20-year life gap separates city's poorest, wealthy

October 16, 2008|By Annie Linskey | annie.linskey@baltsun.com

In West Baltimore's impoverished Hollins Market neighborhood, where the average life expectancy is about 63 years, residents shared beers and cigarettes on their front steps at midday yesterday while pedestrians using canes gingerly avoided two dead rats on the street.

Across town in wealthy Roland Park, where residents live on average to be 83, the scene predicably changed. One gray-haired woman rushed to swimming lessons, while a family rode past on bikes and a man with an iPod jogged nearby.

The two-decade difference in life expectancy between Hollins Market and Roland Park was revealed in data released yesterday by the city Health Department, which for the first time has compiled comprehensive death data on a neighborhood level.

The results are striking. In some impoverished neighborhoods, the death rates from heart disease and stroke are more than twice as high as in wealthier places just a few blocks or miles away. At the extreme, the difference in mortality rates between some neighborhoods is as wide as the disparity in life expectancy between the United States and a Third World nation such as Burma.

"The scale of the differences is definitely eye- opening," said city Health Commissioner Dr. Joshua M. Sharfstein.

The numbers reveal that the chronic illnesses of heart disease and cancer are killers everywhere, regardless of income and race.

The data also show that there are some neighborhoods where homicide steals the most collective life-years from communities.

Sharfstein hopes the new numbers will help attract grant money to the city and spur outrage in the lower-income neighborhoods where life expectancy is lower then average.

"If communities can get as engaged about their health indicators as they are about abandoned housing and the need for new road construction projects, that would be a tremendous force for change," he said.

While people rail against boarded-up homes because they see the blight, "you don't see the health statistics," Sharfstein said. "Until now, we haven't had them."

Mayor Sheila Dixon, who has made health one of her signature issues, stressed that the city's overall health has improved.

In the past eight years, the average life expectancy in the city increased from 69.2 years to 71.8 years, according to the figures

Still, "in the midst of these developments we have very sick communities," Dixon said, ticking off a number of factors for the gap, including economic development, education, outreach and food choices.

"You could go to a bar or a grocery store and purchase a single cigar easier then a cheap piece of fruit," she said.

Researchers from the city and the Johns Hopkins Bloomberg School of Public Health spent 11 months reviewing and analyzing 37,000 death records from 2002 to 2006 to compile the data. Using lines drawn by the planning department, they separated data into 55 areas that cover two or three neighborhoods - and produced individualized reports for each. Researchers adjusted the data for age so that areas with more senior citizens would not skew the results.

The study does not address why some communities have higher death rates than others, and why causes of death vary. Sharfstein said in some areas that work has been done to determine those causes and, where that work has not been done, he hopes neighborhood leaders will share their ideas.

He expects the data to guide decisions about where to concentrate health programs, and to help communities apply for health grants. Councilwoman Helen Holton, who has a strong health interest, said yesterday that she plans to use the data to seek national money.

Mirroring national trends, the results show that in most neighborhoods, heart disease and cancer are the biggest killers, regardless of income. "These are deaths that are in many cases preventable," Sharfstein said.

Life expectancy tends to rise with median income, the data show. For every increase of $10,000 in a neighborhood's median household income, residents lived 3.4 years longer, according to Sharfstein. But he noted that even among neighborhoods with similar incomes there are ranges of up to 10 years in life expectancies.

Though the city's poorer neighborhoods tend to be predominantly African-American, the data did not show as strong a relationship between density of black residents and lower life expectancy as other factors such as income, said Caroline Fichtenberg, the Health Department's chief epidemiologist and the project leader.

But since the city is 64 percent African-American, Sharfstein said that all health issues in the city can be viewed through a racial lens.

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