Despite overall progress in recent years, Philadelphia’s health significantly lags behind other major cities. For example, among counties that contain the nation’s largest cities, Philadelphia has the highest rates of premature death, infant and child mortality, cardiovascular disease, hypertension, HIV, and homicide. Underlying these poor health outcomes are also high rates of behavioral and economic determinants, including smoking, poverty, single parent households, housing-cost burden, and low education.
Scroll to read more about the Health Rankings.
Where you live matters
These poor outcomes are not experienced across all communities in Philadelphia. Living just a few miles away can decrease life expectancy by nearly twenty years. Many Philadelphians live, learn, work, shop, and play in neighborhoods that make good health difficult to achieve. These contextual factors mediate genetic determinants of health and shape health behaviors. Ultimately, contextual factors both explain poor health and point toward potential solutions.
ABOUT THE RANKINGS
Using census tract-level data from various sources, a team from the Philadelphia Department of Public Health and from Dornsife School of Public Health at Drexel University created comprehensive community health and well-being rankings for neighborhoods throughout Philadelphia, composed of clusters of census tracts. These rankings elucidate which areas of the City are experiencing the poorest outcomes and facilitate targeted public health interventions and planning efforts to reduce health disparities in Philadelphia.
Using neighborhood-level health-related data in combination with data from other sectors about key determinants of health to understand and target health inequities in the most vulnerable communities in Philadelphia is an essential component of fostering a culture of health in those communities. It is virtually impossible to create healthier, more equitable communities without understanding the unique and underlying drivers of health outcomes in those communities. The Neighborhood Health Rankings provide key insights into community health and well-being and serve as a baseline for monitoring and improving health.
Methodology
To create neighborhoods, census tracts were grouped together based on boundaries created for the Southeast Pennsylvania Household Health Survey. Special land-use tracts with little or no residential population and special characteristics such as large parks or employment areas were not assigned to neighborhoods.
Based on methodology used by the Robert Wood Johnson Foundation County Health Rankings, data were collected from various sources, including the CDC 500 Cities, the US Census Bureau American Community Survey, the School District of Philadelphia, and the Pennsylvania Department of Health Vital Statistics. Using data at the census tract level, estimates for each measure were created for every neighborhood.
The included measures were assigned to several categories, weighted by importance, across two domains: health outcomes and health factors.
Health Outcomes
- Length of Life (50%)
- Quality of Life (50%)
Health Factors
- Health Behaviors (30%)
- Clinical Care (20%)
- Social and Economic Factors (40%)
- Physical Environment (10%)
The weighted scores for each category were aggregated and neighborhoods received rankings for both domains.
WHAT CAN BE DONE?
The neighborhood ranking results make clear several points:
- People living in poverty are more likely to develop the chronic diseases that are the leading causes of death and to have shorter life spans.
- Neighborhoods that are hit hard by poverty have substantially worse health statistics than wealthier neighborhoods. These health rankings show exactly how much income matters to health.
- These health rankings do not lay out solutions to these problems; that is not the purpose of this report. However, there are steps everyone can take to prevent the risk factors for the leading causes of death and to reduce disparities in health by income and by neighborhood.
Policy-makers can:
- Take steps to reduce poverty, such as supporting a higher minimum wage.
- Support efforts in low-income neighborhoods to improve access to healthy products (such as fresh fruits and vegetables) and reduce the over-supply of unhealthy products, particularly tobacco, alcohol, and junk food.
- Support efforts to reduce neighborhood blight and improve access to affordable housing.
- Support efforts to reduce community gun violence.
- Support infrastructure for active transportation (walking and bicycling) and engineering changes to improve safety for pedestrians.
- Expand access to health insurance for those not currently insured.
Health care providers can:
- Expand primary care services in under-served neighborhoods.
- Identify and treat risk factors for mortality, including obesity, hypertension, diabetes, and high blood cholesterol.
- Counsel patients to reduce or stop risky behaviors, particularly smoking, binge drinking, and drug use, and encourage healthy eating and physical activity.
- Identify and then refer or provide treatment for patients with mental illness or drug dependence.
People can:
- Avoid behaviors that increase health risks, particularly smoking, binge drinking, and drug use. Eat healthier foods, particularly fresh fruits and vegetables, and avoid junk food. Increase your physical activity, including walking regularly.
- Store guns unloaded and in a locked cabinet, safe, or case. Store ammunition in a separate locked container.
- If you are using opioids or other addictive drugs, seek treatment by calling 888-545-2600.
- If you having difficulty coping or have symptoms of mental illness, seek treatment by calling 888-545-2600.
Contributors
The mission of the Drexel Urban Health Collaborative at the Dornsife School of Public Health is to improve health in cities by increasing scientific knowledge and public awareness of urban health challenges and opportunities, and by identifying and promoting actions and policies that improve population health and reduce health inequities. Through three areas of emphasis, research and data, training, and community and policy engagement, the UHC works to advance knowledge, build capacity, and translate knowledge into community and policy actions to improve urban health in Philadelphia and in cities all over the world.
Jana A. Hirsch, MES, PhD
Steven Melly, MS, MA
Kari Moore, MS
Harrison Quick, PhD
Heather Rollins, MS
Guangzi Song, MS
The Philadelphia Department of Public Health (PDPH) promotes and protects the health of all Philadelphians and provides a safety net for the most vulnerable. The agency leads programs to prevent communicable diseases; prevent chronic diseases and promote healthy behaviors; prevent environmental health risks; investigate outbreaks of disease; respond to public health emergencies; and promote the health of women, children, and families. In addition, the department operates the eight City Health Centers that provide primary care to more than 80,000 Philadelphians. PDPH has been on the vanguard of public health, proposing policy solutions to problems like smoking and obesity, and intends to continue that tradition with creative solutions to both long-standing urban health problems and new crises.
Raynard Washington, PhD, MPH
Jessica Whitley, MPH
Sources
Centers for Disease Control and Prevention – 500 Cities
City Health Dashboard
County Health Rankings & Roadmaps
Leonard Davis Institute of Health Economics, University of Pennsylvania
Pennsylvania Department of Health Vital Statistics
Philadelphia Department of Licenses and Inspections
Philadelphia Police Department
School District of Philadelphia
US Census – American Community Survey
USDA Food Access Research Atlas
This research is based upon work supported by the Urban Institute through funds provided by the Robert Wood Johnson Foundation. We thank them for their support but acknowledge that the findings and conclusions presented in this report are those of the author(s) alone, and do not necessarily reflect the opinions of the Urban Institute of the Robert Wood Johnson Foundation