ADDRESSING NUTRITION DISPARITIES For A Healthier Community Julie

ADDRESSING NUTRITION DISPARITIES: For A Healthier Community Julie J Ramos, MD, MS Cardiologist/Nutritionist Montefiore-Einstein Center for Heart and Vascular Care

Hypertension J Am Coll Cardiol. 2011; 57(3): 245 -252. doi: 10. 1016/j. jacc. 2010. 09. 027 Figure Legend: Hypertension Death Rates, 2006 African Americans have death rates from hypertension 3 times as high as other racial and ethnic groups. Date of download: 4/10/2013 Copyright © The American College of Cardiology. All rights reserved.

Prevalence of Metabolic Syndrome in NYC 2004 35, 0% 30, 1% 30, 0% 26, 7% 25, 0% 22, 9% TOTAL 20, 0% MEN WOMEN 15, 0% 10, 0% 5, 0% 0, 0% TOTAL MEN Jordan et al. , Prev Chronic Diseases 2012; 9 WOMEN

Health Disparities vs Health Differences J Am Coll Cardiol. 2011; 57(3): 245 -252. doi: 10. 1016/j. jacc. 2010. 09. 027 Figure Legend: Differences and Disparities in Health Care Quality Health differences among diverse populations reflect multiple factors, whereas health care disparities refer to differences that are not due to access-related factors, clinical needs, patient preferences, or the appropriateness of the intervention. Date of download: 4/10/2013 Copyright © The American College of Cardiology. All rights reserved.

Figure 1. Trends in perceived leading cause of death among women. Mosca L et al. Circulation 2006; 113: 525 -534 Copyright © American Heart Association

Healthcare Provider Misconceptions J Am Coll Cardiol. 2011; 57(3): 245 -252. doi: 10. 1016/j. jacc. 2010. 09. 027 Figure Legend: Web-Based Survey of Cardiologists: Do Clinically Similar Patients Receive Different Care Based on Race/Ethnicity? Only one-third and <5% of surveyed cardiologists acknowledged racial and ethnic disparities in health care, generally, and among their own patients, specifically. Date of download: 4/10/2013 Copyright © The American College of Cardiology. All rights reserved.

NUTRITION and HEALTH DISPARITIES

WHAT CAN WE DO?

SOCIAL Issues Intersect With The HEALTH and WELL Being of Our Community

FOOD DESERTS: Community Issue of Availability • BRONX • UES

Healthier Food Choices Need More of This…………. • Higher Fiber – Legumes, Brown Rice • Less simple starches – white rice, processed cereals, sugary drinks • Healthier Proteins – Legumes, Fish • Low Sodium foods – fresh and less processed

The Mediterranean Diet

National Prevention Strategy Recommendations- June 2012 • Ensure a strategic focus on communities at greatest risk. • Reduce disparities in access to quality health care. • Increase the capacity of the prevention workforce to identify and address disparities. • Support research to identify effective strategies to eliminate health disparities. • Standardize and collect data to better identify and address disparities.

Interventions Needed in Our Community

Education on Healthy Food Choices • – Montefiore School Health Program • Montefiore Bronx Nutrition and Fitness Initiative for Teens (B'N Fit) Program • Pasos Saludables: http: //www. centroaltagracia. org/node/244

EDUCATION Reading Nutrition Labels – – Servings per Container Total Calories Fat Calories Sodium Content

Increase accessibility to Healthier Foods • NYC “Healthy Bodegas Initiative” • Local Farmer’s Markets: www. grownyc. org • Black Urban Growers

Increase safe, open spaces for an active lifestyle • Shape Up NYC • Encourage recreation for exercise with family and friends or in groups

Active Lifestyle • Encourage Physical Education in Schools • Activities after school • Increase availability of open spaces for the community • Encourage activity with friends/family

RESOURCES • • • www. Health. Care. gov/prevention/nphpphc/index. html http: //www. surgeongeneral. gov/initiatives/prevention/2012 -npc-action-plan. pdf http: //www. nyacp. org/files/public/HFR. pdf http: //www. cdc. gov/wisewoman/ http: //millionhearts. hhs. gov/index. html