Ami M. Shah

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

OBJECTIVES Although 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. METHODS We 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. RESULTS Statistically 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). CONCLUSIONS The 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.

Prevalence of Obesity Among Children in Six Chicago Communities: Findings from a Health Survey

Objectives. We analyzed data from a community health survey to assess levels of obesity and overweight among children in some Chicago communities compared with national U.S. estimates. Methods. Data came from the Sinai Improving Community Health Survey, which was conducted via face-to-face interviews with people living in six racially and ethnically diverse Chicago communities during 2002 and 2003. A stratified, three-stage probability study design was employed to obtain a representative sample from each community. Height and weight data reported by the primary caretakers of 501 randomly selected children aged 2–12 years were used to determine age- and gender-specific body mass index (BMI), which was then used to classify weight status (obese ≥95th percentile for age and gender). Results. Compared with 16.8% for the U.S., the prevalence of obesity was 11.8% in a non-Hispanic white community on Chicagos north side, 34.0% in a Mexican American community on the west side, and 56.4% in a non-Hispanic black community on the south side. Conclusions. Surveillance of the childhood obesity epidemic at the local level is limited. Findings describe the extent of disparities in childhood overweight and obesity within one city and how local-level data can shape new initiatives for improved health, one community at a time.

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.

Comparing Selected Measures of Health Outcomes and Health-Seeking Behaviors in Chinese, Cambodian, and Vietnamese Communities of Chicago: Results from Local Health Surveys

We describe how local community organizations partnered to conduct a survey in the Chinese, Cambodian, and Vietnamese populations of Chicago to compare health outcomes and assess progress toward Healthy People 2010 goals. Interviews were conducted with 380 randomly selected Chinese adults through door-to-door sampling, and with 250 Cambodian adults and 150 Vietnamese adults through respondent-driven sampling. Data on 14 key health outcomes are described for this analysis. The three surveyed communities were generally poorer, less educated, more often foreign-born, and had less English proficiency than Asians nationally. There were few significant variations among the three populations, but there were notable differences in the burden of tuberculosis, obesity, diabetes, and arthritis. Insurance coverage and cancer-screening utilization were also significantly lower than for US Asians. Health information about Chinese, Cambodian, and Vietnamese populations in Chicago are available for the first time and serve as baseline data for community interventions. Findings highlight important health concerns for these populations and have implications for funders and policy makers in allocating resources, setting health priorities, and addressing health disparities.