As a reminder, here is a key quote:
>In essence, there is a health gap emerging between our massive metropolis
>and the rest of the country—some X factor that’s improving our health in
>subtle, everyday ways.
I know we have all seen this before and despite the source (NY Magaz), somehow I still become aghast at how the well off in America have moved into self-congratulatory class bubble. They manage not to even know about the majority - those pushed out or just passed over by the new economy.
New York City has swapped populations to a surprising degree. Surely it is obvious that a good part (not necessarily all) of the change in health status is due to the demographic switch in the population (the data the article presents is for current NYC residents, not a longitudinal study of those who used to live there see http://www.nyc.gov/html/doh/downloads/pdf/vs/2004sum.pdf ). Despite what the article says, NYC has a lower cancer or cardiac death rate than the rest of the country because of its new demographics - not because of "leadership" and NYC's "specialness". Even homicide and AIDS deaths are partly a demographic phenomena since the article is comparing NYC today with the rest of the country today.
Many of the former industrial working class - black, latino, white - have been forced out of New York City (into poorer areas outside the City, and dispersed throughout the country). Often their elderly parents must follow (especially given the cost of nursing homes in NYC). They have been replaced with more affluent whites (from the suburbs and around the country) and "new immigrants" from abroad, many of them undocumented.
Those who have been forced out - born and bred New Yorkers - are now included in the poor health numbers for "outside" New York. They disappear from the NY statistics and it is all called a success. Of course the new comers that are affluent have better health bringing the numbers up. And the new immigrants (by dint of the difficulty of immigration) are young and (for now) the healthier part of the population of their country of origin. They have much better health *at the moment* than, for example, the older and more urbanized populations of African Americans and native born Latinos. Indeed, new immigrant Latina's have better birth outcomes *in NYC* than native born NewYoricans or African American New Yorkers of the same age group. New York is more and more clustered around these 2 extremes and now has a gini coefficient (a measure of income inequality) higher than Brazil.
This demographic swap has been amply documented, including in the elite media (see for example http://select.nytimes.com/search/restricted/article?res=F20C1FFA3F5C0C7A8CDDA10894DF404482). But a casual walk through New York's neighborhoods should make this obvious to any New Yorker. Fabled working class neighborhoods have been gentrified or are now Mexican and Asian. Lower East Side/East Village, Hell's Kitchen, Spanish Harlem, Harlem, Sunnyside, Flushing, Williamsburg, etc. How can people be so blind?
Yet the author grasps for extraordinary explanations, mixed in with the politicians' self-promotions. Ironically, the contrived explanations include that New Yorkers exercise by walking around (apparently with their eyes shut to who are their new neighbors). It gets nasty when the article claims the change in NYC Parks has improved health (actually they have been fencing off and privatizing Parks and eliminating youth exercise for the poor). And it gets downright vicious to claim that the poor that remain in a gentrified NYC neighborhood (not many can, actually) so benefit from the privilege of living near the new Wall Street rich that now have a health status equal to the wealthy ! (ever try finding affordable food shopping and basic services in those gentrified neighborhoods?)
I will not dwell on the finer points of the life expectancy data that also mislead: (e.g. these days fewer working class elderly spend their whole retirement until the very end in NYC, so their deaths are not counted as those of NYC residents; or that the City exaggerates some numbers by adjusting in accordance with the 1990 enumerated census that missed so many poor NYers).
The real point here is: out of sight, out of mind.
Paul
Doug H. forwarded:
><http://nymag.com/news/features/35815/?ftr-promo>
>
>Why New Yorkers Last Longer
>This city, once known as a capital of vice and self-destruction, is
>now a capital of longevity. What happened?
>By Clive Thompson
.....