Contributing Antecedents to the Current Health Crisis Among Puerto Ricans Residing in the South Bronx, New York (Blog 2)

Contributing Antecedents to the Current Health Crisis Among Puerto Ricans Residing in the South Bronx, New York

 

To date, Dr. Santiago and I have a greater understanding of the contributing antecedents to the current health crisis among Puerto Ricans residing in the South Bronx, New York.

Our research has taken us on a journey that examined the evolution of food consumption among the residents of Puerto Rico and the continuities of these patterns upon migrating to the U.S. mainland.  We also were able to identify the 1960’s as the period marking the onset of obesity as a public health concern in Puerto Rico. It has been demonstrated that these patterns of obesity have continued and increased both on the island and U.S. mainland.

For the epidemiological component of our research, we relied on data from the Centers for Disease Control and Prevention, the New York City Department of Health and Mental Hygiene, The Hispanic Community Health Study—Study of Latinos sponsored by the National Heart, Lung and Blood Institute, and the Bronx Lebanon Hospital Center 2013 Community Health Needs Assessment.  Our food, nutrition and food evolution sources were obtained the Centro Archives: CUNY Center for Puerto Rican Studies and the Schomburg Center for Research in Black Culture.

The following data, gathered from the NYC Department of Health and Mental Hygiene, outlines the current health crisis in the South Bronx Community Districts 1-4:

 

Mott Haven (District 1) & Hunts Point (District 2)

  • According to the 2011 U.S Census Bureau, the median household income of District 1 residents is approximately $22,017 while District 2 is $18,119.  The average median household income for these 2 districts is $20, 068.  According to the U.S. Department of Health & Human Services, the 2011 federal poverty measure for a family of four is $22,350.  On average, the residents of Districts 1 and 2 are living $2,282 below the federal poverty rate.

 

  • 45% reported they live below poverty rate

 

  • More than 4 out of 10 adults (43%) consider themselves to be in poor health compared to 21% in the Bronx as a whole

 

  • 35% do not have a personal doctor; 16% go to the hospital emergency department (ED) when sick
    • 64% are uninsured

 

  • The cardiovascular disease rate in Mott Haven and Hunts Point is 25% higher than the entire borough—and 50% higher than New York City as a whole.
    • 28% were told they have high blood pressure
    • 25% were told they had high cholesterol

 

  • Obesity is noted on 25% of the district’s total adult population and 1/3 higher than New York City.

 

  • 54% have reported that they never exercise, while 36% report exercising at least 3 days a week

 

  • 17% of adults are diagnosed with Diabetes; twice the percentage among adults in New York City.
    • 95% of these diagnoses are Type II.

 

Morrisania (District 3) and Highbridge (District 4)

  • According to the 2011 U.S Census Bureau, the median household income of District 3 residents is approximately $17,134 while District 4 is $25,734.  The average median household income for these 2 districts is $21, 434.  According to the U.S. Department of Health & Human Services, the 2011 federal poverty measure for a family of four is $22,350.  This translates to an average of residents subsisting on $916 below the federal poverty level.

 

  • 41% reported they live below poverty rate

 

  • More than 1 in 3 adults (36%) consider themselves to be unhealthy or poor health, compared to 28% in the South Bronx as a whole

 

  • 26% do not have a personal medical doctor; 20% go to the hospital emergency department (ED) when sick.
    • 69% are uninsured

 

  • The cardiovascular disease rate in Morrisania and Highbridge is 20% higher than the entire borough—and 40% higher than NYC.
    • 28% were told they have high blood pressure
    • 25% were told they had high cholesterol

 

  • Obesity is noted on 27% of the district’s total adult population; 1/3 high than New York City.

 

  • 54% reported they never exercise, while 36% report exercising at least 3 days a week

 

  • 16% of adults are diagnosed with Diabetes compared to 9% adults in New York City.
    • 95% of these diagnoses are Type II

 

A number of questions were raised with above noted data.  For example, during the past decade, Districts 3 and 4 had a 15% increase in hospitalizations.  What remains unclear is if these hospitalizations are the result of an increase in neighborhood/population density—or another issue that was not documented in the data.  A second concern was the median household income reported by the 2011 US. Census Bureau Subway Tract.  For example, two communities in Mott Haven (District 1) that are predominantly African American and Latino had a median household income of $32,875.  We suspect this elevated income is due to the recent spurt of gentrification and does not truly reflect the economic realities of these communities.

This project has left us yearning for more research time to delve deeper into the topic.  We have decided to continue our project through the site Eat Healthy Now, South Bronx and the Public Service Announcement, Take The Last Look.  As a nursing student, I want to take this experience and employ it to my future endeavors as a health advocate.

Contributing Antecedents to the Current Health Crisis Among Puerto Ricans Residing in the South Bronx, New York

The title of my research is Contributing Antecedents to the Current Health Crisis Among Puerto Ricans Residing in the South Bronx, New York.  My interest in this topic was piqued by volunteering at the nascent New Roots Farm in the South Bronx in which my research mentor, Dr. Denise Belen Santiago is a member.  Moreover as a nursing student, I am interested in the epidemiology of underserved urban communities and the implementation of culturally specific wellness programs.  My research question is: Are there contributing factors in diet, consumption and ill health that predate the contemporary proliferation of fast food products and their associated adverse effects and outcomes?  In order to answer this question, the United States/Puerto Rico colonial relationship needs to be examined.  More specifically, the supplanting of indigenous foods with imports of food and food products from the US mainland.

 

According to the medical, public health and food justice literature, the influx of fast food eateries that sell high caloric and nutritionally vacant food products has been identified as a major contributor to this public health crisis.  This research is further supported by the historic six-and-a half-year study funded by the National Institutes of Health (2006-2013), indicating that Bronx Puerto Rican residents yielded the highest rates of obesity, depression, hypertension, high cholesterol and asthma.  While this is a national issue, our research will take a micro-approach and focus on Puerto Ricans residing in Community Districts 1-4.

 

Our research methodology is to interview island-born Puerto Ricans preferably born between 1920-1955 to document their food memories.  These conversations will provide qualitative data on the transformation of food intake, that is, from the indigenous to the industrial.  In addition, we will conduct a literature review in the following areas: early US/PR colonial relationships and modernization strategies; island and mainland public health (Institute for Tropical Diseases, CDC, National Institutes of Health, New York City Department of Health).

 

Research Goals:

  1. Examine the dynamics that propelled the importation of US foods and food products to Puerto Rico during the early-mid 20th century (1900-1940’s);
  2. Chart the prevalent diseases in Puerto Rico during the 1900’s-1940’s;
  3. Conduct an epidemiological timeline of South Bronx Puerto Rican residents that charts the progression of diabetes, hypertension, cardiovascular disease, obesity and other relevant diseases in 10-year increments, starting in 1940.  [Note: the 1940’s mark the start of the Great Migration from Puerto Rico to the US mainland];
  4. Produce a Public Service Announcement (PSA) that is culturally relevant to Puerto Rican/Latino/a diet and health;
  5. Develop the interactive website Eat Healthy Now, South Bronx! that will provide readers with an awareness on the relationship between nutrition and health.  We also provide resources and tips that help to promote a healthier lifestyle.

We look forward to providing periodic updates on our research.