Abigail Silva

Variations in the Health Conditions of 6 Chicago Community Areas: A Case for Local-Level Data

OBJECTIVESnAlthough local-level chronic disease and risk factor data are not typically available, they are valuable for guiding public health interventions and policies. To present a case for disaggregated community-level health data, we conducted a study exploring the relevance of such data to research on health disparities.nnnMETHODSnWe designed a population-based health survey to gather information on many health measures, 13 of which are presented here. Interviews were conducted with 1699 adults (18-75 years) in 6 Chicago community areas between September 2002 and April 2003.nnnRESULTSnStatistically significant variations in health measures were found between the 6 communities themselves (108 of 195 pairwise comparisons were significant) and between the communities and Chicago as a whole (35 of 54 comparisons were significant).nnnCONCLUSIONSnThe local-level variations in health revealed in this study emphasize that geographic and racial/ethnic health disparities are still prominent in Chicago and shed light on the limitations of existing city- and regional-level data.

Comparison of Health Status Indicators in Chicago: Are Black–White Disparities Worsening?

OBJECTIVESnThis study examined Chicago residents progress toward the Healthy People 2000 goal of reducing racial disparities in health and compared the results with a recent analysis of US data.nnnMETHODSnNon-Hispanic Black-to-non-Hispanic White rate ratios were computed for 14 health status indicators for 1990 and for 1998.nnnRESULTSnNationally and in Chicago, indicators for both Blacks and Whites improved between 1990 and 1998; however, Whites consistently fared better. Nationally, gaps narrowed on 10 indicators; for Chicago, they widened on 10 indicators.nnnCONCLUSIONSnNationally, there is apparent progress in reducing Black-White disparities; this is not true for Chicago. Whether failure to reduce racial disparities is unique to Chicago or is common to other urban centers remains an open question with important implications.

Smoking in 6 diverse Chicago communities - A population study

OBJECTIVESnWe analyzed smoking survey data across communities in Chicago, Ill, to explore community-level variations in smoking behavior.nnnMETHODSnWe conducted a health survey of 6 racially and ethnically diverse Chicago communities during 2002-2003. The survey included questions about current smoking, smoking history, and cessation attempts.nnnRESULTSnSmoking prevalence varied from 18% in the wealthiest (predominately White) community to 39% in the poorest (predominately Black) community. In a contiguous pair of communities, one Mexican and the other Black, smoking prevalence varied by a factor of 2. Men, residents in poorer households and households without telephones, and residents with less education were most likely to smoke.nnnCONCLUSIONSnThe high proportions of current smokers who had attempted to quit indicate a prevalent desire to stop smoking. However, less than 4% of the Master Tobacco Settlement Agreement funds are being spent on smoking prevention, or even on health in general, in Illinois. Although much is known about the prevalence of smoking at the national level, few studies of smoking have been done at the community level, presenting difficulties for the allocation of resources and the design of smoking cessation programs in response to community needs. Understanding community-level smoking rates could improve the allocation of resources and assist the shaping of culturally meaningful prevention efforts.

Diversity and Disparity: GIS and Small-Area Analysis in Six Chicago Neighborhoods

Small-area analysis in health is essential in uncovering local-level disparities often masked by health estimates for large areas (e.g., cities, counties, states). In this context, 14 health status indicators (HSIs) were examined for six Chicago community areas that reflect the substantial diversity of the city. HSIs were compared over time (from 1989–90 to 1999–2000) and across community areas. Important disparities among these community areas in mortality rates, birth outcomes, and infectious diseases were found. In many cases the disparities were in the expected direction with the richest and predominantly White community area experiencing the lowest rates. However, some surprises did manifest themselves. For example, only the poorest community area experienced a statistically significant decline in the infant mortality rate. Since so much of attention is now being paid to reducing and eliminating these disparities, it is important to examine their existence to better understand how to minimize them.

Disproportionate Impact Of Diabetes In A Puerto Rican Community Of Chicago

We assessed the impact of diabetes in a large Puerto Rican community of Chicago by measuring the prevalence of diagnosed diabetes and calculating the diabetes mortality rate. Data were analyzed from a comprehensive health survey conducted in randomly selected households in community areas. Questions on diagnosed diabetes and selected risk factors were asked. In addition, vital records data were analyzed in order to calculate the age-adjusted diabetes mortality rate. When possible, rates were compared to those found in other studies. The diabetes prevalence located in this community (20.8%: 95% CIxa0=xa010.1%-38.0%) is the highest ever reported for Puerto Ricans and one of the highest ever reported in the United States for a non-Native American population. For instance, it is twice the prevalence for Puerto Ricans in New York (11.3%) and Puerto Rico (9.3%–9.6%). Diagnosed diabetes was found to be significantly associated with obesity (pxa0=xa00.023). The prevalence was particularly high among older people, females, those born in the US, and those with a family history of diabetes. Notably, the diabetes mortality rate (67.6 per 100,000 population) was more than twice the rate for all of Chicago (31.2) and the US (25.4). Understanding why the diabetes prevalence and mortality rates for Puerto Ricans in this community are so much higher than those of other communities is imperative for primary and secondary prevention. Collaboration between researchers, service providers and community members can help address the issues of diabetes education, early screening and diagnosis, and effective treatment needed in this community.

HIV Testing Practices and Attitudes on Prevention Efforts in Six Diverse Chicago Communities

Data describing local level HIV testing practices and attitudes regarding HIV prevention are rarely available, yet would be useful for HIV policy and evaluation. A comprehensive health survey was conducted in six community areas of Chicago (nxa0=xa01,699) in 2002–2003. The HIV prevention module of this survey was used for this analysis. The proportion that ever tested for HIV ranged from 40 to 75% and 11 to 38% were tested in the past 12xa0months. Residents favored: needle exchange programs (59–77%), HIV information in high schools (95–100%) and elementary schools (85–94%), and condom distribution in high schools (74–93%). Attitudes were less favorable regarding pharmacies selling clean needles (37–58%) and condom distribution in elementary schools (22–66%). Adults in these areas are over three times more likely to have been tested recently than adults nationally. Residents strongly favor community based HIV prevention initiatives such as needle exchange programs, condom distribution in high schools, and HIV prevention taught in schools. These evidence-based observations may be valuable in planning HIV prevention programs and in shaping policy.