Combining Clinical and Population-Level Data to Understand the Health of Neighborhoods

Background.  Primary care centers and public health agencies rarely work in alignment to effectively increase wellness at both the patient and population levels; due in part to the lack of a data infrastructure that coordinates patient and population health.

Purpose. To describe the first year results of using a set of common behavioral health metrics at both the patient and population levels.

Methods. Health behavior questions assessing physical activity and dietary intake were integrated into the electronic health records of three primary care centers in the Bronx, New York.  Patient responses for adults attending one of the three health centers between February and December 2012 were analyzed and compared to 2012 NYC Community Health Survey neighborhood data.

Results. Across the three health centers, 35%-43% of patients reported no physical activity in the past 30 days.  In the neighborhood surrounding the health centers, 18%-29% of residents reported no physical activity in the last 30 days. Approximately half of patients reported walking or biking for transportation in the last 30 days, compared to 80% of residents living in the neighborhoods surrounding the health centers. Most patients reported consuming sugary drinks daily and 1-4 fruits and/or vegetables on average, which is comparable to that of the residents of their health center neighborhood. 

Conclusions. There was a higher proportion of unhealthy behaviors among health center patients in relation to neighborhood-level data.