Alcohol-related emergency department visits and income inequality in New York City, USA: an ecological study

OBJECTIVES: Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.METHODS: The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.RESULTS: There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate.CONCLUSIONS: This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.

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Monitoring Emergency Department Visits From Puerto Rico in the Aftermath of Hurricane Maria Using Syndromic Surveillance – New York City, 2017

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2019.102 ◽

2019 ◽

Vol 14 (1) ◽

pp. 44-48

Author(s):

Priscilla W. Wong ◽

Hilary B. Parton

Keyword(s):

Emergency Department ◽

New York ◽

New York City ◽

Puerto Rico ◽

York City ◽

Surveillance System ◽

Syndromic Surveillance ◽

Situational Awareness ◽

Syndromic Surveillance System ◽

Ed Visits

ABSTRACTObjective:Syndromic surveillance has been useful for routine surveillance on a variety of health outcomes and for informing situational awareness during public health emergencies. Following the landfall of Hurricane Maria in 2017, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) implemented an enhanced syndromic surveillance system to characterize related emergency department (ED) visits.Methods:ED visits with any mention of specific key words (“Puerto,” “Rico,” “hurricane,” “Maria”) in the ED chief complaint or Puerto Rico patient home Zip Code were identified from the DOHMH syndromic surveillance system in the 8-week window leading up to and following landfall. Visit volume comparisons pre- and post-Hurricane Maria were performed using Fisher’s exact test.Results:Analyses identified an overall increase in NYC ED utilization relating to Puerto Rico following Hurricane Maria landfall. In particular, there was a small but significant increase in visits involving a medication refill or essential medical equipment. Visits for other outcomes, such as mental illness, also increased, but the differences were not statistically significant.Conclusions:Gaining this situational awareness of medical service use was informative following Hurricane Maria, and, following any natural disaster, the same surveillance methods could be easily established to aid an effective emergency response.

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Living With Inequality: Neighborhood Income Diversity and Perceptions of the Income Gap

American Politics Research ◽

10.1177/1532673x17733799 ◽

2017 ◽

Vol 47 (2) ◽

pp. 329-361 ◽

Cited By ~ 9

Author(s):

Scott L. Minkoff ◽

Jeffrey Lyons

Keyword(s):

New York ◽

New York City ◽

Income Inequality ◽

York City ◽

Census Data ◽

Income Gap ◽

Neighborhood Income ◽

The Rich ◽

Neighborhood Boundaries ◽

Lower Educational Attainment

This article explores whether the places where people live—and specifically the diversity of incomes where people live—influence views about income inequality. Using a unique survey of New York City that contains geographic identifiers and questions about attitudes toward inequality, coupled with a rich array of Census data, we assess the degree to which the income diversity within spatially customized neighborhood boundaries influences beliefs about inequality. We find consistent evidence that attitudes about inequality are influenced by the places where people live—those who are exposed to more income diversity near their homes perceive larger gaps between the rich and everybody else, and are more likely to believe that the gap should be smaller. Moreover, this effect appears to be especially pronounced among those with lower educational attainment and at either end of the income spectrum.

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Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2016.89 ◽

2016 ◽

Vol 10 (3) ◽

pp. 512-517 ◽

Cited By ~ 9

Author(s):

Fangtao Tony He ◽

Nneka Lundy De La Cruz ◽

Donald Olson ◽

Sungwoo Lim ◽

Amber Levanon Seligson ◽

...

Keyword(s):

Mental Health ◽

Emergency Department ◽

New York ◽

New York City ◽

York City ◽

Hurricane Sandy ◽

Service Areas ◽

Health Related ◽

Ed Visits ◽

The Impact

AbstractObjectiveHurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health–related emergency department (ED) and inpatient hospital service utilization was studied.MethodsData came from the New York Statewide Planning and Research Cooperative System. We obtained mental health–related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period.ResultsOpen hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months.ConclusionsSeveral NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512–517)

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Monitoring child mental health related emergency department visits in New York City

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7720 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Don Olson ◽

Willem Van der Mei ◽

Sungwoo Lim ◽

Carol Yoon ◽

Melissa Kull ◽

...

Keyword(s):

Mental Health ◽

Emergency Department ◽

New York ◽

New York City ◽

York City ◽

Syndromic Surveillance ◽

Surveillance Data ◽

Age Group ◽

Health Related ◽

Ed Visits

ObjectiveTo assess the use of syndromic surveillance to assess trends inmental health-related emergency department (ED) visits amongschool-aged children and adolescents in New York City (NYC).IntroductionFrom 2001-2011, mental health-related hospitalizations and EDvisits increased among United States children nationwide [1]. Duringthis period, mental health-related hospitalizations among NYCchildren increased nearly 23% [2]. To estimate mental health-relatedED visits in NYC and assess the use of syndromic surveillance chiefcomplaint data to monitor these visits, we compared trends from anear real-time syndromic system with those from a less timely, codedED visit database.MethodsThe NYC ED syndromic surveillance system receives anonymizedpatient chief complaint and basic demographic data for nearly everyED visit citywide to provide timely surveillance information tohealth authorities. Using NYC ED syndromic surveillance datafrom 2003-2015, we applied previously developed definitions forgeneral psychiatric syndromes. We aggregated ED visits by agegroup (5-12 years, 13-17 years, and 18-20 years), geography, andtemporality. Syndromic data were compared with Statewide Planningand Research Collaborative System (SPARCS) data from 2006-2014which reported mental health diagnosis (ICD-9), treatment, service,and basic demographics for patients visiting facilities in NYC. Usingthese two data sources, we compared daily visit patterns and annualtrends overall as well as stratified by age group, area-based poverty(ZIP code), and time of visit.ResultsBoth syndromic surveillance and SPARCS data for NYC showedan increasing trend during the period. While both showed relativeincreases with similar slopes, mental health-related chief complaintdata captured fewer overall visits than the ICD-9 coded SPARCSdata. Trends in syndromic data during 2003-2015 differed by age-group and area-based poverty, e.g., among children ages 5-12 yearsthe annual proportion of mental health-related ED visits increasedroughly 3-fold from 1.2% to 3.8% in the poorest areas, which wasgreater than the increase in the richest areas (1.7% to 2.6%). Seasonal,day-of-week, and school holiday patterns found far fewer visits duringthe periods of NYC public school breaks (Figure).ConclusionsWe conclude that syndromic surveillance data can provide areliable indicator of mental health-related ED visit trends. Thesefindings suggest potential benefit of syndromic surveillance data asthey may help capture temporal and spatial clustering of events in amuch more timely manner than the >1 year delay in availability ofED discharge data. Next steps include a qualitative study exploringthe causes of these patterns and the role of various factors drivingthem, as well as use of patient disposition and matched data to bettercharacterize ED visit patient outcomes.

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Field Investigations of Emergency Department Syndromic Surveillance Signals - New York City

PsycEXTRA Dataset ◽

10.1037/e307182005-032 ◽

2004 ◽

Cited By ~ 1

Author(s):

Linda Steiner-Sichel ◽

L. Greenko ◽

R. Heffernan ◽

M. Layton ◽

D. Weiss

Keyword(s):

Emergency Department ◽

New York ◽

New York City ◽

York City ◽

Syndromic Surveillance ◽

Field Investigations

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Pesticide Spraying for West Nile Virus Control and Emergency Department Asthma Visits in New York City, 2000

Environmental Health Perspectives ◽

10.1289/ehp.6946 ◽

2004 ◽

Vol 112 (11) ◽

pp. 1183-1187 ◽

Cited By ~ 29

Author(s):

Adam M. Karpati ◽

Mary C. Perrin ◽

Tom Matte ◽

Jessica Leighton ◽

Joel Schwartz ◽

...

Keyword(s):

Emergency Department ◽

New York ◽

New York City ◽

West Nile Virus ◽

York City ◽

West Nile ◽

Virus Control

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Alcohol Consumption by Older New York City Residents: The Need for New Policies to Address Misuse

Alcohol and Alcoholism ◽

10.1093/alcalc/agaa022 ◽

2020 ◽

Vol 55 (4) ◽

pp. 448-454

Author(s):

Daniel Weisz ◽

Michael Kelley Gusmano

Keyword(s):

Public Health ◽

New York ◽

New York City ◽

Alcohol Consumption ◽

Alcohol Use ◽

York City ◽

Alcohol Misuse ◽

Cross Sectional ◽

Local Public Health ◽

New Public Health

Abstract Aims The aim of this study is to assess risk factors for alcohol misuse among older New York City residents and examine the effect of local public health efforts to address alcohol misuse. Methods The Community Health Survey, a cross-sectional telephone survey of 8500 randomly selected adult New Yorkers, records the frequency of alcohol use. We examine these results among 65 and older subjects by sociodemographic status using logistic regression modeling and compare trends in smoking and alcohol consumption between 2002 and 2016. Results Those with unhealthy drinking habits, combining binge drinking and excessive consumption, constituted 5.7% of 65 plus population and were more likely to be White, US born, healthy, better educated and wealthier. The percentage of older smokers in New York City has decreased while unhealthy drinking is nearly flat since 2002. Conclusions Our findings reinforce the importance of screening geriatric populations for alcohol use disorders and support the development of new public health efforts to address alcohol misuse if the city is to achieve results similar to those obtained in decreasing tobacco consumption.

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