Identifying New York City Neighborhoods at Risk of Being Overlooked for Interventions

TOOLS FOR PUBLIC HEALTH PRACTICE — Volume 17 — April 23, 2020

Joy X. Kang, PhD1; Amber Levanon Seligson, PhD, MS1; Kacie L. Dragan, MPH2 (View author affiliations)

Suggested citation for this article: Kang JX, Levanon Seligson A, Dragan KL. Identifying New York City Neighborhoods at Risk of Being Overlooked for Interventions. Prev Chronic Dis 2020;17:190325. DOI: http://dx.doi.org/10.5888/pcd17.190325.

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Summary

What is already known about this topic?

Public health agencies are frequently tasked with difficult decisions related to resource allocation. According to a 2011 survey of public health officials, fewer than half reported always or usually using structured means of making allocation decisions, despite most respondents saying needs assessments are moderately to very influential in decision making.

What is added by this report?

Using community-level health outcomes data for New York City (NYC), we assess the number of disparities each neighborhood has relative to its borough (county). We then apply this information to identify NYC neighborhoods that may be at risk of being overlooked for interventions because they represent a group with a moderate number of disparities.

What are the implications for public health practice?

This methodology for examining patterns of disparities that exist across neighborhoods is useful for public health planning and can aid in the making of efficient and equitable allocation decisions.

Abstract

Public health agencies are often faced with difficult decisions about where and how to allocate funding and resources. This question of resource allocation is central to public health policy; however, decisions related to resource allocation are sometimes made via informal or subjective approaches. We walk readers through a process of identifying needs across different neighborhoods in New York City (NYC) by examining community district–level health outcomes using data from published Community Health Profile reports released by the NYC Department of Health and Mental Hygiene (DOHMH) in 2015. In NYC, community districts are represented by community boards that provide a forum for addressing the needs of the community, making them a useful geographic unit for examining health information and turning data into action. We examined prevalence estimates and 95% confidence intervals of health indicators in each community district to identify significant disparities and calculated relative disparities in rates or prevalence to understand the relative magnitude of each disparity. Lastly, we demonstrate an application of this approach by identifying a cluster of neighborhoods with a high chance of being overlooked for public health interventions by conventional methods because of the relative number of disparities that exist in these neighborhoods. We present information on the disparity profile (number of disparities and relative disparity) for each neighborhood within the cluster and discuss potential public health implications. This approach can be applied to other jurisdictions to inform public health planning and resource allocation.