Urban Areas Make ‘Considerable but Inconsistent’ Progress on Federal Health Goals
The United States' largest cities made "considerable but inconsistent progress" toward reaching most of HHS' Healthy People 2000 goals, with the exception of rates of low birthweight among infants, according to a report released this week by the Robert Wood Johnson Foundation and SUNY Downstate Medical Center, USA Today reports (Manning, USA Today, 8/7). The report analyzed information from the 2000 Census, the CDC and the FBI to determine progress toward federal health goals including low birthweight, infant mortality, AIDS, tuberculosis, syphilis and gonorrhea (Scott, New York Times, 8/7). The following are summaries of findings from "Healthy Cities, Healthy Suburbs: Progress in Meeting Healthy People Goals for the Nation's 100 Largest Cities and Their Suburbs:"
- Low birthweight: In 1999, none of the 100 largest U.S. cities and only two of those cities' suburbs met the Healthy People 2000 goal of 5% of infants or fewer being born at low birthweight -- defined as weighing 5.5 pounds or less. In contrast, 14 suburbs met this goal in 1990. Low birthweight rates during the decade were lowest for cities and suburbs in the West, averaging less than 7%. In 1999, Portland, Ore., had the lowest city LBW rate at 5.4% and Stockton, Calif., had the lowest suburban rate at 4.5%. Atlanta, Ga., experienced the largest decline in LBW rates (15%) during the decade among cities, and Las Vegas, Nev., experienced the largest drop (14%) among suburbs ("Healthy Cities, Healthy Suburbs: Progress in Meeting Healthy People Goals for the Nation's 100 Largest Cities and Their Suburbs" executive summary, August 2002).
- Infant Mortality: At 8.8 deaths per 1,000 live births, the overall infant mortality rate among cities in 1999 did not meet the Healthy People 2000 goal of 7 deaths per 1,000 live births. However, the suburban rate of 6.4 deaths per 1,000 live births exceeded the target goal. Infant mortality rates were again lower in the West, with San Francisco recording the lowest city rate of 3.8 deaths per 1,000 live births in 1999. Rochester, N.Y., recorded the lowest suburban rate at 3 deaths per 1,000 live births. Anchorage, Alaska, recorded the largest decline (52%) among cities, while Miami, Fla., experienced the largest decrease (67%) among suburban areas.
- AIDS: Overall, the incidence of AIDS in major U.S. cities decreased by 24% between 1990 and 2000, to 15.4 cases per 100,000 residents, a rate "well below" the Healthy People 2000 target of 43 cases per 100,000. However, the 2000 rate falls "far" short of the Healthy People 2010 goal of 1 case per 100,000 people. AIDS incidence rates were highest in northeastern urban areas and lowest in the Midwest. Miami, New York and San Francisco were the only cities that recorded incidence rates above the 2000 goal. However, San Francisco also recorded the largest decrease in AIDS rates -- 67% -- during the 1990s.
- Tuberculosis: U.S. cities and suburbs experienced "significant" declines in tuberculosis rates from 1990 to 2000. However, those declines were not enough for most areas to meet the Healthy People 2000 goal of 3.5 cases per 100,000 people. Cities in the Northeast experienced on average a 55% decline in TB rates. Albuquerque, N.M., had the lowest city TB rate in 2000 at 1.6 cases per 100,000 people, while Pittsburgh, Pa., experienced the greatest decline (75%) in its TB rate during the 1990s.
- Syphilis: Syphilis rates fell 86% on average throughout the decade to 5.6 cases per 100,000 people in 2000, but they still fell short of the Healthy People 2000 goal of 4 cases per 100,000 people. Rates were highest in the South, averaging 9 cases per 100,000 people despite an 86% decrease from 1990 to 2000. Two U.S. cities -- Akron, Ohio, and Cincinnati, Ohio -- reported no new syphilis cases in 2000.
- Gonorrhea: In 2000, gonorrhea rates in the 100 largest U.S. cities averaged 321 cases per 100,000 people, a 54% average decline from 1990. Rates fell from 1990 to 1995 but began rising again in 1996. The Midwest experienced the highest gonorrhea rates on average, while rates were lowest in the West. San Jose recorded the lowest rate in 2000 with 27 cases per 100,000 people, and Atlanta recorded the greatest decline (85%) between 1990 and 2000 ("Healthy Cities, Healthy Suburbs: Progress in Meeting Healthy People Goals for the Nation's 100 Largest Cities and Their Suburbs" executive summary, August 2002).
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