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Mitchell Rubin, MD1, Ebere Chukwu, MD2, Furcy Pultre, PhD2, Eric Manheimer, MD3, and Glendon Henry, MD4. (1) Department of Pediatrics and Director of Community Medicine, New York Medical College, 413 East 120th Street, New York, NY 10035, 212-410-7940, rubinm@nychhc.org, (2) Preventive Cardiology, Columbia University, 622 West 168th Street Room 10- 203b, New York, NY 10032, (3) Medical Director, Bellevue Hospital, New York University Medical School, 27th Street at 1st Ave., New York, NY 10016, (4) Medical Director, Harlem Hospital, Columbia University, 506 Lenox Ave. Room 2134, New York, NY 10037
Background: Cardiovascular disease is the leading cause of death among adults in the U.S. especially among ethnic minorities. In the Harlem community in New York City, a multi racial and ethnic population, it is also the leading cause of hospitalization with enormous costs and loss of manpower. Harlem Hospital Center in conjunction with a New York City-wide cardiovascular health project (“Heart Beat”) conducted a community outreach pilot study to identify individuals at cardiovascular risk within the Harlem community and refer them for medical care. Objective: To report the prevalence of cardiovascular disease risk factors in Harlem compared to national rates and to evaluate the effect of on site referrals into medical care systems. Methods: Six thousand participants in Harlem were screened through health fairs held over a three-month period (June-August 2003). Mobile health vans, equipped with examination rooms and staffed with nurses, community health education and outreach personnel as well as physicians, were utilized. Height, weight, sitting blood pressure (BP), random blood glucose and total cholesterol were measured and medical history was obtained on a standard form. Medical care referrals, when applicable, were made by the physician member of the screening team. Results: To date, data was analyzed on 1662 participants (mean age was 52 years; 62 % women) composed of 66% African American, 19% Hispanics, and 3% white. Compared to the national prevalence rates, Harlem residents had higher rates of elevated BP (>140/90 mmHg: 41% vs.25%) , diabetes (17% vs. 5.5%) and total cholesterol of > 240 mg/dL (39% vs.8.3%). For participants with hypertension, 49% were not on medication as compared to 11% nationally; of those with elevated cholesterol, 51% had at least one other risk factor (smoking, diabetes, and hypertension), 8% had all three risk factors; 34% of diabetics had blood glucose > 200mg and 20% of the outreach participants lacked access to primary care. A small number of participants (2%) were referred to the emergency room from the health fairs for extreme elevated BP and blood glucose. 36% of these reported a lack of access to primary care. Conclusion: In the urban minority community of Harlem, NY, we are finding, as compared to national prevalence rates, excessive high rates of [modifiable] cardiovascular risk factors (i.e. blood pressure, diabetes and hypercholesteremia). Further data evaluation including follow-up and effect of on site referrals is ongoing.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: Ethnic Minorities, Community Research
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.