Health In the Rockaways: Report On The Elderly
By Miriam Rosenberg
The elderly in the Rockaways (age 65 and older) represent 14 percent of all those living on the peninsula according to Census 2000 (two percent more than all of New York City for the same age group). Those living in Nursing Homes represent about three percent of Rockaway's population.
It is not surprising, with this high concentration of elderly, that the city's Department of Health and Mental Hygiene has shown that Rockaway rates exceeded those of other communities in New York for many adult medical problems.
Hospitalizations for pneumonia and influenza were 90 percent higher than those in the entire city, for chronic lung disease it was two times as high as the city and for diabetes it was five percent higher than the city.
The death rates for residents in the Rockaways were higher in such categories as heart disease (90 percent higher), chronic lung disease (45 percent higher) and diabetes (20 percent higher).
"[There are] 25 nursing homes in the Rockaway community," said Dr. Peter Galvin, Peninsula Hospital's Chief Medical Officer. "Per capita, we have the highest rate of nursing homes, basically, anywhere."
"[These patients] tend to have multi-medical problems85because their im mune systems are compromised," continued Dr. Galvin. "Pneumonia in an 85 year-old nursing home resident, the outcome is probably not the same as pneumonia in you or I because they have all these other medical problems."
Dr. Raymond Pastore, St. John's Epis copal Hospital's (SJEH) Chief Medial Officer, pointed out that many hospital patients also come from the adult homes that are in the Rock aways.
"You have a large concentration of patients who really need a lot of care on the Peninsula," added Dr. Pastore.
Local health providers disagreed with DOH's finding that people smoke less in the Rockaways.
"I travel everyday around Far Rock away and wherever you go85you al ways see [kids] smoking," said Dr. Sne hanshu Ghosh, the Chairman for Ob-stetrics and Gynecology for St. John's. "The incidence of smoking is really not less. Maybe it's not picked up in the statistics, but what I see is there's a lot of smoking."
DOH's smoking statistics only counted adults, so the true numbers for those who smoke in the Rockaways is yet to be determined.
"We have a high rate of smoking, obesity, diabetes and hyper-tension," added Dr. Pastore. "It all contributes to heart disease."
Since education is the key, the health facilities in Rockaway have numerous ways of bringing education and preventive health to the elderly and the community in general.
Peninsula offers flu vaccines in their Family Health Center. They also ask patients, before discharging them, if they have been vaccinated or not.
"There's a lot of misinformation out there about flu vaccinations," ex plain ed Dr. Galvin, who said that many people believe they will get the flu by taking the vaccine. "You try to explain to them you can't get the flu from the flu vaccine. It's impossible.
"People don't realize if you're 65, 70, if you're over 50 certainly you should get the vaccine, without exception, unless you're allergic to eggs."
If you are under 50 but have medical problems like diabetes, getting a flu shot is also recommended because diabetes impairs the body's immune system.
St. John's offers flu vaccines in its Ambulatory Care Unit, JASA Medical and in internal medicine at the Tate Building in Far Rockaway.
"At JASA and our geriatrics clinics, our records indicate that 80 percent of our patients are vaccinated and the rest are largely refusals," said Daniel Buff, the Chief of the Division of Geriatrics for SJEH.
Besides giving flu vaccines, there other initiatives the hospitals take.
"I think the very first thing that we have to do is convince people that they have to go get themselves checked, even for routine checkups," said Dr. Galvin, about improving the health of Rockawayites.
Peninsula Hospital Center's Family Health Center provides screenings, checkups - the same as any primary doctor would do.
Each year, Peninsula hosts a health fair on the grounds of the hospital. Other times the hospital participates in community health fairs throughout the Rockaway area.
St. John's has an Ambulatory Care Center for outpatient visits.
Dr. Pastore described some of the measures that St. John's takes to help Rockaway's residents.
"At St. John's we place a high priority on preventive health education," explained Dr. Pastore. "In our ambulatory care centers, the physicians are responsible for conducting health education with each patient. The hospital has numerous community health initiatives including health education seminars, classes, speakers, and health fairs. In the past the New York State Department of Health supported our community health education efforts with a $400,000 primary care grant to conduct preventive health education and screenings utilizing our mobile health van."
The Joseph P. Addabbo Family Health Center (FHC) offers primary and preventive care to its patients.
"[It] has to do with public education and preventive health education - getting people into care and getting people to change behaviors," said Dr. Peter Nelson, the Executive Director at Addabbo, who called the health center's preventive programs aggressive. "We need to be focusing on these types of programs - smoking cessation, weight reduction85screening, and we've got to get money into the community for that."
Dr. Adam Karpati of the DOH discussed how, perhaps, Belle Harbor might not feel that they have much in common with Far Rockaway.
"Look, the leading causes of illness are heart disease, cancer, pneumonia, lung disease - these are the leading causes of death no matter where you are in New York City," said Dr. Karpati. "[In] any community you'll have the same issues - diabetes, stroke - the order might change in different neighborhoods - but the bottom line is that these issues that we raise are the issues for all communities. It's about cholesterol and high blood pressure control; it's about obesity. These are not just issues for one neighborhood. These are issues for any neighborhood."
Next week Brendan Brosh, The Wave's Assistant Editor, will report on mental health, HIV/AIDS and drug abuse in the Rockaway area.