Health outcomes in Philadelphia are a mixed bag

Just in time for the New Year, the Philadelphia Department of Public Health released its “Health of the City 2018” report. This document is a comprehensive and easy-to-read snapshot of where Philadelphia — the nation’s sixth largest city — stands in terms of overall health outcomes. Anyone who cares about the city should read it — especially those whose livelihood depends upon a vibrant and healthy populace.

The Inquirer’s Aubrey Whelan did a great job summarizing the report, so I’m just going to highlight a few of the key findings and make a larger point about why this matters.

The story this report tells is about a city challenged by the deathly grip of the opioid epidemic. Drug overdoses are the third leading cause of death behind heart disease and cancer, taking the lives of over 1,000 people in 2017. And unlike the other conditions, overdoses generally kill much younger people resulting in many years of potential life lost and a significant decrease in the city’s overall life expectancy. Opiate addiction is also fueling a drop in income, an increase in homelessness, more emergency department visits, more babies born addicted and more HIV infections transferred through illicit injections.

This report also describes a city divided by race, income and neighborhood. Asian women are predicted to live 98 years in contrast to 69.1 years for black men. The racial disparity in health outcomes tends to disappear for the wealthy. And since we’re a city where rich and poor tend to live in different neighborhoods, we see large differences in life expectancy depending on where you look. The range by census track varies from a low of 64.3 years to 87 years.

While violent crime overall is down, the homicide rate is second only to Chicago. Violence and homicides — mostly gun related — tend to afflict only socio-economically disadvantaged neighborhoods.

There is good news in the report. Many health behaviors are improving: smoking, binge drinking, teen births, sweetened beverage consumption (yay, soda tax) are down. Health insurance coverage and access to care is up (yay, Obamacare). This bodes well for a healthier future.

So, why should we care? Aside from the moral imperative to ensure every Philadelphian lives a long and healthy life, we all have an economic stake in the city’s health outcomes. A healthier population lowers healthcare costs for insurers and the employers, employees and taxpayers who ultimately pay for that care. Further, healthy people are more productive and ready to work. A healthier city can devote more resources to programs and activities that improve everyone’s quality of life rather than just fix what’s broken.

One highlight of the report is the decrease in the number of children hospitalized for asthma and diagnosed with lead poisoning. This doesn’t happen by accident. It requires a concerted community effort to address housing issues and get these kids into care earlier. But the payoff from these efforts is great. Childhood lead exposure can initiate a cascade of challenging consequences including lower IQ, behavioral and learning disabilities, hyperactivity, higher incarceration rates and decreased lifetime earnings. We as taxpayers will have to pay for the extra services lead-burdened children (and adults) will need and make up the difference for the taxes they won’t be paying.

So, in 2019 let’s take a long, hard look at what’s working and not working for our fellow Philadelphians and resolve to make every group, every neighborhood and every person healthier. To borrow a phrase, a rising tide of health lifts the boat for everyone.