City reports progress, challenges in residents' health

In the past two years, fewer Baltimoreans have been hospitalized for diabetes, hypertension, asthma and drugs.

More city residents have health insurance, more are exercising and fewer are dying prematurely from heart disease. Fewer teens are having babies or getting shot.

That's the good news in an interim report that the Health Department plans to release this week on the health of the city.

Health officials had set nearly three dozen specific goals in 2011 in a plan called Healthy Baltimore 2015, and progress has been made in two-thirds of them. And while the city's health commissioner says she's "cautiously optimistic" about the midway results, old challenges — and some new ones — still need to be addressed.

"I learned early on in my career in medicine, and it's true across any business discipline, what doesn't get measured doesn't get managed," said Dr. Oxiris Barbot. "This is an opportunity to see where we are and make informed decisions about policies."

The data show serious spikes in the number of people who visit the emergency room for some of the same diseases showing progress. The number who headed to the hospital for Type 1 diabetes nearly doubled, for example. And drug and alcohol visits jumped more than 84 percent.

Barbot didn't know why more people would go to the hospital but fewer would be admitted, and she said she will be investigating.

She said many people in the community deserve credit for improvements, including instances where the disparity between black and white residents and the rich and poor narrowed. In more than a half-dozen areas, the gap was closed to some extent, including in hospitalizations, premature death from heart disease and infant mortality.

A program called B'More for Healthy Babies has put a big dent in those infant death numbers in African-American neighborhoods, the report said, by educating parents on putting their babies to sleep alone, on their backs and in a crib, among other things.

Baltimore officials have long known that the gap in life expectancy between the richest and poorest neighborhoods is 20 years. And in this area, the disparity has not budged, though life expectancy in the city in general ticked up more than a year and a half to 73.5 years.

African-Americans and whites each gained a year, with life expectancy at 70.8 years and 75.3 years, respectively.

A new area of concern is syphilis. Once among the major scourges in Baltimore, cases had dropped drastically and officials hoped to further decrease the number by 25 percent. But cases jumped more than 75 percent, largely in the gay community.

Barbot said doctors must help the Health Department test for and treat the disease in the community, as they do for HIV. HIV infections dropped more than 25 percent in the past two years, according to the report.

Some areas saw no improvement because of forces outside of health officials' control. The report called for a reduction in liquor store density by 15 percent. To achieve this, the city plans to enforce zoning of some stores that were "nonconforming" uses but had been long grandfathered in the law. Owners, largely Korean business owners, balked at losing their livelihoods and said in many instances they serve as primary outlets for a variety of items needed in their communities in addition to liquor.

Barbot said community input about those stores, as well as other needs, has been crucial. Health officials met with representatives from virtually every neighborhood to get input on the most pressing needs in creating healthier environments. The health department effort has no direct funding, but other city agencies were employed to help with such things as lighting paths, creating parks, luring supermarkets and scheduling health screenings.

In one of the most challenged neighborhoods, Upton/Druid Heights, the Rev. S. Todd Yeary, senior pastor of Douglas Memorial Community Church, said all of the same problems remain.

He said there are, however, so many policy changes, laws and efforts under way that could affect the community in the long run, including health care reform, the liquor store effort and some economic development projects. Other legislative pushes, such as those that would increase the minimum wage or limit food stamp funding, could help or hurt residents' health.

"If folks don't eat, they aren't going to be well," he said. "There are multiple conversations going on like this that have yet to be resolved, but the fact that the conversation has started is an important piece."

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