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ASTHMA INITIATIVE

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A Harlem Hospital study is producing an alarming finding: as many as one in four children in Harlem have asthma. Only halfway through an ambitious effort to test every child within a 24-block area, doctors expected to find rates higher than the national average of 6 percent, perhaps even percentages approaching the high teens, but nothing reaching these heights.

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A studyof Philadelphia school children actually produced similar numbers a few years ago, but the children were never examined by doctors. Instead, over 5000 5th and 6th graders were shown a video that dramatized various asthma symptoms and they were asked if they had ever experienced these symptoms or had been told they had asthma: 25 percent said they had, but it was never documented.

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Indications were present here in New York that the situation was bad even a decade ago when hospitalization discharge records for children treated for asthma were four times higher than the national average.

But the Asthma Initiative is the first documented study in the nation to get such high results. Many of the children tested, and their parents, were not even aware that they had the disease, a dangerous situation because asthma symptoms tend to get worse if left untreated.

Triggers for asthma include exposure to smoking, cockroaches, dust mites, mold, and dampness. Deteriorating building stock, diesel fumes, as well as cheap home heating oils that contain a high sulfur content are among other factors suspected of contributing to the problem.

The Asthma Initiative is a collaboration between Harlem Hospital's Department of Pediatrics, the Harlem Children's Zone, Columbia University's Harlem Health Promotion Center, Touchpoints and the New York City Department of Health and Mental Hygiene.

INFANT MORTALITY

New Yorkers recently discoveredthat they have a higher life expectancy than the rest of the country, and that includes a 9 percent decline in infant mortality rates, from 6.7 to 6.1 deaths for every 1000 babies born. This number has been declining for years: in 1984, 13.6 children out of every 1000 born had died before the age of one. New York's infant mortality rate is now lower than the national average of 6.9, and compared to other cities for the same period, the rate of 6.1 is less than Cleveland at 9.7, Chicago at 7.5, or Dallas-Ft. Worth at 6.9, but higher than Los Angeles at 5.4 and San Francisco's 4.3.

However, if you look inside the average to its highs and lows, it becomes clear that not every New York family is benefiting from decreased infant mortalities. If you live in Kips Bay in Manhattan or Red Hook, Brooklyn, infant deaths are the lowest in the city: 1.4 to 2.2 per 1000 births, respectively. If you happen to give birth to a child in Central Harlem, however, the death rate more than doubles from the city average to 13.1 babies dying for every 1000 born. In Bedford, Brooklyn, 10 out of every 1000 infants die, and in Flatbush, 7.4. In Manhattan as a whole, the rates actually rose by 6 percent. The New York City Department of Health and Mental Hygiene provides a table (pdf) that breaks down infant mortality rates by neighborhood throughout the city.

Thomas Frieden, commissioner of the Department of Health and Mental Hygiene, acknowledged this disparity in a recent Letter to New Yorkers. "Babies born in poor neighborhoods are 10 times more likely to die than babies born in the most economically advantaged neighborhoods," wrote Frieden, promising to "prioritize public health efforts to communities that need them the most."

The most common causes of infant deaths are premature births/low birth weight, birth defects, and Sudden Infant Death Syndrome.

LACK OF MENTAL HEALTH SERVICES

"Federal Agencies could play a stronger role in helping states to reduce the number of children placed solely to obtain mental health services". An April 2003 reportfrom the General Accounting Office estimates that the families of at least 12,700 children across the country were driven to give up their kids to child welfare agencies or juvenile justice systems because they knew of no other way to obtain mental health services for them. The report suggests that a reduction in costs for mental health services, as well as improved access to these services, could change this situation.

A CAMPAIGN TO RECRUIT FOSTER PARENTS

Foster parents wanted. Mayor Bloomberg and the Administration for Children's Services (ACS) are kicking off a massive campaign to recruit foster parents. There are currently 25,400 children in foster care in the city. In a press conference with the mayor, William Bell, commissioner of the Administration for Children's services, said they are particularly in pursuit of people willing to parent siblings, teenagers, and mentally fragile children. The agency is hoping to attract a foster parent pool from Bedford-Stuyvesant, Jamaica, Queens, Central Harlem, and Concourse/Highbridge in the Bronx, neighborhoods where many of the children come from, so that the children can remain within their own communities.


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