New York City Boroughs Research Articles

Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City.

There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

Patterns of Physical Activity Among Older Adults in New York City: A Latent Class Approach.

Little research to date has explored typologies of physical activity among older adults. An understanding of physical activity patterns may help to both determine the health benefits of different types of activity and target interventions to increase activity levels in older adults. This analysis, conducted in 2014, used a latent class analysis approach to characterize patterns of physical activity in a cohort of older adults. A total of 3,497 men and women aged 65-75 years living in New York City completed the Physical Activity Scale for the Elderly (PASE) in 2011. PASE scale items were used to classify subjects into latent classes. Multinomial regression was then used to relate individual and neighborhood characteristics to class membership. Five latent classes were identified: "least active," "walkers," "domestic/gardening," "athletic," and "domestic/gardening athletic." Individual-level predictors, including more education, higher income, and better self-reported health, were associated with membership in the more-active classes, particularly the athletic classes. Residential characteristics, including living in single-family housing and living in the lower-density boroughs of New York City, were predictive of membership in one of the domestic/gardening classes. Class membership was associated with BMI even after controlling for total PASE score. This study suggests that individual and neighborhood characteristics are associated with distinct physical activity patterns in a group of older urban adults. These patterns are associated with body habitus independent of overall activity.

Public Perceptions of Plastic Surgery

The general public may not fully appreciate the role that plastic surgeons play in patient care. The authors sought to identify public perceptions of plastic surgery in a major US urban setting. A short, anonymous, survey was distributed to the public in all of the major boroughs of New York City. Respondents were asked to choose the surgeon they believed were experts in 12 specific clinical issues representative of required competencies by both the Plastic Surgery Residency Review Committee and the American Board of Plastic Surgery. A total of 1000 surveys were collected. Respondent demographics were similar by sex (53% women) and age (6% ages<21 years, 31% ages 21-24 years, 46% ages 25-40 years, 10% ages 41-54 years, and 8% ages ≥ 55 years). The majority also completed high school (96%). The percent of respondents who chose plastic surgeons as experts in the following procedures included rhinoplasty (61%), mandible fracture (12%), blepharoplasty (71%), cleft lip and palate surgery (46%), thumb replantation (32%), hand/finger fracture (18%), rhytidectomy (85%), breast reconstruction (87%), breast augmentation (96%), open leg wound (15%), open wound on the face (40%), and Botox (47%). Plastic surgeons were the most commonly selected experts in only 8 of these 12 domains (67%). These included rhinoplasty, blepharoplasty, rhytidectomy, Botox injections, breast augmentation, breast reconstruction, cleft lip and palate surgery, and treatment of open wound of the face. Unfortunately, many conditions at the core of plastic surgery remain outside the realm of plastic surgery in the opinion of the surveyed public.

Hip-hop Culture

IntroductionIN THE 1990S, NUMEROUS AMERICAN SCHOLARS started to write seriously about hiphop.1 is a complex culture, even though it is depicted in a one-dimensional way through the mass media. is widely accepted that hip-hop culture first manifested itself in the early 1970s throughout the five boroughs of New York City, but first in the urban wasteland known as the South Bronx. emerged from the African-American, Latino and Caribbean-American communities. According to Tricia Rose, It is to be perceived as the reaction of marginalised youths in postindustrial urban America. music and culture rely on a variety of Afro-Caribbean and Afro-American musical, oral, visual and dance forms and practices.2 includes four main branches of expression: deejaying (the art of combining sounds and songs using two or three turntables); b-boying (dancing); aerosol art or graffiti writing; and the emerging part of the iceberg, emceeing (rapping).Hip-hop is a way of life that conditions the way its participants are looking at the world, or at society, and the way they interact with other individuals. also participates in the making of their social identity. According to pioneer Kris Lawrence Parker, also known as KRS-One, Hip-hop is something you live and rap is something you do.3 The music industry and the media have helped to make the words hip-hop and rap synonymous, leaving out the other elements of the culture. In this article, when I use the word hip-hop, I will be referring to the culture along with all its elements and not only rap music. Anthropology envisions culture as the abilities individuals acquire in order to think and act according to their environments When one talks about culture, it implies a set of habits, values, an ideal that conditions the way participants look at society, their aspirations and their life choices.* As a consequence, it concerns much more than clothing, songs and videos.Ever since the 1980s, hip-hop has become a cultural product that is being sold and bought all over the world. is a product that garners millions of dollars, produces waged activities and boosts the American and the world economy. culture, mostly through rap music, became a legal way to escape from social exclusion and poverty for a category of young people in America and in Europe. In May 2014, Forbes magazine estimated the personal fortune of certain African-American hip-hop entrepreneurs: the most well known are the producer, rapper, record producer, actor and entrepreneur Sean Combs (born 1969), also known by his stage names Diddy and P. Diddy, whose fortune is valued at US$700 million, and the rapper, entrepreneur and music producer Sean Carter (born 1969), aka Jay-Z, with an estimated fortune of US$520 million. Andre Young, aka Dr Dre, a rapper and music mogul, has an estimated fortune of US$550 million. In 2008, he cofounded the Beats brand of audio equipment with Interscope chief, Jimmy Lovine.6 These artists/ business executives as well as their partners have become dynamic commercial assets.Since hip-hop entered popular culture, it became also a product willing to sell out, to please. Popular culture is commercial, in other words, it is marketed in order to make profits. repeats itself hoping that the products that had commercial appeal will be successful again. At the same time, its producers not only reflect the beliefs and the values of its consumers, they shape them. The culture has had a strong impact on the clothing and food industries, on the media, education, language, sexuality, gender relations, social and economic policies in the United States and other parts of the world.The hip-hop generation is between thirteen and fifty years old. This culture gives them a specific language, a common notion of authenticity, common values and common landmarks that transcend their own ethnic and cultural heritage. Even if the process might be questionable, hip-hop is a cultural unifier. …

The floor area ratio gradient: New York City, 1890–2009

An important measure of the capital–land ratio in urban areas is the Floor Area Ratio (FAR), which gives a building's total floor area divided by the plot size. Variations in the FAR across cities remain an understudied measure of urban spatial structure. We examine how the FAR varies across the five boroughs of New York City. In particular, we focus on the FAR gradient over the 20th century. First we find that the gradient became steeper in the early part of the 20th century, but then flattened in the 1930s, and has remained relatively constant since the mid-1940s. Next we identify the slope of the gradient across space, using the Empire State Building as our core location. We find significant variation of the slope coefficients, using both ordinary least squares and geographically weighted regressions. We then identify subcenters, and show that while accounting for them can better capture New York's spatial structure, by and large, the city remains monocentric with respect to its FAR. Lastly, we find a nonlinear relationship between plot sizes and the FAR across the city.

People with epilepsy who use multiple hospitals; prevalence and associated factors assessed via a health information exchange

Hospital crossover occurs when people seek care at multiple hospitals, creating information gaps for physicians at the time of care. Health information exchange (HIE) is technology that fills these gaps, by allowing otherwise unaffiliated physicians to share electronic medical information. However, the potential value of HIE is understudied, particularly for chronic neurologic conditions like epilepsy. We describe the prevalence and associated factors of hospital crossover among people with epilepsy, in order to understand the epidemiology of who may benefit from HIE. We used a cross-sectional study design to examine the bivariate and multivariable association of demographics, comorbidity, and health service utilization variables with hospital crossover, among people with epilepsy. We identified 8,074 people with epilepsy from the International Classification of Diseases, Ninth Revision (ICD-9) codes, obtained from an HIE that linked seven hospitals in Manhattan, New York. We defined hospital crossover as care from more than one hospital in any setting (inpatient, outpatient, emergency, or radiology) over 2 years. Of 8,074 people with epilepsy, 1,770 (22%) engaged in hospital crossover over 2 years. Crossover was associated with younger age (children compared with adults, adjusted odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.7), living near the hospitals (Manhattan vs. other boroughs of New York City, adjusted OR 1.6, 95% CI 1.4-1.8), more visits in the emergency, radiology, inpatient, and outpatient settings (p < 0.001 for each), and more head computerized tomography (CT) scans (p < 0.01). The diagnosis of "encephalopathy" was consistently associated with crossover in bivariate and multivariable analyses (adjusted OR 2.66, 95% CI 2.14-3.29), whereas the relationship between other comorbidities and crossover was less clear. Hospital crossover is common among people with epilepsy, particularly among children, frequent users of medical services, and people living near the study hospitals. HIE should focus on these populations. Further research should investigate why hospital crossover occurs, how it affects care, and how HIE can most effectively mitigate the resultant fragmentation of medical records.

Scale, Scope, Efficiency and Equity in Public Service Provision: How Might We Analyse the 1898 Consolidation of New York City?

In 1898, the five counties of Richmond, New York, Bronx, Queens, and Kings came together in a consolidation which created the five boroughs of New York City. Staten Island went from being an independent county in the State of New York to a interdependent borough of the new City of New York, as did the other counties. The consolidation offered a lot of promises, and a lot of promises were made to get it to happen. Which raises a basic question: has this merger resulted in more efficient provision of public services and greater economic returns than would have been the case had the five counties remained independent entities? From an equity perspective, what have the residents of the outer boroughs gained and what have they lost, especially in relation to Manhattan? This paper reviews some very preliminary data assessing the efficiency and equity gains and losses of the largest municipal consolidation in American history. The existing literature on public choice, optimal public scale and fiscal federalism is examined to provide a framework for the initial findings.

Parents' education, school‐age children and household location in American cities

AbstractThe location of households within metropolitan areas has been a topic of interest for many decades. It has been receiving more attention by researchers recently because of the increasing attractiveness of many cities in the United States to certain types of households and to certain types of jobs. This study considers whether 15 large cities and the boroughs of New York City are attractive to families with school‐age children, especially those with college‐educated parents. It is shown that overall more affluent and educated families with school‐age children are less likely to live in many large central cities with a few important exceptions.

Successful Strategies for Recruitment of Emergency Medical Volunteers

A robust medical volunteer program is critical to ensuring a successful response to public health and medical emergencies. The New York City (NYC) Department of Health and Mental Hygiene created the NYC Medical Reserve Corps in 2003 to build a multidisciplinary team of health professionals who wish to assist NYC with response during large-scale health emergencies. This article reports on the search to determine which recruitment activities have been most successful to date, with the goal of modeling future activities upon those that worked best. A retrospective review of effectiveness of recruitment strategies to identify and register new NYC Medical Reserve Corps volunteers was undertaken. A broad range of recruitment activities have been implemented since the program's inception, with varying degrees of success. Various recruitment modalities were tried, including direct invitations to licensed professionals by the NYC Health Commissioner and announcements through professional organization partners. The direct invitation by the NYC Health Commissioner to health professionals licensed in 1 of the 5 boroughs of NYC has proved to be the most successful recruitment tool to date. The local health commissioner or other trusted community figure is an excellent messenger for recruiting emergency volunteers. It is also critical that recruitment messages reach as many potential volunteers as possible to ensure that the requisite number of volunteers and mix of professional disciplines are identified.

The Battle of Brooklyn: World City and Space of Neighborhoods

Observers have long suggested New York City is undergoing a vast transformation. Between globalization, hyper development and accompanying homogenization, the city's neighborhoods are being remade in front of our eyes (Sites, 2003). Increasingly, even the borough of New York, is experiencing this phenomenon. is booming, wrote Kennth Brown (2007, 1) in the business glossy Brooklyn Tomorrow. a decade, it be vastly different, packed with more parks waterfront destinations, glittering residential towers with style views. The facelift of Coney Island and the Atlantic Yards Project will change the heart of Brooklyn, (p.l). Others wonder what of it remain. Two centuries after the 1776 Battle of the landscape of Brooklyn is being remapped anew in a struggle over what it become.Independent of the other four boroughs of New York Brooklyn would be the fourth biggest city in the United States. Today Brooklyn is experiencing both the benefits and limitations of its experience as a world city. While urban spaces are thought to magnify the democratic possibilities (Glasser, 2010), their development tends to expand social inequalities (Smith, 1990). Yet, the people of Brooklyn have long resisted elements of the homogenization steamroller - including big box stores, chains, and high-rises - exorbing other cities including their neighbor, which is currently coping with its own brand of suburban urbanism (Hammett and Hammett, 2007). For decades, the people of the borough fought to preserve their brownstones (Osman, 2011). While many revel in the borough's vast cultural history (Hamill, 2008; Hughes, 2011), others lament patterns of displacement, pollution, and environmental disrepair which follows patterns of uneven urban development (Eviator, 2007; Smith, 1990; Witt, 2006). Throughout regular people are fighting off negative dynamics of the globalization experience, including speculative gentrification, displacement, and police brutality. The battle over these transformations is a struggle over the contested nature of globalization in Brooklyn.The Battle of Brooklyn is an effort to help keep what is distinct and rich about its streets, distinct neighborhoods, and people. While certainly some of the renaissance taking place in Brooklyn is a good thing, growth is paradoxical (Mooney, 2011). Today, the battle is a struggle against the sea of identical details, stadiums, out of place buildings, and displacement. With the foreclosure crisis on the rise (Witt, 2006), some wonder if the borough is a space for displacement or democracy? What is the future of Brooklyn's neighborhoods once they have been rezoned? And can there be a new model of sustainable development for a world city? In highlighting the ways Brooklyn residents, groups, and neighborhoods are experiencing urban development and the strategies activists have employed to address the issues of displacement and homogenization of urban space, we consider alternative models of urban development in which the poor are not pushed from neighborhood to neighborhood, the character of streets is not blandified, and community space is supported rather than squeezed from public view.BROOKLYN AS GLOBAL CITYWhy did Brooklyn lose the Dodgers and work on the waterfront in a matter of years a half a century ago? 60,000 jobs and a beloved home team were lost with containerization (Freeman, 2000; Levinson, 2008). Brooklyn has long coped with the ravages of displacement and deindustrialization, forces many describe as features of globalization (Sites, 2003).Brooklyn be the City, argued George Templeton Strong on March 18, 1865 (Burns, 2001). Manhattan be the suburb. The borough of Brooklyn has long been considered a unique geography, even as one of the five boroughs of New York City. Yet, unlike Manhattan, it is a space which extends deep into the horizon. Today, it is a space for social and cultural capital, mass transportation, and policy innovation (Freeman, 2000, Mooney, 201 1). …

Characteristics of Multimodal Conflicts in Urban On-Street Bicycle Lanes

In urban areas, bicycles that travel in bicycle lanes encounter a variety of obstructions, including pedestrians and various types of motor vehicles. Earlier studies focused on the frequency of such events. The goal of this study was to characterize the obstructions. Data were collected in the Manhattan and Brooklyn boroughs of New York City to evaluate specific characteristics (e.g., bicycle lane designs, curb regulations, land use) that might influence the frequency of specific conflict types. A method is described for evaluating the frequency of conflicts between bicycles that travel in on-street bicycle lanes and various other transportation modes and for identifying factors that might affect the frequency of such conflicts.

The Urbanization of the Billboard Top Album and Singles Charts: How SoundScan Changed the Game

IntroductionIt's been said anonymously, and repeated in many industry circles, music business is a game where you can't make a living, only a killing. The key is to try to have as many (successes) in a row as you can. Following that line of thinking, the reading, studying, and analyzing of Billboard magazine's weekly charts is a practice many music professionals engage in to make decisions on behalf of their companies, artists, clients, or associates in an attempt to create as many successive killings as possible. Every game has rules and regulations that have to be complied with in order for contestants to be successful. In addition to the rules, certain practices, procedures, and methods make the process of playing and chances of winning greater. Occasionally, certain rules, practices, and protocols undergo severe adjustments that may create controversy and redirect the course of the game. This article is written to both document and examine an adjustment in Billboard chart-ranking methodology that changed not only the genre make-up of the charts, but also influenced several elements of a burgeoning music industry during its peak period, the 1990s, and beyond.Billboard, the leading and sole surviving weekly music publication,1 has ranked music since 1942 under various designations including Race Records, Harlem Hit Parade, R&B, Soul, and music charts.2 In 1948, Billboard's chart manager, Jerry Wexler, coined the term Rhythm and Blues (R&B) to identify music that was marketed primarily to consumers and played on stations targeting listeners. Since that time, R&B music has had a significant impact on the popular music scene. Soultracks.com's Chris Rizak says:While its influence had been silently profound during most of the 20th century, in the 1960s music firmly established itself as the music of a nation. Motown called itself of Young America, and popular secular music derived from Gospel and Blues roots became the dominant creative and cultural driver-a role it would maintain for the next several decades.3Motown's promulgation of the Sound of Young America did accelerate the popularity of music among the general market audience. The influence of R&B/Soul music continues to this day with the recent rise of an Electronic Dance (EDM) genre that was born out of the musical stylings of the R&B/Disco music of the 1970s.Urban music initially was a term used to reference a musical genre of the 1980s and 90s defined by recordings by Rhythm and Blues or Soul artists with broad crossover appeal. contemporary began as an American format designed to appeal to advertisers who felt that black radio would not reach a wide enough audience.4 Rap/Hip-Hop music, also an urban art form, originated in the boroughs of New York City in the latter 1970s and 80s. As Rap/Hip-Hop music (an extension of R&B/Soul) grew during the last two decades of the twentieth century, the term Urban Music was employed to identify the aggregate genres.Billboard s change of methodology in determining Top Album and Hot 100 Singles chart rankings to include the use of actual point-of-sale information from SoundScan in 1991 led to a significant increase in the sales, amount, and frequency of music being programmed on Top 40 in the latter 90s and extending into the new millennium. It also gave rise to other significant changes in the music business in general that are worth noting.History of Billboard's Top Album and Singles ChartsOn March 24, 1956 Billboard inaugurated a weekly Best Selling Popular Albums chart in response to the explosion in sales of R&B influenced Rock & Roll music. Prior to that time, R&B music was relegated to only R&B charts that marginalized the significance of its actual market appeal. Ironically, the chart's first number-one album was Belafonte by Harry Belafonte. …

Using Old Maps and New Methods to Discover the Early Chemicals and Petroleum Industries of Newtown Creek in New York City

Historical maps can be invaluable as sources of information that are relevant to twenty-first century environmental issues in that they indicate the identities of landowners or lease holders, the locations and materials of construction of buildings on production sites, and frequently include indications of specific production equipment. In providing this kind of detail, the maps reveal the locations of potential sources of pollution. Newtown Creek, a narrow but navigable channel separating Queens and Brooklyn, two outer boroughs of New York City, was one of the country's most productive industrial corridors during the nineteenth and early twentieth centuries. This paper describes the use of online maps to discover the history of chemical and oil production of Newtown Creek using the fine detail found on fire insurance maps of the time. These digitized maps, available from the Web site of the New York Public Library, establish not only the locations of the area's major oil refineries and chemical manufacturers, but also their methods of production. Of particular interest are the geographic and technological relationships between the producers of sulfuric acid and the petroleum refineries.

Geographical distribution of patients visiting a health information exchange in New York City.

ObjectiveFor a health information exchange (HIE) organization to succeed in any given region, it is important to understand the optimal catchment area for the patient population it is serving. The objective of this analysis was to understand the geographical distribution of the patients being served by one HIE organization in New York City (NYC).Materials and MethodsPatient demographic data were obtained from the New York Clinical Information Exchange (NYCLIX), a regional health information organization (RHIO) representing most of the major medical centers in the borough of Manhattan in NYC. Patients’ home address zip codes were used to create a research dataset with aggregate counts of patients by US county and international standards organization country. Times Square was designated as the geographical center point of the RHIO for distance calculations.ResultsMost patients (87.7%) live within a 30 mile radius from Times Square and there was a precipitous drop off of patients visiting RHIO-affiliated facilities at distances greater than 100 miles. 43.6% of patients visiting NYCLIX facilities were from the other NYC boroughs rather than from Manhattan itself (31.9%).DiscussionMost patients who seek care at members of NYCLIX live within a well-defined area and a clear decrease in patients visiting NYCLIX sites with distance was identified. Understanding the geographical distribution of patients visiting the large medical centers in the RHIO can inform the RHIO's planning as it looks to add new participant organizations in the surrounding geographical area.

Health of Older Adults in New York City Public Housing: Part 1, Findings From the New York City Housing Authority Senior Survey

Older adults are an important and growing part of the social fabric of New York City (NYC). As people age, they face health concerns that can affect their ability to live comfortable, independent lives. Recent national surveys have found that more than 60% of older Americans have multiple chronic conditions and 20% have a physical disability.1,2 The quality of life older adults experience can be greatly improved by living in supportive physical and social environments and having routine access to high-quality health care services. More than 61,500 New Yorkers aged 65 and older live in New York City Housing Authority (NYCHA) public housing developments. 3 Age group projections suggest that the growth of this group will outpace that of NYC's older adult population,4 as NYCHA residents are more likely to stay in their residences instead of moving into assisted living facilities or out of the City. The large and growing number of older NYCHA residents also presents tremendous opportunities to target health, social, and financial services towards older adults in NYC. Despite the critical financial relief provided by subsidized housing, poverty remains a critical challenge for many. Almost half of older NYCHA residents live with incomes below the federal poverty level. In general, lowincome adults have higher rates of chronic illnesses, have worse access to health care services, and receive poorer quality of care than higher-income adults.5-7 In 2007, NYCHA convened a multidisciplinary task force to develop a strategy and recommend actions to address the needs of its large and expanding older population. The same year, the Age-friendly New York City initiative was launched by the NYC Mayor's Office and City Council with the New York Academy of Medicine.8 Following these efforts, NYCHA collaborated with the New York City Departments of Health and Mental Hygiene (DOHMH) and for the Aging (DFTA), as well as with the City University of New York (CUNY) School of Public Health, to conduct a survey among NYCHA residents aged 65 and older to examine health status and barriers to care in the context of nearuniversal Medicare coverage. This report summarizes our survey findings, makes recommendations to improve physical and mental health outcomes among older public housing residents in NYC, and aims to promote a more informed dialogue among residents, community-based organizations, and City agencies on how best to improve quality of life for older New Yorkers living in NYCHA housing. About the Data More than 1,000 randomly selected adults aged 65 and older living in NYCHA housing were interviewed by telephone in June 2009 for the NYCHA Senior Survey. Participants' demographic information was obtained from the NYCHA Tenant Data System. Analyses presented in this report were statistically weighted to be representative of all older NYCHA adults, and all comparisons discussed in the text are statistically significant. Additional data sources were used to draw comparisons between the demographics and health of older NYCHA adults and those of older adults in NYC and the US. Qualitative feedback was gathered from meetings with resident leaders across the five boroughs and a variety of NYCHA officials and development-based staff. OVERVIEW OF THE NEW YORK CITY HOUSING AUTHORITY (NYCHA) NYCHA is the largest public housing authority in North America, comprising more than 178,000 apartments in 334 developments with 2,602 residential buildings throughout the five boroughs of NYC. Nearly 404,000 individuals officially reside in NYCHA's public housing developments. The first senior development exclusively for residents aged 62 and older, Gaylord White Houses in Manhattan, was completed in 1964. Since then, the number of senior developments has grown to 42, and 14 mixed family developments include designated buildings for older adults. In total, 10,000 apartments in NYCHA's public housing portfolio are reserved for older adults. …

Selfhelp Community Services: Innovations Help Older Men and Women Maintain Independence in a Changing World

INDEPENDENCE WITH DIGNITY Selfhelp is a 75-year-old, not-for-profit organization with a very specific mission: enable older adults age independently and with dignity, in their own homes despite continuous pressures and obstacles. Collectively, our wide range of services aims protect older adults' safety and independence in an ever-changing world. OUR ORIGINS To refer the mid-1930s as a time of change is a colossal understatement. It was a time of unconscionable persecution, with the Nazi regime driving thousands of men, women, and children flee Europe and seek refuge in America. A handful of concerned emigres banded together here in the United States, assembled a group of volunteers, and formed Selfhelp for German Refugees. Their goal was take in displaced persons who escaped without family, homes or money, and provide the resources enable them rebuild their lives. Moreover, their vow was, and still is, to serve as the last surviving relative victims of Nazi persecution. The organization later became Selfhelp of Emigres from Central Europe, reflect its widened scope. And in 1969, the name changed for the final time a term synonymous with what we offer an ever-expanding population base: Selfhelp Community Services. Over the years, Selfhelp earned a stellar reputation for providing the resources and support help ensure survivors' personal safety, housing, some degree of restitution, social work, health care, and socialization opportunities. We are, in fact, the largest provider of services for Holocaust survivors in North America, last year serving more than 5,300 individuals in the New York City area. Our track record in helping this fragile, vulnerable population has earned the attention of state legislators, New York City officials, and several national as well as international associations on aging. We have expanded our reach thousands more seniors, providing resources and new approaches make it possible for more men and women of all ethnicities age independently, with dignity, in their own homes. Today we serve more than 20,000 of the older adults and at-risk populations in four boroughs of New York City and in Nassau County. We build senior housing and establish services for the broad-based community. We provide home care, assistance with obtaining entitlements and benefits, legal advocacy for home-based services, and more. Perhaps our toughest challenge is identify and implement new approaches and mechanisms serve our clients in a constantly changing environment-impacted by shifting demographics in which the country's 65 years or older population will double in the next 20 years, drastic cuts in health care and home care, a shortage of affordable housing, escalating labor costs, shrinking city and state budgets for social service programs for the older adults, a global economic downturn, and the resulting philanthropic fundraising challenges that we and other not-for-profit organizations have been experiencing for years. Although we do not have a magic formula share with other organizations-one ensure resilience and nimble transformation- several of our endeavors have shown potential progress and dramatic results. The following is not so much a retelling of our chronological evolution, as it is a closer look at some of our specific programs which many of our partners, clients and contributors believe be the most innovative and successful. These three areas of innovation focus on Seniors and Technology, Pro-Independence Services at Home, and Continuing Insights and Innovations for Nazi Victims Programs. SENIORS AND TECHNOLOGY Using Technology Transform Lives, Improve Health, and Reshape our Future Since our founding, the Selfhelp approach has become known for its personalized, high-touch care and interactions with our clients. A case manager's relationship with a client often appears as close as that of a blood relative. …

Project to expand diversity in the nursing workforce

The Bronx, one of the five boroughs of New York City, has a diverse population, but the largest ethnic group is Hispanic, or Latino. More than half (53 per cent) of the students at Lehman College of the City University of New York are from this group, reflecting the population demographic of the borough, but in 2006 Hispanic students comprised just 8 per cent of those enrolled in the department of nursing. To address this disparity, the department undertook a project to increase recruitment, retention and graduation of Hispanic nursing students. The project involved several activities in collaboration with a Bronx high school, Lehman College's baccalaureate nursing programme, and a partner hospital that serves thousands of people of Hispanic origin. This article describes the project and the lessons learnt.

Thirty-Five Years and Counting BQSI/MB Formula for Success: Cooperation, Education and Resource Sharing

In 2010, the Brooklyn, Queens, Staten Island, Manhattan and the Bronx Health Sciences Librarians (BQSI/MB) celebrated its 35th anniversary. Over the years this organization has grown from a small group of hospital librarians to a much larger one that now includes medical librarians representing all types of institutions from all five boroughs of New York City. Along the way, the group met new challenges and achieved many goals. This article summarizes some key BQSI/MB experiences and achievements that may be of help to those in other library consortia.

Case fatality rates based on population estimates of influenza-like illness due to novel H1N1 influenza: New York City, May-June 2009.

BackgroundThe public health response to pandemic influenza is contingent on the pandemic strain's severity. In late April 2009, a potentially pandemic novel H1N1 influenza strain (nH1N1) was recognized. New York City (NYC) experienced an intensive initial outbreak that peaked in late May, providing the need and opportunity to rapidly quantify the severity of nH1N1.Methods and FindingsTelephone surveys using rapid polling methods of approximately 1,000 households each were conducted May 20–27 and June 15–19, 2009. Respondents were asked about the occurrence of influenza-like illness (ILI, fever with either cough or sore throat) for each household member from May 1–27 (survey 1) or the preceding 30 days (survey 2). For the overlap period, prevalence data were combined by weighting the survey-specific contribution based on a Serfling model using data from the NYC syndromic surveillance system. Total and age-specific prevalence of ILI attributed to nH1N1 were estimated using two approaches to adjust for background ILI: discounting by ILI prevalence in less affected NYC boroughs and by ILI measured in syndromic surveillance data from 2004–2008. Deaths, hospitalizations and intensive care unit (ICU) admissions were determined from enhanced surveillance including nH1N1-specific testing. Combined ILI prevalence for the 50-day period was 15.8% (95% CI:13.2%–19.0%). The two methods of adjustment yielded point estimates of nH1N1-associated ILI of 7.8% and 12.2%. Overall case-fatality (CFR) estimates ranged from 0.054–0.086 per 1000 persons with nH1N1-associated ILI and were highest for persons ≥65 years (0.094–0.147 per 1000) and lowest for those 0–17 (0.008–0.012). Hospitalization rates ranged from 0.84–1.34 and ICU admission rates from 0.21–0.34 per 1000, with little variation in either by age-group.ConclusionsILI prevalence can be quickly estimated using rapid telephone surveys, using syndromic surveillance data to determine expected “background” ILI proportion. Risk of severe illness due to nH1N1 was similar to seasonal influenza, enabling NYC to emphasize preventing severe morbidity rather than employing aggressive community mitigation measures.

Separate and unequal: The influence of neighborhood and school characteristics on spatial proximity between fast food and schools

ObjectiveSocial science and health literature have identified residential segregation as a critical factor in exposure to health-related resources, including food environments. Differential spatial patterning of food environments surrounding schools has significant import for youth. We examined whether fast food restaurants clustered around schools in New York City, and whether any observed clustering varied as a function of school type, school racial demographics, and area racial and socioeconomic demographics. MethodWe geocoded fast food locations from 2006 (n=817) and schools from 2004–2005 (n=2096; public and private, elementary and secondary) in the five boroughs of New York City. A point process model (inhomogeneous cross-K function) examined spatial clustering. ResultsA minimum of 25% of schools had a fast food restaurant within 400m. High schools had higher fast food clustering than elementary schools. Public elementary and high schools with large proportions of Black students or in block groups with large proportions of Black residents had higher clustering than White counterparts. Finally, public high schools had higher clustering than private counterparts, with 1.25 to 2 times as many restaurants than expected by chance. ConclusionThe results suggest that the geography of opportunity as it relates to school food environments is unequal in New York City.