Neighborhood Profiles Reveal Patterns
Profiles of 26 Philadelphia neighborhoods, based on data compiled by Philadelphia Corporation for Aging (PCA) from a variety of sources, reveal both similarities and striking differences that can be used to help shape programs and policies in serving older Philadelphians. By comparing neighborhoods on the basis of a variety of factors, including age, health care plans, reports of chronic illness, health status and income, it is possible to learn how certain factors combine to create significantly different outcomes from similar conditions.
"What we see here is that bad outcomes are less related to the illness, and more to how it’s managed," said Dr. Allen Glicksman, PCA’s director of research and evaluation.
For example, in comparing Nicetown with Center City, each has the same proportion of persons over age 60 who report a chronic illness – about 41%. On average, the over-60 population in Center City is older (73) than in Nicetown (68); so with the same proportion of chronic illness, it might be expected that those in Center City would be experiencing more health problems. However, more than twice as many Nicetown residents reported being in fair to poor health (54%) as Center City residents (26%) who reported being in better health. Further, more than five times as many Nicetown residents (32%) reported having problems with performing activities of daily living for themselves (such as eating, bathing and dressing) as those in Center City experiencing the same problems (6%).
At the same time, 37.5% of Nicetown elders reported three or more symptoms of depression, as opposed to 9.62% of Center City elders. The numbers of those living alone – a risk factor for depression – are not at all comparable. In Center City, 46% of elders live alone, compared with 31% in Nicetown.
The economic disparities between the two are even more significant, with 77% of Nicetown residents living below 200% of the poverty level, as opposed to 11 % of Center City residents; and Nicetown residents were more likely to have an HMO health plan – 55% versus 30% of Center City residents.
This brief comparison highlights the importance of considering multiple factors in identifying either individuals or neighborhoods in greatest need of intervention. Age alone, or the incidence of chronic illness, do not determine outcomes; many other factors contribute, and should be considered when developing programs and policies to serve older populations.
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