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Socio-economics, Health and Immigration in Philadelphia
Giridhar Mallya, MD, MSHPPhiladelphia Department of Public Health
7.6.09

10 Largest U.S. Cities
Rank 1960 20071 New York City New York City2 Chicago Los Angeles3 Los Angeles Chicago4 Philadelphia Houston5 Detroit Phoenix6 Baltimore Philadelphia7 Houston San Antonio8 Cleveland San Diego9 Washington, DC Dallas10 St. Louis San Jose

Interlocking Cycles of Disadvantage
Unemployment
Poverty
Population Loss
Health
Education
Crime

Manufacturing Workers -1980

Top 10 Most Populous Cities Unemployment, 2007
0
1
2
3
4
5
6
Percent Unemployed
City
PhoenixSan AntonioHoustonDallasSan DiegoNew YorkSan JoseChicagoLos AngelesPhiladelphia
U.S. Bureau of the Census, Annual Population Survey, 2008.

% Population in Poverty - 1980

Top 10 Cities Poverty Rate
0
5
10
15
20
25
Percent in poverty
City
San JoseSan DiegoPhoenixSan AntonioNew YorkChicagoLos AngelesHoustonDallasPhiladelphia
U.S. Bureau of the Census, Annual Population Survey, 2008.

Poverty by race-ethnicity and household structure
Philadelphia Poverty Estimates, 2005-2007
15.1%
25.7%
31.0%
41.1%
42.9%
28.3%
19.3%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0%
All families
Families with children
Families with female head only and children
White
Asian
Black
Hispanic
American Community Survey, US Census 2005-2007

Interlocking Cycles of Disadvantage
Unemployment
Poverty
Population Loss
Health
Education
Crime

Poverty = poor health
Red= census tracts with >20% poverty Dark green= census tracts with

Health

Philadelphia births, 2000-2006
MCFH Data Watch 2009

Philadelphia births and birth rate, 1960-2006
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
Births
0
5
10
15
20
25 Births Per 1,000
Births Birth Rate
*Philadelphia Vital Statistics Reports

Philadelphia, 1961-2006Infant Mortality Rate
05
101520253035404550
1961 1966 1971 1976 1981 1986 1991 1996 2001 2006
WHITEBLACK
Deaths per 1000 live
births
*Philadelphia Vital Statistics Reports

Philadelphia vs. 6 other major cities: Overall mortality
Overall Mortality Rate- Deaths/100,000 persons, 2004
0.0
200.0
400.0
600.0
800.0
1000.0
1200.0
Overall mortality
Philadelphia
D.C.
Baltimore
Los Angeles
NYC
Chicago
Detroit
3
NCHS Vital Statistics Reporting System, 2004

Leading Causes of Death: Philadelphia, 2005
22%
37%
27%
4%4%
6%
CancersHeart DiseaseStrokeUnintentional InjuriesChronic lung diseaseAll other causes
CANCERS
HEART DISEASE
Philadelphia Vital Statistics Report, 2005

*Centers for Disease Control

Adult tobacco use
Smoking among adults in Philadelphia
25.9
24.8
25.9 25.9
27.3
23.524.024.525.025.526.026.527.027.5
2000 2002 2004 2006 2008
Perc
enta
ge
*PHMC Household Health Survey
12% HP 2010

Philadelphia vs. 6 other major cities: Smoking during pregnancy
Percentage of pregnant women who smoke, 2003
0.02.04.06.08.0
10.012.014.016.018.020.0
Percentage of pregnant women who smoke
PhiladelphiaD.C.BaltimoreLos AngelesNYCChicagoDetroit
1

Children (

Obesity among adults in Philadelphia
25.2
28.0
26.2
27.8
29.1
23.0
24.0
25.0
26.0
27.0
28.0
29.0
30.0
2000 2002 2004 2006 2008
Perc
enta
ge
*PHMC Household Health Survey
15% HP 2010
Adult obesity

Obesity or Overweight among children 6-17 yrs in Philadelphia
39.7
46.6
42.0
46.9
36.0
38.0
40.0
42.0
44.0
46.0
48.0
2002 2004 2006 2008
Perc
enta
ge
PHMC Household Health Survey
5% HP 2010
Childhood overweight and obesity

Philadelphia vs. 6 other major cities: cancer mortality
Cancer mortality rates, 2004
0.0
50.0
100.0
150.0
200.0
250.0
Cancer mortality Lung cancermortality
Breast cancermortality
Age-
adj
uste
d de
aths
/100
,000
per
sons
PhiladelphiaD.C.BaltimoreLos AngelesNYCChicagoDetroit
1
22
NCHS VSRS 2004

Cancer mortality and poverty
Cancer mortality rates as a function of poverty for 7 major cities
0.0
50.0
100.0
150.0
200.0
250.0
19.0 20.0 21.0 22.0 23.0 24.0 25.0 26.0 27.0
% Individuals in poverty (2000)
Age
-adj
uste
d de
aths
/100
,000
per
sons
Cancer mortality
Lung cancer mortality
Breast cancer mortality
Chicago DC
NYC LA
Philly - Baltimore
Detroit

Hypertension among adults in Philadelphia
31.3 32.7 29.634.0 35.7
0.05.0
10.015.020.025.030.035.040.0
2000 2002 2004 2006 2008
Perc
enta
ge
14% HP 2010
Adult hypertension

Diabetes among adults in Philadelphia
9.4 10.210.9
12.013.0
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
2000 2002 2004 2006 2008
Perc
enta
ge
*2000-2002: now have diabetes; 2004-2008: ever have diabetes
Adult diabetes

Hyperlipidemia among adults in Philadelphia
22.6
23.9
22.8
26.6
25.3
20.0
21.0
22.0
23.0
24.0
25.0
26.0
27.0
2000 2002 2004 2006 2008
Perc
enta
ge
17% HP 2010
Adult hyperlipidemia

Childhood asthma in Philadelphia
22.8% of children have ever had asthma
12.9 asthma hospitalizations/100,000 (0-14 yrs) Healthy People 2010 goal: 1.7/100,000
PHMC Household Health Survey, 2008
PA Health Care Cost Containment Council, 2006

Air Management Services, Air Quality Report 2006
Air Quality Index
0% HP 2010

% Philadelphia Children (Birth to Age 6) with Elevated Venous Blood Lead Levels (>10 ug/dl), 1994-2007
46.1
37.7
31
22.317.3
14.5 12.8 11.67.6
41 38.5
13.7
3.38.6
0
10
20
30
40
50
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Year
% E
leva
ted
% Elevated
*City of Philadelphia Lead Database
0% HP 2010
Childhood lead poisoning

AIDS Incidence in Philadelphia, 1984-2007
0200400600800
1000120014001600
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
Cases
AIDS Activity Coordinating Office
New AIDS cases per year

AIDS Mortality in Philadelphia, 1984-2006
0100200300400500600700800900
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
Dea
ths
AIDS deaths per year

New cases of HIV in Philadelphia
Year Prevalence New cases2006 5827 1285
2007 6621 1258
Of new cases in 2006 67% among African-Americans 30% among women 32% among MSM 15% among 13-24 yrs; 51% among 25-44 yrs

Chlamydia rates in large cities, 2000
Chlamydia rates per 100,000 persons in cities of >200,000 population (2000)
0.0
200.0
400.0
600.0
800.0
1000.0
1200.0
1400.0
Rich
mond
, VA
Milw
auke
e, W
IPh
ilade
lphia,
PA
Baltim
ore,
MDNe
w Or
leans
, LA
St. L
ouis,
MO
Detro
it, MI
Atlan
ta, G
AMi
nnea
polis
, MN
Kans
as C
ity, M
O
New
York
City,
NY
Case
s/10
0,00
0
958.2/100,000
# 3 in the U.S.
CDC, Division of Sexually Transmitted Diseases, 2000

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