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One Resident at a Time

March 15, 2013
by Michael Greenwood

Can New Haven, a city with tens of thousands of people living in widely different circumstances, move toward better health?

It would take an enormous effort, sustained over many years, creativity and commitment from city officials, educators and residents alike.

Progress would likely be slow in many areas, even halting, but a recent survey completed by the Community Alliance for Research and Engagement (CARE) at the Yale School of Public Health shows that progress is possible.

“Compared to 2009, we see improvements in health in the city,” said Jeannette Ickovics, CARE’s director and a professor at the School of Public Health. “We see improvements in health behaviors in these low-resource neighborhoods.”

The research group recently completed a two-month, door-to-door survey of some 1,300 adult residents aged 18 to 65 years in six of New Haven’s most underserved neighborhoods— Dixwell, West River/Dwight, Fair Haven, Hill North, Newhallville and West Rock/West Hills. The study found a number of changes for the better since a similar canvass in 2009 of the same communities.

Since that first survey, CARE and its community partners have launched a number of programs to address health inequity in many of the city’s neighborhoods and in its schools. These initiatives encourage healthier diet, smoking cessation and increased exercise.

The 2012 survey results released Wednesday during a press conference at New Haven City Hall found that:

  • 39 percent of residents surveyed reported improved health compared to one year ago.
  • 40 percent indicated that people in their neighborhoods are encouraging healthier lifestyles.
  • 42 percent said physical changes within their neighborhoods (e.g., recreational facilities) had made healthier lifestyles more possible.
  • 63 percent of those surveyed reported increasing their physical activity.
  • 58 percent reported making healthy changes to their diet.
  • 65 percent of smokers indicated that they want to quit.

“The changes that we have made with our community partners have begun to make a difference,” Ickovics said. “There is still a long way to go, but with growing support from local partners – our local residents, City government, hospitals, health centers, schools and the faith and business communities – we can continue to implement stronger initiatives to tackle health disparities in the region.”

CARE will begin a series of community meetings next week in the neighborhoods that were surveyed to inform residents about the survey results and to gather ideas to further improve New Haven’s health.

While the 2012 survey identified encouraging trends, New Haven continues to be a city marked by wide health disparities and people in the six neighborhoods surveyed have higher rates of obesity and chronic diseases than their peers in other parts of the state or the country.

In the six New Haven neighborhoods, for instance, nearly 15 percent of those surveyed reported having diabetes, whereas the rate in Connecticut is close to 6 percent.

Also in New Haven, nearly 70 percent of the adult population in the neighborhoods is either overweight or obese, a factor that contributes to a range of chronic diseases. Throughout Connecticut, about 60 percent of the population is overweight or obese.

The survey also found widespread concerns among residents about household finances and personal safety within their neighborhoods, factors that often contribute to poor health. Nearly 51 percent of the survey respondents said that they are, at best, “just getting by” financially (while 15 percent of respondents indicated that they were faring even worse) and 44 percent receive food assistance. As many as 23 percent of the respondents in the labor market were unemployed, a rate that is many times higher than both the state and national averages. In terms of safety, 67 percent of residents said they do not feel it is safe to walk in their neighborhood at night.

Stacy Spell, president of New Haven’s West River Neighborhood Services Corp., which is a partner with CARE, said that conditions are improving in New Haven.

“We are getting better,” he said at Wednesday’s City Hall event. “We know that New Haven is on the move. There is a lot of energy galvanizing us to make improvements in our community. The only way that we are going to move forward is when we work together.”

When Paul Cleary became dean of the Yale School of Public Health, he identified improving health in New Haven as one of the his priorities. He has frequently said that if the School could not use its research and knowledge to help city residents improve their health, he would consider his tenure as dean a failure.

“To be honest, my earlier statements about improving health in New Haven were aspirational and I realized that it might be impossible to make enough substantial changes to actually change people’s health. Recently, however, the many programs started or precipitated by CARE have started to have a real impact and having seen the energy and commitment of researcher and community members involved in various new initiatives, I now am much more confident that we will continue to see improvements in our neighborhoods.”

CARE’s programs in New Haven include community gardens and expanded Farmers’ Markets to make healthy produce more available; healthier goods in neighborhood stores through the Healthy Corner Store Initiative; the Health Heroes program that encourages students, families and adults to make lifestyle changes for better health; advocating for food policy changes through the New Haven Food Policy Council and encouraging people to stop smoking through the Quit & Win program.

The survey was sponsored by Yale-New Haven Hospital and the Donaghue Foundation. DataHaven, a community-based nonprofit organization that promotes data sharing, is also a partner is the project.

Ickovics said the latest survey results would be used to fine-tune these programs and to develop others. Maintaining the status quo, where more affluent people enjoy relatively good health and low income residents suffer from a range of preventable diseases, is unacceptable.

“We want to use this to change health in our community,” she said. “In these challenging financial times we have to redouble our efforts for prevention and for action.”

More information about CARE and its community initiatives are available on its website at www.care.yale.edu

Submitted by Denise Meyer on March 15, 2013