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Risk factors for excess mortality in Harlem. Findings from the Harlem Household Survey
R E Fullilove1, M T Fullilove, M E Northridge
1Harlem Center for Health Promotion and Disease Prevention, Joseph L. Mailman School of Public Health, Columbia University/Harlem Hospital Center, New York, NY 10032, USA.
American Journal of Preventive Medicine
|April 13, 1999
Summary
Harlem residents reported high insurance and preventive care use, but also high rates of substance use and trauma. Community-level strategies are needed to address these health disparities.
Area of Science:
- Public Health
- Epidemiology
- Community Health
Background:
- Central Harlem had the highest age-adjusted mortality rates in NYC in 1980.
- This study addresses health conditions, risk factors, and behaviors in the Harlem community.
Purpose of the Study:
- To describe self-reported health conditions, behavioral risk factors, preventive practices, and drug use in Harlem.
- To compare Harlem's health patterns with other populations.
Main Methods:
- Population-based study conducted from 1992 to 1994.
- In-person interviews with 695 randomly selected adults (18-65 years) in Central Harlem.
- Descriptive statistics computed for men and women, compared to other surveys.
Main Results:
- High self-reported medical insurance coverage (74% men, 86% women) and preventive practices (e.g., cholesterol screening).
- Elevated lifetime rates of substance use (e.g., crack cocaine, 14%) and history of traumatic events (e.g., witnessing violence).
- Harlem's rates for substance use and trauma were notably high compared to other populations.
Conclusions:
- Identified significant similarities and differences in risk behaviors between Harlem and other populations.
- Highlights the need for multi-level strategies (community, municipal, regional, individual) to improve Harlem's health.
- Emphasizes addressing individual behavior and risk-taking alongside broader societal factors.
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