Life and death by the numbers

If you have a basic fascination about the causes of disease and their distribution -- go get yourself a Ph.D. in epidemiology, and we can commiserate! Failing that, you can play around with the sortable statistics of the New York City Community Health Profiles.

I'm not actively involved in researching these issues (though I'd like to work for the Department of Health someday). Nevertheless, here are some observations I don't understand.

Highbridge and Morrisania (in the Bronx) has the dubious honor of the highest all-cause mortality rate of any city neighborhood. Mortality from heart disease is highest in the Rockaways, but stroke mortality is highest in East Harlem -- and each of these is found pretty far down the list for the other cause of death. Why is this?

Chelsea and Hell's Kitchen, sorry, I mean Clinton, in Manhattan, seem to have a higher infant morality rate than other neighborhoods in Manhattan (although there are no confidence intervals on the rates presented, so it's hard to tell). The infant hospitalization rate is also higher than many other boroughs. Again, why is this?

(Part of the answer is certainly the fact that Chelsea/Hell's Kitchen* is poorer than most other Manhattan neighborhoods, although how much longer this will stay the case is open to question.)

I could go on like this for hours. These general issues are more and more classified under what's called social epidemiology, an attempt to elucidate and interrelate the different strata of causal factors that affect disease in the individual and society. (The latest issue of Epidemiologic Reviews is devoted to this subfield, and the rigor of some articles made me feel somehwat less skeptical toward social epidemiology in general.)

*Yes, I could write "Chelsea/Clinton," but I won't. So there.


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