Editing Harlem (section)

==Health==

{{As of|2018}}, [[preterm birth]]s and births to teenage mothers are more common in Central Harlem than in other places citywide. In Central Harlem, there were 103 preterm births per 1,000 live births (compared to 87 per 1,000 citywide), and 23 births to teenage mothers per 1,000 live births (compared to 19.3 per 1,000 citywide), though the teenage birth rate is based on a small sample size.<ref name="CHP2018" />{{Rp|11}} Central Harlem has a low population of residents who are [[Health insurance coverage in the United States|uninsured]]. In 2018, this population of uninsured residents was estimated to be 8%, less than the citywide rate of 12%.<ref name="CHP2018" />{{Rp|14}}

The concentration of [[particulates|fine particulate matter]], the deadliest type of [[air pollution|air pollutant]], in Central Harlem is {{convert|0.0079|mg/m3|oz/ft3}}, slightly more than the city average.<ref name="CHP2018" />{{Rp|9}} Ten percent of Central Harlem residents are [[Smoking|smokers]], which is less than the city average of 14% of residents being smokers.<ref name="CHP2018" />{{Rp|13}} In Central Harlem, 34% of residents are [[Obesity|obese]], 12% are [[Diabetes mellitus|diabetic]], and 35% have [[hypertension|high blood pressure]], the highest rates in the city—compared to the citywide averages of 24%, 11%, and 28% respectively.<ref name="CHP2018" />{{Rp|16}} In addition, 21% of children are obese, compared to the citywide average of 20%.<ref name="CHP2018" />{{Rp|12}}

84% of residents eat some fruits and vegetables every day, which is less than the city's average of 87%. In 2018, 79% of residents described their health as "good", "very good", or "excellent", more than the city's average of 78%.<ref name="CHP2018" />{{Rp|13}} For every supermarket in Central Harlem, there are 11 [[convenience store|bodegas]].<ref name="CHP2018" />{{Rp|10}}

The nearest major hospital is [[Harlem Hospital Center|NYC Health + Hospitals/Harlem]] in north-central Harlem.<ref>{{cite web |title=Manhattan Hospital Listings |website=New York Hospitals |url=http://www.allny.com/health/hosp-manhattan.html |access-date=March 20, 2019 |archive-date=November 15, 2016 |archive-url=https://web.archive.org/web/20161115151717/http://www.allny.com/health/hosp-manhattan.html |url-status=live }}</ref><ref>{{cite web |title=Best Hospitals in New York, N.Y. |website=U.S. News & World Report |date=July 26, 2011 |url=https://health.usnews.com/best-hospitals/area/new-york-ny |access-date=March 20, 2019 |archive-date=May 29, 2019 |archive-url=https://web.archive.org/web/20190529091928/https://health.usnews.com/best-hospitals/area/new-york-ny |url-status=live }}</ref>

===Social factors===
The [[population health]] of Central Harlem is closely linked to influential social factors on health, also known as [[social determinants of health]], and the impact of [[structural racism]] on the neighborhood. The impact of discriminatory policies such as [[redlining]] have contributed to residents' bearing worse health outcomes in comparison to the average New York city resident. This applies to life expectancy, poverty rates, environmental neighborhood health, housing quality, and childhood and adult asthma rates. Additionally, the health of Central Harlem residents are linked to their experience of racism.<ref>Hinterland K, Naidoo M, King L, Lewin V, Myerson G, Noumbissi B, Woodward M, Gould LH, Gwynn RC, Barbot O, Bassett MT. Community Health Profiles 2018, Manhattan Community District 10: Central Harlem; 2018;10(59):1–20.</ref><ref name=":1">{{Cite journal |last1=Paradies |first1=Yin |last2=Ben |first2=Jehonathan |last3=Denson |first3=Nida |last4=Elias |first4=Amanuel |last5=Priest |first5=Naomi |last6=Pieterse |first6=Alex |last7=Gupta |first7=Arpana |last8=Kelaher |first8=Margaret |last9=Gee |first9=Gilbert |date=September 23, 2015 |title=Racism as a Determinant of Health: A Systematic Review and Meta-Analysis |journal=PLOS ONE |volume=10 |issue=9 |pages=e0138511 |doi=10.1371/journal.pone.0138511 |issn=1932-6203 |pmc=4580597 |pmid=26398658 |bibcode=2015PLoSO..1038511P |doi-access=free}}</ref> Public health and scientific research studies have found evidence that experiencing racism creates and exacerbates chronic stress that can contribute to major causes of death, particularly for African-American and Hispanic populations in the United States, like cardiovascular diseases.<ref name=":1" /><ref>{{Cite web |url=https://www.cdc.gov/healthequity/lcod/men/2016/nonhispanic-black/index.htm |title=From the CDC-Leading Causes of Death-Non-Hispanic Black Males 2016 |last=CDC |date=September 27, 2019 |website=Centers for Disease Control and Prevention |language=en-us |access-date=October 27, 2019 |archive-date=April 23, 2020 |archive-url=https://web.archive.org/web/20200423090324/https://www.cdc.gov/healthequity/lcod/men/2016/nonhispanic-black/index.htm |url-status=live }}</ref><ref>{{Cite web |url=https://www.cdc.gov/healthequity/lcod/men/2016/hispanic/index.htm |title=From the CDC-Leading Causes of Death Hispanic Males 2016 |last=CDC |date=September 27, 2019 |website=Centers for Disease Control and Prevention |language=en-us |access-date=October 27, 2019 |archive-date=May 13, 2020 |archive-url=https://web.archive.org/web/20200513153912/https://www.cdc.gov/healthequity/lcod/men/2016/hispanic/index.htm |url-status=live }}</ref><ref>{{Cite web |url=https://www.cdc.gov/women/lcod/2016/nonhispanic-black/index.htm |title=From the CDC-Leading Causes of Death by Age Group, All Females-US |last=CDC |date=September 27, 2019 |website=Centers for Disease Control and Prevention |language=en-us |access-date=October 27, 2019 |archive-date=May 24, 2020 |archive-url=https://web.archive.org/web/20200524024545/https://www.cdc.gov/women/lcod/2016/nonhispanic-black/index.htm |url-status=live }}</ref>

Certain health disparities between Central Harlem and the rest of New York City can be attributed to 'avoidable causes' such as substandard housing quality, [[Poverty in the United States|poverty]], and law enforcement violence – all of which are issues identified by the [[American Public Health Association]] as key social determinants of health. These deaths that can be attributed to avoidable causes are known as "avertable deaths" of "[[Mortality displacement|excess mortality]]'"in public health.<ref>{{Cite web |url=https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/18/housing-and-homelessness-as-a-public-health-issue |title=Housing and Homelessness as a Public Health Issue |website=www.apha.org |access-date=October 27, 2019 |archive-date=December 6, 2019 |archive-url=https://web.archive.org/web/20191206105920/https://apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/18/housing-and-homelessness-as-a-public-health-issue |url-status=live }}
* {{Cite web |url=https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/18/reducing-income-inequality-to-advance-health |title=Reducing Income Inequality to Advance Health |website=www.apha.org |access-date=October 27, 2019 |archive-date=August 1, 2020 |archive-url=https://web.archive.org/web/20200801140411/https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2018/01/18/reducing-income-inequality-to-advance-health |url-status=live }}
* {{Cite web |url=https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2019/01/29/law-enforcement-violence |title=Addressing Law Enforcement Violence as a Public Health Issue |website=www.apha.org |access-date=October 27, 2019 |archive-date=December 19, 2019 |archive-url=https://web.archive.org/web/20191219073916/https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2019/01/29/law-enforcement-violence |url-status=live }}</ref>

=== Health problems ===

==== Health and housing conditions ====
Access to affordable housing and employment opportunities with fair wages and benefits are closely associated with good health.<ref name=":2">{{Cite journal |last=Bashir |first=Samiya A |date=May 2002 |title=Home is where the harm is: inadequate housing as a public health crisis. |journal=American Journal of Public Health |volume=92 |issue=5 |pages=733–738 |pmid=11988437 |pmc=3222229 |doi=10.2105/ajph.92.5.733}}</ref> Public health leaders have shown that inadequate housing qualities is linked to poor health.<ref name=":3">{{Cite journal |last=Ernie |first=Hood |date=May 2005 |title=Dwelling Disparities: How Poor Housing Leads to Poor Health |journal=Environmental Health Perspectives |volume=113 |issue=5 |pages=A310–A317 |pmc=1257572 |pmid=15866753 |doi=10.1289/ehp.113-a310}}</ref> As Central Harlem also bears the effects of racial segregation, public health researchers claim that racial segregation is also linked to substandard housing and exposure to pollutants and toxins. These associations have been documented to increase individual risk of chronic diseases and adverse birth outcomes.<ref name=":0" /> Historical income segregation via [[redlining]] also positions residents to be more exposed to risks that contribute to [[Mental health issue|adverse mental health]] status, [[Food desert|inadequate access to healthy foods]], [[Asthma|asthma triggers]], and [[lead exposure]].<ref name=":3" /><ref name=":2" /> [[File:Drew Hamilton NYCHA jeh.jpg|thumb|right|Drew Hamilton Houses, a large low-income [[NYCHA]] [[housing project]] in Central Harlem]]

==== Asthma ====
[[Asthma]] is more common in children and adults in Central Harlem, compared to other New York City neighborhoods.<ref name=":4">[https://a816-health.nyc.gov/hdi/profiles/ Housing and Health in Central Harlem – Morningside Heights.] {{Webarchive |url=https://web.archive.org/web/20191028072517/https://a816-health.nyc.gov/hdi/profiles/ |date=October 28, 2019 }} (2018). [https://www1.nyc.gov/site/doh/data/data-home.page NYC Health Environmental and Health Data] {{Webarchive |url=https://web.archive.org/web/20191215181803/https://www1.nyc.gov/site/doh/data/data-home.page |date=December 15, 2019 }}.</ref> The factors that can increase risk of childhood and adult asthma are associated with substandard housing conditions.<ref>{{Cite web |url=https://ephtracking.cdc.gov/showAsthmaAndEnv |title=Health Effects Asthma and the Environment – CDC Tracking Network |website=ephtracking.cdc.gov |access-date=October 27, 2019 |archive-date=September 28, 2019 |archive-url=https://web.archive.org/web/20190928044715/https://ephtracking.cdc.gov/showAsthmaAndEnv |url-status=live }}</ref> Substandard housing conditions are water leaks, cracks and holes, inadequate heating, presence of mice or rats, peeling paint and can include the presence of mold, moisture, dust mites.<ref>{{Cite journal |last=Krieger |first=James |date=May 2002 |title=Housing and Health: Time Again for Public Health Action |journal=American Journal of Public Health |volume=92 |issue=5 |pages=758–768 |pmc=1447157 |pmid=11988443 |doi=10.2105/ajph.92.5.758}}</ref> In 2014, Central Harlem tracked worse in regards to home maintenance conditions, compared to the average rates Manhattan and New York City. Twenty percent of homes had cracks or holes; 21% had leaks and 19% had three or more maintenance deficiencies.<ref name=":4" />

Adequate housing is defined as housing that is free from heating breakdowns, cracks, holes, peeling paint and other defects. Housing conditions in Central Harlem reveal that only 37% of its renter-occupied homes were adequately maintained by landlords in 2014. Meanwhile, 25% of Central Harlem households and 27% of adults reported seeing cockroaches (a potential [[Asthma trigger|trigger]] for asthma), a rate higher than the city average. Neighborhood conditions are also indicators of population: in 2014, Central Harlem had 32 per 100,000 people hospitalized due to pedestrian injuries, higher than Manhattan's and the city's average.<ref name=":4" />

The environment also factors into the health of the people of Central Harlem with the neighborhood being found to have levels of fine particulate matter (PM2.5) at 7.9 micrograms per cubic meter compared to all of NYC at 7.5 micrograms per cubic meter. Poorer neighborhoods have some of the highest levels of air pollution in the city. Adults with asthma emergencies experiencing high rates of poverty visit the emergency department at rates nearly 5 times higher than those neighborhoods with lower levels of poverty. Nearly 3 in 4 deaths related to PM2.5 occurs in adults 65 years or older. The attribution of premature adult mortality rate to exposure of PM2.5 experiencing 77.4–117.7 deaths per 100,000 people.<ref>Kheirbek, I., Wheeler, K., Walters, S., Pezeshki, G., & Kass, D. (n.d.). ''Air Pollution and the Health of New Yorkers: The Impact of Fine Particles and Ozone''. https://www1.nyc.gov/assets/doh/downloads/pdf/eode/eode-air-quality-impact.pdf {{Webarchive|url=https://web.archive.org/web/20221108085503/https://www.nyc.gov/assets/doh/downloads/pdf/eode/eode-air-quality-impact.pdf |date=November 8, 2022 }}</ref>

Additionally, poverty levels can indicate one's risk of vulnerability to asthma. In 2016, Central Harlem saw 565 children aged 5–17 years old per 10,000 residents visiting emergency departments for Asthma emergencies, over twice both Manhattan's and the citywide rates. The rate of childhood asthma hospitalization in 2016 was more than twice that of Manhattan and New York City, with 62 hospitalizations per 10,000 residents.<ref name=":4" /> Rates of adult hospitalization due to asthma in Central Harlem trends higher in comparison to other neighborhoods. In 2016, 270 adults per 10,000 residents visited the emergency department due to asthma, close to three times the average rates of both Manhattan and New York City.<ref name=":4" />

==== Other health problems ====
Health outcomes for men have generally been worse than those of women. [[Infant mortality]] was 124 per thousand in 1928, meaning that 12.4% of infants would die.<ref name="NYT19291024">{{cite web |title=SEEK WAYS TO CUT HARLEM DEATH RATE; Six City Health Groups Meet to Discuss Program for New Centre There. BAD HOUSING IS STRESSED Congestion Causes Mortality Toll 40 Per Cent Higher Than City as a Whole, Experts Assert. |website=The New York Times |date=October 24, 1929 |url=https://www.nytimes.com/1929/10/24/archives/seek-ways-to-cut-harlem-death-rate-six-city-health-groups-meet-to.html |access-date=March 21, 2019 |archive-date=March 21, 2019 |archive-url=https://web.archive.org/web/20190321152458/https://www.nytimes.com/1929/10/24/archives/seek-ways-to-cut-harlem-death-rate-six-city-health-groups-meet-to.html |url-status=live }}</ref> By 1940, infant mortality in Harlem was 5%, and the death rate from disease generally was twice that of the rest of New York. [[Tuberculosis]] was the main killer, and four times as prevalent among Harlem citizens than among the rest of New York's population.<ref name="NYT19291024" />

A 1990 study of [[life expectancy]] of teenagers in Harlem reported that 15-year-old girls in Harlem had a 65% chance of surviving to the age of 65, about the same as women in Pakistan. Fifteen-year-old men in Harlem, on the other hand, had a 37% chance of surviving to 65, about the same as men in [[Angola]]; for men, the survival rate beyond the age of 40 was lower in Harlem than [[Bangladesh]].<ref>{{cite journal |last1=McCord |first1=C. |first2=H. P. |last2=Freeman |title=Excess Mortality in Harlem |journal=[[New England Journal of Medicine]] |volume=322 |year=1990 |issue=3 |pages=173–177 |doi=10.1056/NEJM199001183220306 |pmid=2294438 |doi-access=free}}</ref> Infectious diseases and [[cardiovascular disease|diseases of the circulatory system]] were to blame, with a variety of contributing factors, including consumption of the [[soul food|deep-fried foods]] traditional to [[Stroke Belt|the South]], which may contribute to [[heart disease]].