2004-01-30 / Community

Health In The Rockaways And Broad Channel

By Miriam Rosenberg

Maternal, Infant and Children's Health ConcernsPart Two Of A Five-Part Series
Contributing Editor

Lillian Ayala, 4, of Far Rockaway takes a pulmonary function test administered by Elaine Dechagas at the St. John's Hospital/Health First Children's and Teen Health Fair last summer. The test detects respiratory diseases such as asthma.Lillian Ayala, 4, of Far Rockaway takes a pulmonary function test administered by Elaine Dechagas at the St. John's Hospital/Health First Children's and Teen Health Fair last summer. The test detects respiratory diseases such as asthma.

Some of the most startling information contained in the De partment of Health and Men tal Hygiene (DOH) health profile on the Rockaways concerns maternal and infant health along with the health of children in the area.

Lack of prenatal care, high numbers of babies born with low birthweight and infant mortality on the peninsula appear to be significant problems.

In 2001, 45 percent of women re ceived late prenatal care, or none at all - that's 15 percent higher than the rest of the city, and 35 percent higher than the national goal. Babies born in the Rockaways with low birthweight was 12 percent, which is also higher than the other city neighborhoods and the national goal. From 1999 to 2001, for every 1,000 live births there was an 11 percent infant mortality rate (deaths of babies under one year of age) in the Rockaways. It is an almost five percent jump from the citywide average. The infant mortality rate is the most alarming number of all.

DOH Assistant Commissioner Dr. Adam Karpati was in charge of putting the data together from the different sources used by the agency.

"Infant mortality is a sensitive marker of the overall health of a community," said Karpati. "It's more than just about mothers and child. It's sensitive not only to the medical care situation; it's sensitive to the overall situation."

Karpati said people living in the Rockaways have burdens that other communities in the city do not, such high infant mortality, hospitalization and adult mortality rates.

"African-Americans have the poorest health when it comes to maternal health," continued Karpati. African-Americans make up about 40 percent of the population in the Rockaways, and Karpati said that poor maternal health in that community goes across socio-economic lines.

There is a higher incidence of hyper-tension and diabetes among Amer ican-Americans, said Raymond Pas tore, St. John's Episcopal Hospital's Chief Medical Officer, about things that affect maternal health in the African-American community.

Obesity in the mother can also contribute to low birthweight babies.

"[The women] really don't come [to our clinic or prenatal providers] early enough for prenatal care," added Dr. Snehanshu Ghosh, the Chairman of Obstetrics and Gynecology at St. John's. "A lot of tests can't be done unless they come early enough."

Every medical provider repeated that education was the main solution.

Although the hospital has outreach programs and works with the Joseph P. Addabbo Family Health Center (FHC), Ghosh said more needs to be done.

"It's a social issue which has to be addressed all the way from the high school level to the community level ," continued Ghosh. "There needs to be an outreach program in the community to increase the awareness of our population. The institution can't do it alone. It needs help from the community to reach out to these people and make sure they understand how much of a problem it is for them not to come [in for prenatal care]."

The medical providers interviewed agreed that Rockaway's hospitals and the Addabbo FHC should work together to help the community.

"I think it's going to take a large social marketing campaign program that can best be done by all of us [the hospitals and the Addabbo FHC] working together85.to raise the consciousness of women between the ages of 14 and 45, in those child bearing years, to really be aware of the fact that as soon as they have any hint that they are pregnant to get to the doctor," said Dr. Peter Nelson, the Executive Director at the Addabbo (FHC).

All parties said there are no economic barriers for women to find prenatal care in the Rockaways.

In children's health, the profile found that children living in the Rockaways have a higher level of hospitalization for asthma than children in other neighborhoods of the city.

Asthma might not seem like the kind of problem that the Rockaways should be concerned about. Yet it is. The cause could range from parents cigarette smoking, air pollution, allergies, animals or mold in the home.

Nelson came up with another theory. "Studies show asthma belts in New York City," he said.

"These asthma belts are around either the major airports or they follow major transportation routes where trucks most frequently go by."

Early warning signs of childhood asthma is shortness of breath or huffing and puffing after exercise or running said Dr. Peter Galvin, the Chief Medical Officer of Peninsula Hospital.

"The first thing [a parent] needs to do is to get the child evaluated by a competent pediatrician who may actually refer the child to a pulmonologist and have an actual pulmonary screening done," said Galvin.

Both Rockaway hospitals and Addabbo FHC treat pediatric asthma.

St. John's has an outreach program that goes into the community and schools.

"We've educated the parents in terms of how to treat the patient and how to avoid hospitalizations," said Pastore, who also pointed out that St. John's provides its patients with free nebulizers if the parents cannot afford them.

Galvin also said there is a link between asthma and childhood obe- sity.

"We have to educate parents first," said Galvin. "They have to be more observant of what their children are eating and be stronger in terms of telling the children don't eat this, eat this."

Childhood obesity can also be linked with juvenile diabetes or adult onset diabetes.

"Eating habits you develop as a child will carry you through adulthood," explained Galvin, who added that parents teach eating habits to their children.

Next week The Wave will report on the elderly and the health findings that affect seniors and the community in general.

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