Surveys detail neighborhood health

CARE health survey

In the cafeteria of New Haven’s Augusta Lewis Troup School last week, Alycia Santilli asked everyone to get up out of their seats and moving.

Given three Post-it notes each, over 30 parents, neighborhood residents and employees in Yale’s Community Alliance for Research and Engagement voted on their most pressing priorities out of five options the CARE team compiled from a health survey of six of New Haven’s poorest neighborhoods the organization conducted last year. The overall findings of the survey, published earlier this month, found that while residents of Dixwell, Fair Haven, Hill North, Newhallville, West River/Dwight and West Rock/West Hills tend to report poorer health on average than residents of Connecticut or the United States, more were behaving healthfully since CARE last surveyed the neighborhoods in 2009.

The survey results have been supported by findings in a similar survey released around the same time by DataHaven, a New Haven-based nonprofit, which also show that certain city neighborhoods experience lower resident health.

“Data is knowledge, and that knowledge is best used in the hands of neighborhoods,” said Billy Bromage, a CARE neighborhood community organizer who presented at the school meeting. His presentation focused on health in the West River/Dwight neighborhood in which the school is located, but also shared information collected from all six neighborhoods.

According to the CARE survey, 40 percent of residents in the six neighborhoods reported “excellent” or “very good” health, compared to 64 percent and 56 percent of residents in Connecticut and the United States, respectively. Thirty percent smoked cigarettes — double the rate in Connecticut and about one and a half times the rate of the United States — and percentages of residents who had suffered from a stroke or struggled with asthma, diabetes and heart disease were higher than state and national numbers. The survey also found that more neighborhood residents were obese or overweight than their peers across the country.

Despite these findings, 39 percent of the 1,298 residents CARE interviewed felt their health was better than it was a year earlier, and 58 percent reported making healthy changes to their diet, including consuming smaller portions, fewer sweets and fewer sugary drinks. An additional 42 percent said that their neighborhood has changed in ways that has made healthy living easier.

Jeannette Ickovics, professor of epidemiology and psychology and the founding director of CARE, said that environmental factors help explain why residents of the six neighborhoods had relatively worse health than their peers elsewhere.

“What we find is disparities in wealth co-occur with disparities in health,” Ickovics said.

The DataHaven survey supports Ickovics’ statement, as 51 percent of Elm City lower-income neighborhood residents reported “excellent” or “very good” health in the DataHaven survey, compared to 84 percent of New Haven residents in higher-income areas. Individuals making less than $30,000 a year also more frequently reported hypertension, high cholesterol, diabetes, heart disease, asthma and obesity.

Other neighborhood attributes, such as safety, walkability and access to healthy foods can also affect a community’s health, according to the CARE report, because they influence the probability one engages in healthy behaviors and activities. Lower-income New Haven residents surveyed by the DataHaven report were less likely to report that they had high-quality public parks, many stores and banks within walking distance of their home, or safe sidewalks on which to walk. They were also less likely to agree that people around their neighborhood were willing to help or be trusted.

The experiences of some attendees at the meeting last week echoed these findings. Ann Greene came to the meeting because after working as a surveyor for the 2009 CARE study, she became convinced that individual and communal health are connected. She has lived in West River for five years and feels that social isolation and a dearth of resources contribute most heavily to the health problems low-income neighborhoods face.

“Our individual health benefits from communities that we sense are safe, neighborhoods where we feel comfortable letting kids outside to play, and where there is more casual and random social interaction,” she said. “All of us benefit from communities like that.”

In the West River neighborhood, CARE has provided funding for a community garden, mobile farmer’s market and annual International Day of Peace during which bands, clergy and community groups come together to espouse nonviolence in the city.

Greene said that these community initiatives brought people together and changed their expectations of what their environment could be, as well as giving residents a sense of self-efficacy.

“Here’s something I can do. I can walk across the street or block and grow some of my own food,” Green said. “As simple as that sounds, it wasn’t an expectation a few years ago for a lot of people. It is now.”

Bromage said that members of low-income communities do not have as easy access to medical care, exercise facilities or healthy food. He said the food industry was set up in a way that people in poverty cannot easily purchase healthy food, making living a healthy lifestyle more difficult.

“People just don’t have access to whole grains and fresh fruit because of the way the system works. Those things are more expensive than potato chips or 89-cent macaroni and cheese,” he said.

Mario Garcia, the director of public health for New Haven, said that both the CARE and DataHaven studies have helped the city look at public health comprehensively. He hoped the studies would not just guide public investment but also encourage private agencies, such as Yale-New Haven Hospital and United Way, to invest in more public health programming.

CARE will release a plan for further action this summer.a

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