Despite efforts by Bronx officials, the borough earned the unwelcome title of New York state's most unhealthy county for the seventh straight year.
The Bronx ranked last among 62 counties statewide in an annual list published Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. It has held that spot since the annual rankings were first published.
The survey takes into account health factors, such as the smoking and obesity rates of a given county. But it also includes measures that reflect social and economic realities that are associated with poor health outcomes.
“When you talk about the social determinants of health—the things that affect people's lives that make them end up in the hospital—there's no getting around those disparities and how they affect kids, families and whole communities. That's the context we're in now in the Bronx,” said Dr. Daniel Stephens, director of adolescent medicine at the Union Community Health Center in the Fordham Heights section of the borough.
For instance, the rate of childhood poverty in the Bronx was 43% in 2014, almost double the statewide average. Its unemployment rate remains higher and the high school graduation rate is lower than in most other counties.
But there are signs that the Bronx is finally improving. It performed better across several measures, including length of life, sexually transmitted infections and preventable hospitalizations. Its progress even garnered recognition from the Robert Wood Johnson Foundation. The Bronx won the foundation's $25,000 Culture of Health award last October. The borough was honored for encouraging bodegas to sell healthy food and building more green spaces where residents can exercise, among other improvements.
Borough President Ruben Diaz Jr. has made bettering health outcomes, and the social, economic and environmental factors that contribute to them, a priority. Diaz has worked with Bronx healthcare providers and researchers to try to lift the county off the bottom rung through an initiative called #Not62-The Campaign for a Healthy Bronx.
“The Robert Wood Johnson Foundation named us the least healthy county in New York state—62 of 62. That was somber news,” Diaz said in his state of the borough address in February. “But we acted. And we are seeing real progress.”
He pointed to the borough's $28 million investment in city parks since 2009 and its push to have developers include more green space in their projects.
The campaign's goal is to get the Bronx out of the last spot by 2020 through collaboration across multiple sectors, including healthcare, education, transportation, housing and public safety, said Charmaine Ruddock, project director of Bronx Health REACH, a group of 70 organizations addressing health disparities that is a partner in the campaign. The group is hosting a town hall April 2 to discuss the results of the most recent RWJF report.
“We gave ourselves a timetable of five years to at least have the infrastructure in place [to improve the ranking],” Ruddock said. “We're moving quite nicely toward that timetable.”
The data used to create the report lag several years behind real-time results, so it could be a while before the campaign's efforts are noticeable.
“Even when you're doing good work, it's going to take a while to catch up with what's being done,” said Kate Konkle, an associate researcher with the University of Wisconsin Population Health Institute.
The rankings weren't just unfavorable news for the Bronx. The other four boroughs also fell on the list relative to the other counties statewide. Manhattan fell to 11th (from 8th), Queens was 17th (down from 12th), Staten Island was 26th (from 24th) and Brooklyn was 52nd (from 43rd). Saratoga County upstate was named the healthiest New York county, displacing Rockland, which topped the list last year.