Health and Wellness in The District of Columbia

Health and Wellness in the District of Columbia From substance abuse to hunger to violent crime, D.C. residents experience a wide range of interrelated health concerns. These concerns are best addressed by looking at prevention methods first. Through this graphic, we explore a number of critical issues that public health practitioners are working to address through a variety of on-the-ground initiatives. D.C. Demographics from 2012 646,449 POPULATION 50% RACE According to the U.S. Census Bureau, the Though the African American population has decreased in D.C., it still comprises half of the population. In the 1980s, 70% of the population was African American. In 2000 it dropped to 61%. estimated population of D.C. increased 7.4% over its 2010 population of 601,767. 42.9% 50.1% White African American Mix of Two or 2.4% .6% American Indian and More Races Alaska Native 3.8% Asian Native Hawaiian and .2% Other Pacific Islander D.C.'s Hispanic population has grown 14.6% from 2010 to 2012 – outpacing the national average of 5.1%. MEDIAN AGE 33.8 YEARS LIFE EXPECTANCY 77.5 YEARS D.C.'s population is getting younger. Between 2000 and 2010, the 18- to 34-year-old age group grew by 37,000. Millennials (young adults between the ages of 18 and 34) represent 35% of the D.C. population, compared to 23% nationally. Life expectancy for D.C. residents in 2012. Heart disease and cancer are the two leading causes of death among residents, accounting for 50% of the deaths in the last five years, reported the Department of Health. Tobacco use is the single most preventable cause of death and disease in the United States. In Washington, D.C., 700 adults die each year from smoking, and 7,000 kids under the age of 18 will ultimately die prematurely from smoking. INEQUALITY Problems Throughout the D.C. metropolitan area - which includes counties in Virginia and Maryland - the poverty rate was 8.4% in 2010 (compared to 6.8% in 2007). In the District specifically, rate was 19%. more e poverty than double that of the D.C. metropolitan area. The average poverty rate across the U.S. is 15%. The top fifth of income earners in D.C. earn on average 29 times more than the 29x MORE Residents of Wards 5. 7 and 8 are more likely to suffer from bottom fifth. chronic diseases than residents of other wards. Solutions The District of Columbia covers 30% of residents through health insurance programs, including Medicaid, Medicare, D.C. Healthcare Alliance, SCHIP and Healthy D.C. To counteract the low availability of providers, the District has increased Medicaid and Alliance reimbursements. Using a model public/private partnership called Medical Homes D.C., which has worked with the D.C. Department of Health, the District is trying to improve access to quality primary care in medically underserved neighborhoods. Key Organizations DC Healthy Families http://dhcf.dc.gov/service/dc-healthy-families National Health Equity Coalition http://www.nationalhealthequitycoalition.org/main/default.aspx Health Equity Initiative (HEI) http://www.healthequityinitiative.org/about HIV AND AIDS Problems 2.4% of the population in the District is living with Reasons for the HIV/AIDS epidemic: HIV. Lack of access to health care Men in D.C. are three times more likely to be diagnosed with HIV as women (4,238.8 per 100,000 men vs. 1,422.4 per 100,000 women). Unprotected sex Lack of awareness of HIV status HIV Prevalence Rates per 100,000 by Sex Race/Ethnicity, for Adults/Adolescents, 2010 High rates of other sexually 6,344.1 Black men transmitted infections 2,996.7 Latino men 2,601.5 Black women Drug use 2,374.1 White men 593.6 Latinas High poverty rate | 106.4 White women *This list is in no particular order. Overall D.C. Rate: 2,739.0 Solutions High percentage of HIV testing: 68% of D.C. residents aged 18-64 report ever having been tested for HIV (which is higher than any other state.) 6.5 million male and female condoms were distributed in 2013, 5.7 million in 2012 and 4.6 million in 2011. In a D.C. needle-exchange Pre-exposure prophylaxis, or PREP, program, 648,000 syringes were exchanged in 2013. is an emerging HIV prevention intervention in which HIV-negative individuals take an antiretroviral to Routine HIV testing expanded. In i 2011, 120,000 publicly supported HIV reduce their individual risk of rapid tests were distributed in D.C. acquiring HIV. HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) Key Organizations http://doh.do.gov/page/hivaids-hepatitis-std-and-tb-administration-hahsta Metro Teen Aids http://metroteenaids.org/site/ Whitman-Walker Health http://www.whitman-walker.org/ SUBSTANCE ABUSE AND DRUG USE Problems D.C. is ranked 21st for the highest prescription drug overdose mortality rate in the United States. This translates to 12.9 overdoses from 11.3% of people 12 years and older abused or were dependent on alcohol or drugs between 2010-2011, compared to the national average of 8.9%, reported SAMHSA. prescription drugs per 100,000 people, a 55% increase since 1999. Solutions In October 2013, Trust For America's Health (TFAH) gave Washington, D.C., a score of 6 out of 10 for implementing strategies that could reduce prescription drug abuse, which include: Doctor shopping laws Rescue drug laws Good Samaritan laws Physical exam requirement Support for substance abuse treatment services Lock-in programs For the state-by-state scoring, each state received one point for achieving an indicator, or zero points if it did not achieve the indicator. Zero is the lowest possible score, 10 is the highest. Key Organizations Addiction Prevention and Recovery Administration (APRA) http://doh.dc.gov/service/doh-substance-abuse Regional Addiction Prevention Inc. (RAP) http://www.rapinc.org/ Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.samhsa.gov/ House of Ruth http://www.houseofruth.org/ HUNGER Problems In 2008-2012, 30.5% of households with children in D.C. could not afford enough food, the second worst rate in the nation. By Only 48% of full-service grocery comparison, food stores accept WIC. insecurity for households without children was 13.5%. Between 2010 and 2013, 12% of D.C. households Wards 7 and 8, with the were food insecure, compared to 12,9% highest poverty rates, have the city's highest obesity rates. nationally. The U.S. Dept. of Agriculture (USDA) defines "food insecurity" availability of, or inability to acquire, as limited nutritionally adeguate and safe food for a household. Solutions Washington D.C. ranks first in the nation for reaching children with summer meals through the D.C. Free Summer Meals Program, administered by the Office of the State Superintendent of Education (OSSE). Grants for before-and-after-care nutrition programs Funding to promote physical activity and nutrition in childcare programs Key Organizations DC Central Kitchen http://www.dccentralkitchen.org/ DC Hunger Solutions http://www.dchunger.org/ DC Free Summer Meals Program (FSMP) Miriam's Kitchen http://www.miriamskitchen.org/cause OBESITY AND CHRONIC DISEASES Problems Low-income populations are disproportionately impacted by obesity. In D.C., 41% of residents are considered to be "low-income," 35% of D.C. children ages 10 to 17 are obese or overweight and are at risk for high blood pressure, diabetes and heart disease. 22% of D.C. residents 21% of D.C. residents do not engage in physical activity on a monthly basis. are obese. Obesity rates within 15% of deaths in the District are related to the District contribute to an estimated $400 million in yearly health poor diet and obesity. care costs. Solutions Improving Health Through Parks/Green Spaces Access to parks and recreational spaces can help reduce obesity and the risk of chronic diseases including heart disease and diabetes. D.C. is revamping its Master Plan for Parks. The D.C. mayor designated $35 million to improve 32 playgrounds. 19.7% of the city's 39,071 acres are parks, or 7,679 acres of parks. Improving Health Through Active Commuting Walking and biking can lower obesity rates, helping to prevent chronic health problems. 2,300 bike racks have been installed since 2001. • In 2010, 9,300 D.C residents (3%) biked to work daily. In 2010, 35,000 D.C. residents (12%) walked to work daily. *Look to the hunger section above for solutions connected to the role food access plays in this issue. Key Organizations American Public Transit Association http://voicesforpublictransit.org/ Capital Bikeshare http://capitalbikeshare.com/ DC Department of Parks and Recreation http://dpr.dc.gov/ POLLUTION, ENVIRONMENT AND WATER Problems In 2013, air quality in D.C. had a failing grade, according to the American Lung Median age of water main pipes in D.C.: 78 years | old, including 9% Association. that were installed in the 1900s and 2% as old as the Ozone: Grade F (unhealthy) 1860s, before the Civil War D.C. Water (utillity) serves more than Particle pollution: Grade C (unhealthy for sensitive populations) 600,000 residents and 17.8 million visitors every year. Solutions Driving less, using public transportation and bike-sharing opportunities Asking legislators and government officials to support measures that cut air pollution Checking vehicle emissions and keeping non-passing Since 2005, the concentration of nitrogen dioxide, a pollutant linked to adverse effects on the respira- vehicles off the road tory system, has decreased, which resulted in D.C. experienc- Conserving electricity and energy ing a drop in the number of days in which air quality falls below federal health standards. Not burning wood or trash Key Organizations DC Environmental Network http://www.dcen.net/ Clean Air Partners https://www.mwcog.org/environment/air/partners/ Anacostia Watershed Society http://www.anacostiaws.org/ Neighborhood Farm Initiative http://www.neighborhoodfarminitiative.org/about-us/our-mission/ CRIME Problems Improvements In 2012, D.C.s murder rate ranked 8th In 1990, there were 474 homicides in the District. In 2013, there were 104. among the nation's most populated cities with a count of 88. Between 1990 and 1995, 2,643 people The number of were murdered in victims under the D.C. – an average of more than 400 deaths per year. age of 18 has declined: 20 in 2008 compared to three in 2012 Solutions Since the 1990s, federal and city law enforcement agencies led several initiatives to target violent crime including: The Hot Spot Initiative: 18 participating agencies developed targeted work plans to make an impact on crime in 14 neighborhoods. Federal Assistance Project: An infusion of resources from 18 federal agencies helped target violent crime and enhance enforcement efforts. Project Ceasefire: This initiative increased the number of attorneys focused on gang violence, created an Intelligence Unit and Project Safe Neighborhoods: This national anti-gun violence campaign emphasized collaboration among law enforcement agencies. launched a media campaign to raise awareness of gun violence. Homicide Prevention Project: By 9 facilitating coordination among detectives and narcotics investigators, this project closed over a dozen homicide cases. Key Organizations National Crime Prevention Council http://www.ncpc.org/programs DC Metro PD Safe City Project http://mpdc.dc.gov/node/214292 District of Columbia Crime Policy Institute http://www.dccrimepolicy.org/ SOURCES ' http://quickfacts.census.gov/qfd/states/11000.html * http://datatools.urban.org/features/changingcities/irace * http://datatools.urban.org/features/changingcities/#age * http://doh.do.gov/sites/default/files/dc/sites/doh/page_content/attachments/ 2nd%20Draft%20CHNA%20%28v4%202%29%2008%2004%202013%20-%20VO19%201.pdf * http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8335.pdf * http://washingtonexaminer.com/d.c.-tops-nation-in-drug-aloohol-abuse/article/118789 * http://healthyamericans.org/reports/drugabuse2013/release.php?stateid=DC * http://www.dchunger.org/pat/grocerygap.pdf * nttp://www.dchunger.Org/fedfoodprogs/cacfp/cacfp_index.htm 1° http://www.dchunger.org/fedfoodprogs/summer/summer_index.htm " https://sphhs.gwu.edu/sbsrn2013/presentations/3_Castel.pdf 12 http://dpr.dc.gow/node/135652 19 http://www.dchunger.org/pdt/doparks_rec_nutrition_strategies_2011.pdf 14 http://playdc.org/project http://wamu.org/programs/metro_connection/13/05/24/building_bstter_playgrounds_for_do_kids 1* nttp://parkscore.tpl.org/city.php?city=Washington " https://comp.ddot.dc.gov/Documents/Bioycle%20Program%20Fact%20Sheet%20Summer%202012.pdf 18 http://wamu.Org/news/13/04/25/dc_area_gets_fin_air_quality 19 http://www.stateoftheair.org/2013/states/district-of-columbia/district-of-columbia-11001.html * http://www.dowater.com/news/publications/dowater_2012_annual.pdf 21 http://green.dc.gov/air * http://www.washingtonpost.com/opinions/the-number-of-homicides-falls-in-do-and-prince-georges/ 2012/12/27/25afefde-5089-11e2-950a-7883a013284D_story.html * http://mpdc.dc.gov/node/197822 * http://mpdc.dc.gov/sites/default/files/do/sites/mpdo/publication/attachments/homicidereport_0.paf * http://homicidewatch.org/2013/08/17/d-c-2012-murder-rate-ranked-8th-among-nations- most-populated-cities/ * http://doh.do.gov/sites/default/files/dc/sites/doh/publication/attachments/ Section%201.%20Diagnosed%20and%20Living%20HV%20Cases.pdf 7 http://www.hubariatrics.com/files/ObesityinDCFactSheet.pdf 2* http://www.prepwatch.org * http://www.dchunger.org/press/do_2014_summer_meals_report.htm * http://www.washingtonpost.com/blogs/capital-weather-gang/wp/2014/08/28/ nasa-showcases-major-decline-in-air-pollution-over-d-c-i-86-corridor-since-2005/?wpisrc=n_buzz 3" http://www.tobaccofreekids.org/facts_issues/tolLus/do 12 http://mpdc.dc.gov/sites/default/files/dc/sites/mpdo/publication/attachments/HomicideReduction Strategy-USAO.paf * http://quickfacts.census.gow/qfd/states/11000.html * http://washingtonexaminer.com/dc-area-outpaces-nation-in-booming-asian-hispanic-growth/article/2531709 Milken Institute School of Public Health. 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