From substance abuse to hunger to violent crime, DC residents experience a wide range of interrelated health concerns. These concerns are best addressed by looking at prevention methods first. Through this graphic, we explore a number of critical issues that public health practitioners are working to address through a variety of on-the-ground initiatives.

Population: 646,449

According to the US Census Bureau, the estimated population of DC increased 7.4% over its 2010 population of 601,767.

Race: Though the African American population has decreased in DC, it still comprises half of the population. In the 1980s, 70% of the population was African American. In 2000 it dropped to 61%.

DC’s Hispanic population has grown 14.8% from 2010 to 2012 – outpacing the national average of 5.1%.

Median Age: 33.8 Years

DC’s population is getting younger. Between 2000 and 2010, the 18 to 34-year-old age group grew by 37,000. Millennials (young adults between the ages of 18 and 34) represent 35% of the DC population, compared to 23% nationally.

Life expectancy for DC residents in 2012: 77.5 years

Heart disease and cancer are the two leading causes of death among residents, accounting for 50% of the deaths in the last five years, reported the Department of Health.

Tobacco use is the single most preventable cause of death and disease in the United States. In Washington, DC, 700 adults die each year from smoking, and 7,000 kids under the age of 18 will ultimately die prematurely from smoking.

Throughout the DC metropolitan area – which includes counties in Virginia and Maryland – the poverty rate was 8.4% in 2010 (compared to 6.8% in 2007).

The top fifth of income earners in DC earn on average 29 times more than the bottom fifth.

In the District specifically, the poverty rate was 19%, more than double that of the DC metropolitan area. The average poverty rate across the US is 15%.

Residents of Wards 5, 7 and 8 are more likely to suffer from chronic diseases than residents of other wards.

The District of Columbia covers 30% of residents through health insurance programs, including Medicaid, Medicare, DC Healthcare Alliance, SCHIP and Healthy DC.

To counteract the low availability of providers, the District has increased Medicaid and Alliance reimbursements.

Using a model public/private partnership called Medical Homes DC, which has worked with the DC Department of Health, the District is trying to improve access to quality primary care in medically underserved neighborhoods.

DC Healthy Families

http://dhcf.dc.gov/service/dc-healthy-families

National Health Equity Coalition

http://www.nationalhealthequitycoalition.org/main/default.aspx

Health Equity Initiative (HEI)

http://www.healthequityinitiative.org/about

Reasons for the HIV/AIDS epidemic*

Lack of access to health care

Unprotected sex

Lack of awareness of HIV status

High rates of other sexually transmitted infections

Drug use

High poverty rate

The above list is in no particular order.

2.4% of the population in the District is living with HIV.

Men in DC are three times more likely to be diagnosed with HIV as women (4,238.8 per 100,000 men versus 1,422.4 per 100,000 women).

HIV Prevalence Rates per 100,000 by Sex, Race/Ethnicity, for Adults/Adolescents, 2010

6,344.1 – Black men

2,996.7 – Latino men

2,601.5 – Black women

2,374.1 – White men

593.6 – Latinas

106.4 – White women

Overall DC Rate: 2,739.0

6.5 million male and female condoms were distributed in 2013, 5.7 million in 2012 and 4.6 million in 2011.

In a DC needle-exchange program, 648,000 syringes were exchanged in 2013.

Routine HIV testing expanded. In 2011, 120,000 publicly supported HIV rapid tests were distributed in DC.

High percentage of HIV testing: 68% of DC residents aged 18-64 report ever having been tested for HIV (which is higher than any other state).

Pre-exposure prophylaxis, or PrEP, is an emerging HIV prevention intervention in which HIV-negative individuals take an antiretroviral to reduce their individual risk of acquiring HIV.

HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA)

http://doh.do.gov/page/hivaids-hepatitis-std-and-tb-administration-hahsta

Metro Teen Aids

http://metroteenaids.org/site/

Whitman-Walker Health

http://www.whitman-walker.org/

DC is ranked 21st for the highest prescription drug overdose mortality rate in the United States. This translates to 12.9 overdoses from prescription drugs per 100,000 people, a 55% increase since 1999.

11.3% of people 12 years and older abused or were dependent on alcohol or drugs between 2010-2011, compared to the national average of 8.9%, reported SAMHSA.

In October 2013, Trust for America’s Health (TFAH) gave Washington, DC a score of 6 out of 10 for implementing strategies that could reduce prescription drug abuse, which include:

Doctor shopping laws

Good Samaritan laws

Support for substance abuse treatment services

Rescue drug laws

Physical exam requirement

Lock-in programs

For the state-by-state scoring, each sate received one point for achieving an indicator, or zero points if it did not achieve the indicator. Zero is the lower possible score, 10 is the highest.

Addiction Prevention and Recovery Administration (APRA)

http://doh.dc.gov/service/doh-substance-abuse

Regional Addiction Prevention Inc. (RAP)

http://www.rapinc.org/

Substance Abuse and Mental Health Services Administration (SAMHSA)

http://www.samhsa.gov/

House of Ruth

http://www.houseofruth.org/

In 2008-2012, 30.5% of households with children in DC could not afford enough food, the second worst rate in the nation. By comparison, food insecurity for households without children was 13.5%.

Wards 7 and 8, with the highest poverty rates, have the city’s highest obesity rates.

Only 48% of full-service grocery stores accept WIC.

Between 2010 and 2013, 12% of DC households were food insecure, compared to 12.9% nationally. The US Department of Agriculture (USDA) defines “food insecurity” as a limited availability of, or inability to acquire, nutritionally adequate and safe food for a household.

Grants for before-and-after-care nutrition program

Funding to promote physical activity and nutrition in childcare programs

Washington, DC ranks first in the nation for reaching children with summer meals through the DC Free Summer Meals Program, administered by the Office of the State Superintendent of Education (OSSE).

DC Central Kitchen

http:/www.dccentralkitchen.org/

DC Hunger Solutions

http://www.dchunger.org/

DC Free Summer Meals Program (FSMP)

Miriam’s Kitchen

http://www.miriamskitchen.org/cause

Low-income populations are disproportionately impacted by obesity. In DC, 41% of residents are considered to be “low-income”.

22% of DC residents are obese.

15% of the deaths in the District are related to poor diet and obesity.

35% of DC children ages 10 to 17 are obese or overweight and are at risk for high blood pressure, diabetes and heart disease.

21% of DC residents do not engage in physical activity on a monthly basis.

Obesity rates within the District contribute to an estimated $400 million in yearly health care costs.

Access to parks and recreational spaces can help reduce obesity and the risk of chronic diseases including heart disease and diabetes.

DC is revamping its Master Plan for Parks.

The DC mayor designated $35 million to improve 32 playgrounds.

19.7% of the city’s 39,071 acres are parks, or 7,679 acres of parks.

Walking and biking can lower obesity rates, helping to prevent chronic health problems.

2,300 bike racks have been installed since 2001.

In 2010, 9,300 DC residents (3%) biked to work daily.

In 2010, 35,000 DC residents (12%) walked to work daily.

*Look to the hunger section above for solutions connected to the role food access plays in this issue.

American Public Transit Association

http://voicesforpublictransit.org./

Capital Bikeshare

http://capitalbikeshare.com/

DC Department of Parks and Recreation

http://dpr.dc.gov/

In 2013, air quality in DC had a failing grade, according to the American Lung Association.

Ozone: Grade F (unhealthy)

Particle pollution: Grade C (unhealthy for sensitive populations)

Median age of water main pipes in DC: 78 years old, including 9% that were installed in the 1900s and 2% as old as the 1800s, before the Civil War.

DC Water (utility) serves more than 600,000 residents and 17.8 million visitors every year.

Driving less, using public transportation and bike-sharing opportunities

Checking vehicle emissions and keeping non-passing vehicles off the road

Conserving electricity and energy

Not burning wood or trash

Asking legislators and government officials to support measures that cut air pollution

Since 2005, the concentration of nitrogen dioxide, a pollutant linked to adverse effects on the respiratory system, has decreased, which resulted in DC experiencing a drop in the number of days in which air quality falls below federal health standards.

DC Environmental Network

http://www.dcen.net/

Clean Air Partners

https://www.mwcog.org/environment/air/partners/

Anacostia Watershed Society

http://www.anacostiaws.org/

Neighborhood Farm Initiative

http://www.neighborhoodfarminitiative.org/about-us/our-mission/

In 2012, DC’s murder rate ranked 8th among the nation’s most populated cities with a count of 88.

Between 1990 and 1995, 2,643 people were murdered in DC – an average of more than 400 deaths per year.

In 1990, there were 474 homicides in the District. In 2013, there were 104.

The number of victims under the age of 18 has declined: 20 in 2008 compared to three in 2012.

Since the 1990s, federal and city law enforcement agencies led several initiatives to target violent crime including:

Federal Assistance Project: An infusion of resources from 18 federal agencies helped target violent crime and enhance enforcement efforts.

Project Ceasefire: This initiative increased the number of attorneys focused on gang violence, created an Intelligence Unit and launched a media campaign to raise awareness of gun violence.

Homicide Prevention Project:  By facilitating coordination among detectives and narcotics investigators, this project closed over a dozen homicide cases.

The Hot Spot Imitative: 18 participating agencies developed targeted work plans to make an impact on crime in 14 neighborhoods.

Project Safe Neighborhoods: This national anti-gun violence campaign emphasized collaboration among law enforcement agencies.

National Crime Prevention Council

http://www.ncpc.org/programs

DC Metro PD Safe City Project

http://mpdc.dc.gov/node/214292

District of Columbia Crime Policy Institute

http://www.dccrimepolicy.org/