In the South Bronx, the poorest urban congressional district in the country, the population suffers high rates of diabetes, obesity, heart disease, asthma, HIV/AIDS, and infant mortality.
The level of Emergency Department use was strongly associated with neighborhood poverty; the proportion of uninsured residents, Blacks, and Hispanics; and residents’ reports of poor/fair health status, no regular doctor, and difficulty getting medical care when needed.
Health problems may be major outcomes of chronic substance abuse and attendant conditions like homelessness, which leads to rates of illness and injury from two to six times higher than for people who are housed. Men and women suffering chronic substance use disorder have higher rates of a number of health conditions, many of which can affect HIV and vice versa. TB, liver conditions, asthma, diabetes and hypertension create a complex mix that is difficult to treat and where medical therapy for any of them creates new sets of problems. A recent survey of HELP/PSI (BOOM!Health’s FQHC partner) clients identified barriers to access to health care:
- The most frequent barrier was not knowing where to go for a service - 32.4%
- Not being able to afford care - 29.5%
- Experiencing too much confusion, hassle, or waiting to obtain it - 27.1%
Persons with severe mental illness are at high risk of becoming homeless for a number of reasons related to their lack of individual resources, inadequate systems of community supports, and the tendency toward social exclusion of mentally ill persons and others with stigmatizing conditions.
The Bronx’s suicide rate is .53 per 10,000 residents. There are nearly 12,000 people diagnosed with serious mental illness.