with the previous years. Also at places, the author has provided graphs and data tables relating the values of variable at the time of the survey as well as five to ten years back. While analysing the data, a reference to past year and 5 years values have been made. This approach has made the report even more structured as anybody reading it in the future would be able to relate the present date scenario to the prevalent years. Also this approach comes in handy while intending to study the similarity in patterns as a variable follows over years and the possible reasons for any deviation if noticed. Similarly, in the report, life expectancy of men and women is compared and it is revealed that 5 years back the gap between the two more, but with increased life expectancy of women this gap has reduced. The author throughout the report has a maintained a flow of thoughts wherein he address the problems and at the same time recommend possible solutions for the same. Unlike some reports where after writing pages of discussing a problem, a brief of possible solutions are given. The author here has very intelligently addressed one problem at a time and gives related recommendations for the same following it. This approach can be considered effective in binding the reader’s concentration and avoiding long boring speech like pattern which does not interest many. The usage of language and words throughout the report is very healthy and suitable for any group of people who would like to read it. Though varied ethnic groups and income groups have been referred to, the way whole of the discussion has been framed excellently in terms of maintaining individual identity and respect for all being referred to in the report. Overall the writing pattern, flow of language and ideas followed offer great examples in terms of the information given and the writing style which has been adopted. The author also gives suggestions/recommendations to the health care providers, communities and organisations about the ways they can modify their health care system, related techniques and routes of reaching people. Through all the points mentioned above, it can be said that the author has adopted a clean structural approach while collecting data, compiling the report, and discussing the results of the survey done. Work Cited Bird, Chloe E & Rieker, Patricia P. Gender Matters: An Integrated Model for Understanding Men’s and Women’s Health. Social Science and Medicine 48 (6). 1999. Web. Dec. 11, 2011. < http://www.ciesas.edu.mx/biblioteca/BIBLIOGRAFIAS/DA-%20REARTES-OSORIO/17.%20R-O.PDF> Health Disparities in New York City. NYC Health. 2010. Web. Dec. 11, 2011. Link, Bruce G et al. Social Conditions As Fundamental Causes of Disease. Journal of Health and Social Behavior. 1995. 35(Extra Issue). pp. 80-94. Print. Nazroo, James Y. The Structuring of Ethnic Inequalities in Health: Economic Position, Racial Discrimination, and Racism. American Journal of Public Health. 2003. Web. Dec. 11, 2011. < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447729/> Racial and Ethnic Disparities in Women's Health. The American Congress of Obstetricians and Gynecologists. 2005. Web. Dec. 11, 2011. Wiliams, David R. & Jackson, Pamela Braboy. Social Sources of Racial Disparities in Health. Health Affairs. 2005. Web. Dec. 11, 2011. < http://content.healthaffairs.org/content/24/2/325.full> Read More