Bronx Community Health Dashboard Communicable Disease Last Updated

Bronx Community Health Dashboard: Communicable Disease Last Updated: 9/24/2019 See last slide for more information about this project. 1

Food- & Water-Borne Diseases Data note: All data are reported by labs and are not a measure of true incidence in the population as not all people seek care or are tested. 2

Overall, salmonella rates have declined in all five boroughs Bronx Age-adjusted Salmonella rate per 100, 000 25 Brooklyn Manhattan Queens Staten Island Salmonella is a group of bacteria that is one of the most common causes of food poisoning in the U. S. Most infected people develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness typically lasts 4 to 7 days, and most people recover without treatment. However, in some people, the diarrhea may be so severe that they need to be hospitalized. 20 16. 0 15 15. 5 13. 1 10 16. 2 12. 6 12. 3 10. 1 7. 0 5 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 3 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Salmonella rates are above average in the Morrisania, Pelham, and Fordham areas of the Bronx compared to New York City overall 101 15. 5 16 14. 4 10. 3 8 4 7) (1 0 05 ) en (1 av to ot t. H ro C Br on st th ea na x (1 0 ge or N Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. M 1) 04 ) Pe lh am (1 (1 a ni sa (1 02 ) 0 or ri M 4 10. 1 8. 8 06 ) 107 Mott Haven 12 rid 106 Morrisania 12. 8 3) 107 105 Crotona 104 ng sb 106 104 Pelham 13. 9 (1 0 103 Fordham Ki 105 Age-adjusted Salmonella rate per 100, 000 102 Northeast Bronx am 102 rd h 103 Fo 101 Kingsbridge

Campylobacter rates have increased in all five boroughs and are highest in Manhattan. Bronx Brooklyn Manhattan Queens Staten Island 40 37. 0 Age-adjusted Campy rate per 100, 000 35 Campylobacter is the leading cause of bacterial diarrheal illness in the U. S. Most cases occur as isolated events, not as part of outbreaks. 30 27. 6 25 23. 5 20 16. 7 15 10 5 15. 5 14. 8 10. 3 9. 8 7. 7 7. 0 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 5 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Campylobacter rates are below average in the Bronx and highest in Southwest Brooklyn, Upper Manhattan, Chelsea, and Lower Manhattan 101 103 102 Northeast Bronx 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 105 106 107 102 104 24 Age-adjusted Campy rate per 100, 000 101 Kingsbridge 22. 4 21. 5 20 16. 9 16. 4 16 15. 9 14. 3 11. 7 12 8 4 0 Kingsbridge Morrisania (101) (106) 6 Fordham (103) Pelham (104) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Crotona (105) Mott Haven Northeast (107) Bronx (102)

Shigella rates have decreased in all five boroughs, but the most in Brooklyn. Bronx 25 Age-adjusted Shigella rate per 100, 000 21. 1 20 Brooklyn Manhattan Queens A shigella outbreak outside of NYC spread to Brooklyn in 2008. 19. 6 Staten Island Shigella is a group of bacteria that can cause diarrheal disease. Bloody diarrhea, stomach cramps, and fever are common symptoms. 15 11. 5 10. 2 6. 7 4. 5 5. 0 4. 0 3. 5 2. 0 0 0. 2 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 7 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Shigella rates are higher in Mott Haven, Morrisania and Kingsbridge areas of the Bronx as compared to NYC overall 101 Kingsbridge 103 102 10 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 105 106 107 104 Age-adjusted Shigella rate per 100, 000 102 Northeast Bronx 8 9. 7 7. 1 6. 4 6 5. 5 5. 3 4 2. 3 2. 2 Pelham (104) Northeast Bronx (102) 2 0 Mott Haven Morrisania Kingsbridge Fordham (107) (106) (101) (103) 8 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Crotona (105)

Giardia rates have decreased in all five boroughs, but the most in Manhattan Bronx Brooklyn Manhattan Queens Staten Island 60 Age-adjusted Giardia rate per 100, 000 55. 4 50 Giardia is a single-celled parasite that can cause diarrheal disease. Abdominal cramps, bloating, nausea, and bouts of watery diarrhea are common symptoms. 40 30 20 21. 3 17. 5 13. 8 10 11. 9 5. 3 10. 1 8. 5 7. 7 6. 6 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 9 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Except for Fordham, Giardia rates are below average in the Bronx and highest in all of Manhattan and downtown Brooklyn 101 103 102 Northeast Bronx 105 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 106 107 102 104 14 Age-adjusted Giardia rate per 100, 000 101 Kingsbridge 12 10 11. 7 10. 8 9. 1 7. 5 8 7. 3 6. 9 5. 9 6 4 2 0 Fordham Morrisania Kingsbridge Crotona (103) (106) (101) (105) 10 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) Mott Haven Northeast (107) Bronx (102)

Cryptosporidiosis (crypto) rates have nearly doubled in the Bronx Brooklyn Manhattan Queens Staten Island 6 5. 2 Age-adjusted Crypto rate per 100, 000 5 Crypto is a diarrheal disease caused by microscopic parasites that can reside in the intestines of humans and animals and get transmitted through the fecal-oral route, often through contaminated water. Over 98% of cases go unreported in the U. S. 4. 3 4 3 3. 1 2 1. 9 1. 3 1 1. 0 0. 3 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 11 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017. Data missing for Staten Island for 2008, 2009, and 2012.

Crypto rates are above average in Morrisania and Crotona areas of the Bronx as compared to NYC overall 101 Kingsbridge 101 102 Northeast Bronx 103 102 5 4. 5 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 104 Age-adjusted Crypto rate per 100, 000 103 Fordham 4 3. 1 3 1. 9 2 1. 6 1. 5 1 0. 0 0 Morrisania (106) 12 Crotona (105) Fordham Kingsbridge (103) (101) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) 0. 0 Mott Haven Northeast (107) Bronx (102)

Amebiasis rates have decreased in all boroughs except Staten Island, but the most in Manhattan. Bronx Brooklyn Manhattan Queens Staten Island 30 Age-adjusted Amebiasis rate per 100, 000 26. 6 25 Amebiasis is an intestinal infection that is caused by the parasite Entamoeba histolytica. In some cases, it invades the colon wall, causing colitis, acute dysentery, or chronic diarrhea. 20 15 10 8. 2 6. 0 5 4. 9 4. 2 0. 9 3. 8 3. 4 2. 8 1. 8 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 13 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Amebiasis rates are above average in the Crotona area of the Bronx as compared to NYC overall 101 Kingsbridge 101 102 Northeast Bronx 103 102 6 105 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 106 107 104 Age-adjusted Amebiasis rate per 100, 000 103 Fordham 5. 6 5 4. 2 4 3. 6 3. 3 3. 1 3 2 1. 0 1 0 Crotona (105) 14 Fordham (103) Morrisania (106) Pelham (104) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Kingsbridge Mott Haven Northeast (101) (107) Bronx (102)

Vector-Borne Diseases Data note: All data are reported by labs and are not a measure of true incidence in the population as not all people seek care or are tested. 15

The Bronx had the highest burden of Zika in 2017 4 3. 6 Age-adjusted Zika rate per 100, 000 3. 5 Orange indicates Bronx community districts 3 NYC Overall 2. 5 2. 0 2 1. 5 1. 3 1 0. 8 0. 5 0 Bronx 16 101 Zika is a virus that is mainly spread by mosquitoes. A pregnant mother can transmit it to her baby during pregnancy or around the time of birth. It can spread through sexual contact. Brooklyn Manhattan Queens Staten Island Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017 Based on CDC/CSTE case definition of non-congenital Zika disease and infection. Data not available prior to 2016. 103 102 105 104 106 107

In NYC overall, Zika rates are highest for 25 -44 year olds and women 4 3. 7 Age-adjusted Zika rate per 100, 000 3. 1 2. 9 3 2 1 0. 5 0 17 0. 0 <1 1 -4 5 -14 0. 1 15 -24 25 -44 45 -64 65+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, Zika rates are highest in high poverty neighborhoods Age-adjusted Zika rate per 100, 000 4 3. 1 3 2 1. 8 1. 2 1 0 0. 8 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 18 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

Malaria rates have decreased in all boroughs except the Bronx, where the malaria rate is highest and has modestly increased Bronx Brooklyn Manhattan Queens Staten Island 9 Malaria is a life-threatening disease caused by a parasite, transmitted through the bite of infected mosquitoes. It was eliminated from the U. S. in the early 1950 s, but between 1, 500 and 2, 000 cases still occur annually, mostly in people who have recently traveled to malaria-endemic areas. Age-adjusted malaria rate per 100, 000 8 7 6. 2 6 5 5. 1 4 3 2 2. 5 2. 3 2. 2 2. 1 As NYC has a large number of international migrants, most of these are imported cases. 2. 6 2. 2 1. 9 1. 5 1 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 19 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Malaria rates are highest in the Bronx, Central Harlem, and North Staten Island 101 103 102 Northeast Bronx 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 105 106 107 102 14 104 Age-adjusted malaria rate per 100, 000 101 Kingsbridge 12. 8 12 10 8 6. 9 6. 5 6 3. 7 4 2. 3 2 1. 9 0 Mott Haven Morrisania (107) (106) 20 Crotona (105) Fordham Northeast (103) Bronx (102) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) Kingsbridge (101)

In NYC overall, malaria rates are highest for 45 -64 year olds and men 4 3. 5 3. 3 Age-adjusted malaria rate per 100, 000 3. 2 3 2. 8 2. 2 2. 1 2 1. 7 1 0. 9 <1 1 -4 0 21 5 -14 15 -24 25 -44 45 -64 65+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, malaria rates increase as neighborhood poverty level increases 6 Age-adjusted malaria rate per 100, 000 5. 1 5 4 3. 2 3 2 1 0 1. 6 1. 0 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 22 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

Lyme disease rates have increased in all five boroughs, but most dramatically in Staten Island. Rates are lowest in the Bronx Age-adjusted Lyme disease rate per 100, 000 35 Brooklyn Manhattan As Lyme disease is not endemic to Manhattan, most of these are imported cases. 30 Queens 32. 7 Staten Island Lyme disease is caused by a bacterium that is transmitted to humans through the bite of infected backlegged ticks. Fever, headache, fatigue, and a skin rash called erythema migrans are common symptoms. 25. 9 25 23. 1 20 15 10 14. 8 8. 8 6. 3 5 4. 0 3. 3 1. 3 0 1. 1 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 23 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017.

Lyme disease rates are below average in the Bronx except for Kingsbridge and are highest in Northwest Brooklyn, Manhattan and Staten Island 14. 7 102 Northeast Bronx 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 103 102 105 106 107 104 Age-adjusted Lyme disease rate per 100, 000 101 Kingsbridge 14 12 10 8 6 4. 2 4 2. 8 2. 7 2. 0 2 1. 7 1. 5 Crotona (105) Morrisania (106) 0 Kingsbridge (101) 24 Pelham (104) Mott Haven Northeast Fordham (107) Bronx (102) (103) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

Other Communicable Diseases Data note: All data are reported by labs and are not a measure of true incidence in the population as not all people seek care or are tested. 25

For all boroughs, rates of new TB infections have declined. In the Bronx, the rate has decreased by 55% Bronx 20 Brooklyn Manhattan Queens Staten Island 18. 6 15. 6 Tuberculosis rate per 100, 000 15 15. 0 TB is a disease caused by bacteria that are transmitted from person to person through tiny droplets released into the air via coughs and sneezes. The bacteria typically attack the lungs, but they can also affect other parts of the body. Many TB strains resist the drugs most used to treat the disease. People with active TB must take several types of medications for many months to eradicate the infection. 12. 2 10. 4 10 6. 0 7. 1 6. 9 5 3. 8 2. 3 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 26 Data source: New York City Department of Health and Mental Hygiene Tuberculosis Surveillance Data, 2001 -2017.

TB rates are about average in the Bronx and highest in Queens Orange indicates Bronx community districts 101 102 103 NYC Overall 12 105 106 10. 4 107 TB rate per 100, 000 10 8 7. 1 6. 9 6 3. 8 4 2. 3 2 0 Bronx 27 Brooklyn Manhattan Queens Staten Island Data source: New York City Department of Health and Mental Hygiene Tuberculosis Surveillance Data, 2017. 104

In the Bronx, TB rates are highest for those who are 20 -29 year old, male, and Asian/Pacific Islander 30 26. 8 25 15 10. 4 8. 7 10 8. 2 7. 7 9. 4 9. 2 6. 5 5. 1 5 2. 2 2. 0 Data source: New York City Department of Health and Mental Hygiene Tuberculosis Surveillance Data, 2017. nd er hi la w Pa n/ ia As N on -H is ci fic pa ni Is c c pa ni is on -H N 28 te ck bl a ni c pa is H Fe m al e e al M 60 + -5 9 50 -4 9 40 -3 9 30 -2 9 20 19 0 0 - TB rate per 100, 000 20

The chronic hepatitis B rate has remained stable in the Bronx, but declined in Brooklyn, Manhattan and Queens Bronx Brooklyn Manhattan Age-adjusted chronic hepatitis B rate per 100, 000 140 120 Queens Staten Island Hepatitis B is a liver infection caused by the hepatitis B virus. It is transmitted when people come in contact with the blood, open sores, or body fluids of someone who has the virus. Having chronic hepatitis B increases the risk of developing liver failure, liver cancer or cirrhosis. 124 120 113 100 92 86 80 75 72 60 53 48 40 39 20 0 2006 29 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2006 -2017. 2017

Chronic hepatitis B rates are about average in the Bronx, and highest in Queens, Southwest Brooklyn, and Lower Manhattan 101 102 Northeast Bronx 103 102 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 105 106 107 104 Age-adjusted chronic hepatitis B rate per 100, 000 101 Kingsbridge 103 100 91 87 85 80 59 60 45 40 30 20 0 Morrisania (106) 30 Crotona (105) Fordham Mott Haven (103) (107) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) Northeast Kingsbridge Bronx (102) (101)

In NYC overall, chronic hepatitis B rates are highest for 3039 year olds and men 138 140 Age-adjusted chronic hepatitis B rate per 100, 000 127 118 120 111 100 95 81 80 66 60 60 36 40 20 10 0 0 -19 31 20 -29 30 -39 40 -49 50 -59 60 -69 70 -79 80+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, chronic hepatitis B rates increase as neighborhood poverty level increases Age-adjusted chronic hepatitis B rate per 100, 000 120 115 103 100 80 63 60 40 32 20 0 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 32 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

The chronic hepatitis C rate has decreased by 71% in the Bronx Brooklyn Manhattan Queens Staten Island Age-adjusted chronic hepatitis C rate per 100, 000 350 300 In the U. S. , infection with hepatitis C virus is the most common cause of chronic hepatitis. Chronic hepatitis C is usually curable with oral medications taken daily for two to six months. However, about half of people with the disease do not know that they are infected because most symptoms do not appear until cirrhosis develops and the liver begins to fail. 315 250 200 175 150 146 105 100 91 88 57 53 45 38 50 0 2006 33 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2006 -2017. 2017

Four of the 10 neighborhoods with the highest chronic hepatitis C rates are in the Bronx 101 103 102 Northeast Bronx 103 Fordham 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 105 106 107 102 104 Age-adjusted chronic hepatitis C rate per 100, 000 101 Kingsbridge 120 119 115 108 100 77 80 60 50 44 36 40 20 0 Mott Haven Morrisania (107) (106) 34 Crotona (105) Fordham (103) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) Kingsbridge Northeast (101) Bronx (102)

In NYC overall, chronic hepatitis C rates are highest for 6069 year olds and men 123 Age-adjusted chronic hepatitis C rate per 100, 000 125 100 73 75 77 76 76 58 51 50 41 25 3 0 0 -19 35 20 -29 20 -39 40 -49 50 -59 60 -69 70 -79 80+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, chronic hepatitis C rates increase as neighborhood poverty level increases Age-adjusted chronic hepatitis C rate per 100, 000 100 83 80 60 60 51 40 29 20 0 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 36 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

The legionella rate in the Bronx has increased 7 -fold from 2000 to 2017 Bronx Brooklyn Manhattan Queens Staten Island Age-adjusted Legionella rate per 100, 000 16 14 Legionella is a respiratory disease caused by bacteria that grow and multiply in a building water system. When contaminated water spreads in droplets small enough for people to breathe in, people can acquire a serious type of pneumonia called Legionnaires’ disease. 12 There were two Legionella outbreaks in the Bronx in 2015. 10 8 7. 0 6 5. 6 4. 8 4. 3 4 3. 2 2 1. 0 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 37 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2000 -2017. Data missing for Staten Island for 2001.

Two of the 10 neighborhoods with the highest Legionella rates are in the Bronx 101 102 Northeast Bronx 103 Fordham 103 104 Pelham 105 Crotona 106 107 106 Morrisania 107 Mott Haven 102 104 15 Age-adjusted Legionella rate per 100, 000 101 Kingsbridge 12. 9 10 9. 0 7. 5 5. 2 3. 9 0 Crotona (105) 38 Morrisania (106) Fordham (103) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Pelham (104) Northeast Kingsbridge Mott Haven Bronx (102) (101) (107)

In NYC overall, Legionella rates are highest for 65+ year olds and men Age-adjusted Legionella rate per 100, 000 20 19. 3 16 12 7. 7 8 6. 5 4 3. 3 1. 8 0. 1 0 15 -24 39 25 -44 45 -64 65+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, Legionella rates are higher in neighborhoods with higher poverty 8 Age-adjusted Legionella rate per 100, 000 7 6. 5 6 5. 3 5 4. 6 4 3 2 1 0 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 40 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

The streptococcus pneumoniae rate has increased over 3 -fold in the Bronx Brooklyn Manhattan Queens Staten Island Streptococcus pneumoniae are bacteria that can cause many types of illnesses, including pneumonia, ear infections, sinus infections, meningitis, and bacteremia. Age-adjusted Streptococcus Pneumoniae rate per 100, 000 16 14 12 11. 4 10 8 8. 0 7. 6 6 6. 2 6. 1 4 3. 5 3. 4 2. 6 2 2. 0 1. 4 0 2001 41 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2001 -2017. 2017

101 Kingsbridge 101 103 102 Northeast Bronx 102 103 Fordham 105 104 Pelham 105 Crotona 106 Morrisania 107 Mott Haven 42 106 107 104 Age-adjusted Streptococcus Pneumoniae rate per 100, 000 Four of the 10 neighborhoods with the highest streptococcus pneumoniae rates are in the Bronx 20 18 17. 3 16. 1 16 14 11. 9 12 10 11. 3 10. 5 8 7. 5 6 4 2 0 Mott Haven Morrisania (107) (106) Crotona (105) Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017 Fordham Kingsbridge Northeast Pelham (103) (101) Bronx (102) (104)

In NYC overall, streptococcus pneumoniae rates are highest for 65+ year olds and men 25 Age-adjusted Streptococcus Pneumoniae rate per 100, 000 22. 6 20 15 13. 5 9. 2 10 5. 1 6. 3 6. 0 5 3. 1 2. 3 0. 8 0 <1 43 1 -4 5 -14 15 -24 25 -44 45 -64 65+ Male Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017. Rates for age not age-adjusted. Female

In NYC overall, streptococcus pneumoniae rates are higher in neighborhoods with higher poverty Age-adjusted Streptococcus Pneumoniae rate per 100, 000 12 10. 8 9 7. 4 7. 0 6 5. 7 3 0 Low (<10% of residents have incomes below 100% of the FPL*) Medium (10 -19% of residents have incomes below 100% of the FPL) High (20 -29% of residents have incomes below 100% of the FPL) Very high (≥ 30% of residents have incomes below 100% of the FPL) Neighborhood Poverty Level 44 Data source: New York City Department of Health and Mental Hygiene Communicable Disease Surveillance Data, 2017.

About the Community Health Dashboard Project § The goal of the project is to provide Bronx-specific data on risk factors and health outcomes with an emphasis on presenting data on trends, socio-demographic differences (e. g. , by age, sex, race/ethnicity, etc. ) and sub-county/neighborhood level data § Data will be periodically updated as new data becomes available. § Produced by Montefiore’s Office of Community & Population Health using publicly-available data sources § For more information, please contact us at OCPHDept@montefiore. org 45