AGE FRIENDLY BROOKLYN We are pleased to present this report summarizing the results of a 2018 survey of nearly 2,000 older Brooklynites and outlining a series of recommendations to improve their quality of life. This is the first important step in Age-friendly Brooklyn, a joint effort between the Brooklyn Borough President’s Office and The New York Academy of Medicine (NYAM), to ensure that people of all ages and abilities can enjoy and contribute to the borough. We deeply appreciate the extensive survey outreach and data analysis conducted by Jialiang Li and Harpreet Kaur from the CUNY School of Public Health and Health Policy and Leah Todd from the SUNY Downstate School of Public Health. We are also grateful to all of the people and organizations who took the time to complete and disseminate the survey, including but not limited to: AARP, OATS, United Neighborhood Houses, United Community Centers, St. Nicks Alliance, LiveOn NY, the Brooklyn Public Library, the New York City Department for the Aging, and Stefani Zinerman and the Age-friendly District 36 Ambassadors. Finally, we acknowledge the team that has helped to bring Age-friendly Brooklyn to fruition, especially: Nannearl Blackshear, Stefan Ringel, Eileen Newman, and Sandra Chapman of the Office of the Brooklyn Borough President; Lindsay Goldman, Ahsia Badi, Diane Kolack, Elana Kieffer, Alyssa Kies, Carolyn Stem, Linda Weiss, and Jo Ivey Boufford of NYAM; Marianne Fahs of CUNY, and Pam Brier of Hunter College. With strong community partners, including the Brooklyn Chamber of Commerce, the Brooklyn Community Foundation, and the Brooklyn Public Library, we are committed to using the information collected to build an even better, more equitable Brooklyn where young and old can live healthy and meaningful lives. We look forward to working together with residents, service providers, arts and cultural institutions, local businesses, and many others to achieve this vision. Eric L. Adams Judith A. Salerno, MD, MS Brooklyn Borough President President, The New York Academy of Medicine Contents Introduction: Brooklyn’s Older Adults .......................................................................................... 2 Background: Age-friendly Brooklyn............................................................................................... 5 Methodology .................................................................................................................................. 5 Limitations ...................................................................................................................................... 6 Survey Participants......................................................................................................................... 7 Findings: Outdoor Spaces and Buildings ..................................................................................... 11 Findings: Transportation .............................................................................................................. 16 Findings: Housing ......................................................................................................................... 17 Findings: Respect, Social Inclusion, and Social Participation ..................................................... 19 Findings: Civic Participation and Employment ............................................................................ 27 Findings: Access to Information and Services ............................................................................. 30 Next Steps ..................................................................................................................................... 33 Appendix A: Survey ...................................................................................................................... 34 Appendix B: Classification of Brooklyn Geography .................................................................... 38 Appendix C: Survey Responses by Community District .............................................................. 40 Bibliography.................................................................................................................................. 41 1 Introduction: Brooklyn’s Older Adults Nearly one-third of New York City’s 1,168,268 million adults aged 65 and older live in Brooklyn. 1 These 337,741 individuals comprise 13% of the borough’s 2.6 million residents. By 2040, this population is projected to grow to over 428,845, becoming 15% of the population.2 TOP TEN NEIGHBORHOODS WITH THE HIGHEST CONCENTRATION OF OLDER ADULTS IN 2017* RANK NEIGHBORHOOD PERCENTAGE POPULATION OF TOTAL OF ADULTS AGES ADULTS AGES POPULATION 65+ 65+ 1 West Brighton 35.3% 5,559 15,754 2 Starrett City 29.1% 3,607 12,388 3 Brighton Beach 22.8% 7,804 34,157 4 Sea Gate-Coney Island 19.3% 5,717 29,677 5 Sheepshead Bay, 19.1% 12,695 66,293 Gerritsen Beach, Manhattan Beach 6 Gravesend 18.2% 5,523 30,288 7 Madison 17.4% 6,984 40,122 8 Georgetown, Marine 16.1% 7,735 47,997 Park, Bergen Beach, Mill Basin 9 East Bensonhurst 15.7% 10,107 64,267 10 Bath Beach 14.7% 4,888 33,163 NEIGHBORHOODS PROJECTING THE MOST DRAMATIC INCREASE OF OLDER ADULT RESIDENTS FROM 2010-2030 RANK NEIGHBORHOOD TOTAL PROJECTED PROJECTED POPULATION 65+ POPULATION POPULATION IN 2010 CHANGE AGE 65+ CHANGE AGE 65+ FROM 2010 TO FROM 2010 TO 2030 2030 1 DUMBO-Vinegar Hill- 3,081 207.4% 6,389 Downtown Brooklyn- Boerum Hill 2 Williamsburg 3,261 124.8% 4,068 3 Prospect Heights 1,640 92.0% 1,508 4 Fort Greene 2,998 86.4% 2,592 5 East New York 2,394 69.0% 1,652 * Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the population of older adults in Brooklyn as a percentage of the total population, by neighborhood 2 Women make up 60% of the population of older Brooklynites. Slightly over 50% of the older adult population of Brooklyn is non-white, with African Americans (34.2%) and Asians (9.6%) comprising the largest racial groups. Hispanics/Latinos make up 14.5% of older adults (of any race).1 More older adults are foreign born (55%) than native-born. Almost all (90%) of these foreign-born older adults have lived in the U.S. for 18 years or more. Nearly half (48%) speak a language other than English at home, and slightly more than one-third (36%) speak English less than very well. 1 Neighborhood conditions can facilitate or impede access to health-promoting resources for older people. Living in economically disadvantaged communities, often characterized by lower quality housing, high levels of crime and pollution, and fewer resources, is associated with more chronic health conditions, mobility challenges, high levels of stress, and shorter life spans among older residents.3 As indicated by the charts below, life expectancy significantly varies by neighborhood. Brownsville has the lowest life expectancy of any neighborhood in Brooklyn and in New York City. RANK NEIGHBORHOOD LOWEST RANK NEIGHBORHOOD HIGHEST LIFE LIFE EXPECTANCY EXPECTANCY 1 Brownsville 75.1 years 1 Borough Park 84.2 years 2 Bedford- 76.9 years 2 Bensonhurst 83.8 years Stuyvesant 3 Sheepshead Bay 83.7 years 3 East New York 78.6 years 4 Bay Ridge 83.1 years 4 Crown Heights 79.3 years 5 East Flatbush 82.6 years North 5 Sunset Park 82.6 years 5 Coney Island 80.4 years Source: NYC DOHMH, 2017, Summary Of Vital Statistics 2015 The City Of New York4 A large older population can stimulate economic growth and bring added social and financial capital to Brooklyn communities and institutions—if older people can remain actively involved in public life. Often among the most civically engaged,† older adults have higher voting rates than other age groups. Older adults have a strong economic impact on Brooklyn, as reported in the Brooklyn Chamber of Commerce’s economic assessment in 2017. The report showed that Brooklyn’s older adults earned nearly $9 billion in annual income and contribute more than $7 billion to the local domestic product per year.5 With the exception of Greenpoint, all neighborhoods in Brooklyn are projecting an increase in their percentage of residents over the age of 65.‡ † Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of older adults in Brooklyn that voted in the 2016 presidential primary, by neighborhood ‡ Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the population growth projections of older adults in Brooklyn, by neighborhood 3 The table below shows the neighborhoods in which the 65 and older population is projected to increase most dramatically: RANK NEIGHBORHOOD TOTAL PROJECTED PROJECTED POPULATION POPULATION POPULATION 65+ IN 2010 CHANGE AGE CHANGE AGE 65+ FROM 65+ FROM 2010 TO 2010 TO 2030 2030 1 DUMBO-Vinegar Hill- 3,081 207.4% 6,389 Downtown Brooklyn-Boerum Hill 2 Williamsburg 3,261 124.8% 4,068 3 Prospect Heights 1,640 92.0% 1,508 4 Fort Greene 2,998 86.4% 2,592 5 East New York 2,394 69.0% 1,652 6 East Bensonhurst 9,956 61.4% 6,115 7 Dyker Heights 6,995 57.9% 4,049 8 Cypress Hills-City Line 3,689 57.4% 2,119 9 Bath Beach 5,111 55.9% 2,859 10 West Bensonhurst 13,241 55.0% 7,285 4 Background: Age-friendly Brooklyn Beginning in 2018, the Brooklyn Borough President’s Office partnered with The New York Academy of Medicine (NYAM) to launch Age-friendly Brooklyn—an initiative that builds on earlier neighborhood-specific work and an accessibility audit of Brooklyn Borough Hall—to make the entire borough inclusive and welcoming to older people. Age-friendly Brooklyn is working to: • Regularly solicit feedback from older people about their quality of life to inform neighborhood planning processes; • Create new opportunities for health and well-being and increase social, physical, and economic participation; • Better connect older people with information and resources; and • Mobilize older people and their service providers to advocate for local age-friendly improvements. As part of Age-friendly NYC, the City’s long-standing partnership between NYAM, the Mayor’s Office, and the City Council, Age-friendly Brooklyn uses a framework developed by the World Health Organization that asks older people about their daily lives with respect to:  Outdoor spaces and buildings  Transportation  Housing  Social participation  Respect and social inclusion  Civic participation and employment  Communication and information  Community support and health services7 Collectively, these are known as the Eight Domains of an Age-friendly Community. This report summarizes the findings of a survey covering the Eight Domains that asked people about their experiences living in Brooklyn in 2018. Through the launch of Age-friendly Brooklyn, the Brooklyn Borough President has committed to working with the City and private-sector partners to make improvements to local resources, institutions, services, and amenities that reduce or eliminate barriers identified through the survey, where possible. Methodology The Age-friendly Brooklyn survey included questions about basic demographics and health status; the availability, accessibility, and proximity of jobs, services, and resources for older people; and built- environment features (see Appendix A: Age-friendly Brooklyn Survey). The target population included all adults aged 18 and older who live, work, or partake in activities in Brooklyn, with a focus on those aged 65 and older. The survey was available in English, Spanish, and Chinese, in hardcopy and online, from May 1, 2018- September 30, 2018. A total of 1,895 responses were collected. Respondents were concentrated in northern Brooklyn. Outreach was conducted in-person and via digital platforms, including listservs, newsletters, and social media by the Brooklyn Borough President’s Office, NYAM, AARP, the Brooklyn Public Library (BPL), the New York City Department for the Aging (DFTA), pro-bono marketing by FY-Eye, existing Age-friendly Neighborhood Initiatives (such as the Age-friendly Ambassadors of Bedford-Stuyvesant), and community-based organizations 5 including JASA, United Neighborhood Houses, United Community Centers, St. Nicks Alliance, and Older Adults Technology Services (OATS). The survey was self-administered with assistance provided on-site, as necessary, by two graduate students from the CUNY School of Public Health and Health Policy and one graduate student from the SUNY Downstate School of Public Health. The CUNY students provided verbal language access for Mandarin Chinese, Hindi, Urdu and Punjabi. The students spent the fall of 2018 analyzing the primary data collected, working to identify any statistically significant associations, and contextualizing the data using the IMAGE:NYC Interactive Map of Aging, an open-source map of New York City’s current and projected population aged 65 and older with overlays of age-friendly resources, services, and amenities by neighborhood. Limitations Due to limited time and funding, our survey used a convenience sample of older adults, a majority of whom received the survey at senior centers. We were unable to directly target homebound older adults, and those with cognitive, hearing, and/or vision impairments. As a result, our sample may be biased towards older people who are more active and in better health. Additionally, we did not administer the survey in Russian; 10% of people aged 60 and over speak Russian with limited English-speaking ability in Brooklyn.8 As such, this sample is not necessarily representative of the population aged 65 and older in Brooklyn. Because the surveys were self-administrated and voluntary, some participants submitted incomplete questionnaires, which led to missing data. This missing data may have diluted the representativeness of demographic and geographic samples for the analysis and may have also confounded the estimation of parameters. We saw lower response rates in some districts including Borough Park, East Flatbush, Sunset Park, and Crown Heights. To overcome very small local sample sizes in our geographic analysis, surveys were divided into four geographic categories based on zip code selection (see Appendix B: Geographic Distribution and Appendix C: Survey Responses by Community District). In general, we found that we had a greater survey response in the north and south geographic categories and fewer respondents from central and east Brooklyn. Survey Responses by Location in Brooklyn 1,242 answered/653 did not answer 1000 800 600 400 200 0 Central East South North Further, we saw uneven survey sampling, with a greater number of survey collections in communities where there is an active older adult population that is engaged and successfully advocates for their own needs (i.e., 6 Community Board 3). This uneven sampling may have influenced the results of the survey, especially from those neighborhoods where people are more civically active. Survey Participants We received 1,895 survey responses from adults 18 and older who live, work, or participate in activities in Brooklyn. Nearly 67% were aged 65 and over, and 72% were female. Survey Responses by Age 1,734 answered/161 did not answer 400 350 300 250 200 150 100 50 0 18-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 Over 85 Survey Responses by Gender 1,697 answered/198 did not answer 1400 1200 1000 800 600 400 200 0 Male Female Other 7 Of the 1,755 people who answered the race/ethnicity question, 43% identified as black. Survey Responses by Race 1,755 answered/140 did not answer 800 700 600 500 400 300 200 100 0 Asian Black Latino White Multiple Other Races A majority (65%) of respondents were heterosexual; nearly one-third preferred not to answer. Survey Responses by Sexual Orientation 707 answered/1,188 did not answer 500 400 300 200 100 0 One in five participants were working (21%), and nearly one in ten were seeking work (9.85%). 8 Are you employed? 1,773 answered/122 did not answer 1600 1400 1200 1000 800 600 400 200 0 Yes No Are you currently looking for work? 1,747 answered/148 did not asnwer 2000 1500 1000 500 0 Yes No We did not ask about income but used Medicaid as a proxy. Over one-third of respondents reported receiving Medicaid. Do you receive Medicaid? 1,718 answered/177 did not answer 1200 1000 800 600 400 200 0 Yes No 9 As a group, nearly three-quarters of participants reported their perceived health as “good,” “very good,” or “excellent.” How would you describe your health? 1,767 answered/128 did not answer 1000 800 600 400 200 0 Excellent Very Good Good Fair Poor Nearly a quarter of our survey participants benefited from the support of caregivers to meet their daily needs. In addition, 16% were caregivers themselves. Do you provide care for a family member or friend? 1,722 answered/173 did not answer 2000 1500 1000 500 0 Yes No Do you depend on a family member, friend, or home care worker to help you meet your daily needs? 1,756 answered/139 did not answer 1500 1000 500 0 Yes No 10 With respect to self-reported health status, our analysis yielded the following statistically significant correlations:  Those who were not dependent on family members for help or care were more likely to report “excellent,” “very good,” or “good” health.  Those over 65 years of age were more likely to report “poor” health than those under 65.  Over one-third of our participants (38%) were on Medicaid and these individuals were more likely to express “fair” or “poor” health.  African Americans were more likely to report “excellent,” “very good,” or “good” health, while Asians were more likely to report “fair” or “poor” health.  Central Brooklyn residents were more likely to report “excellent,” “very good,” or “good” health, while those in east, north, and southern Brooklyn were more likely to report “fair” or “poor” health. Findings: Outdoor Spaces and Buildings To what extent does the natural and built environment help older people get around easily and safely in the community and encourage active community participation associated with improved health and well-being? Survey participants were asked about the adequacy of public seating, the safety of intersections, the quality of sidewalks, and the presence and quality of parks and other outdoor spaces. Public Seating Public seating enables people to stop and rest while walking, to enjoy the outdoors, and to build relationships with neighbors. Through the CityBench program (funded by a grant from the Federal Transit Administration), the New York City Department of Transportation (DOT) has installed over 1,500 new benches around the city, particularly near senior centers and senior housing, hospitals and community health centers, commercial zones and shopping districts, and municipal facilities. New benches have been specially designed with armrests to support people to sit down and stand up and can be requested by individuals and communities. Additionally, DOT installed nearly 4,000 new bus shelters that include seating. However, survey respondents frequently mentioned the need for additional public seating. A map of the concentration of people aged 65 and over with an overlay of CityBenches and bus shelters with benches indicates that new public seating has not been distributed evenly across neighborhoods, nor has public seating been sited in neighborhoods with the largest concentrations of older people.§ For example, West Brighton, which has the largest population § Visit NYAM’s IMAGE:NYC map (www.imagenycmap.org) to view every CityBench in Brooklyn, compared to the number of older adults in Brooklyn as percentage of total population, by neighborhood 11 of people aged 65 and over (35%) of any Brooklyn neighborhood, has only one CityBench and twelve new bus shelters, as compared to Crown Heights North where 11% of the population is aged 65 and over and 27 benches and 49 new bus shelters have been installed. “Our neighborhood needs more public seating areas.” – Park Slope resident “I live in Downtown Brooklyn in a rent-stabilized subsidized apartment. We use the bus stops for sitting because there are no local rest places or parks suitable for the elderly.” – Boerum Hill resident While 45% of survey respondents said benches were either “very available” or “available,” one- third said benches were “not available.” Residents of southern Brooklyn and east Brooklyn were more likely to report bench availability as compared to residents of north Brooklyn. Benches for resting or sitting 1,768 answered/127 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Intersections DOT established the Safe Streets for Seniors Program in 2008 to implement safety measures in areas with high rates of senior pedestrian fatalities and injuries. This included extending crossing times at crosswalks to accommodate slower walking speeds, constructing pedestrian safety islands, widening curbs and medians, narrowing roadways, and installing new stop controls and signals. DOT has worked in 41 “Senior Pedestrian Focus Areas,” of which 13 were in Brooklyn: Bath Beach (map) Bay Ridge (map), final report) Bedford Stuyvesant (map) Bensonhurst (map, final report) Borough Park (map, presentation, final report, photos) Brighton Beach (map, presentation, photos) Brownsville (map) East Flatbush (map, Community Board 9 presentation, Community Board 17 presentation, final report) 12 Flatbush (map, presentation, final report) Greenpoint (map, presentation, final report, photos) Kings Bay-Gerritsen (map, final report) Midwood (map, presentation, final report) Sheepshead Bay (map, presentation, final report) “[We] need more curb cuts for wheelchairs, etc. at every corner; more benches in more places.” – Brooklyn Heights/Vinegar Hill resident “[We] need more lights on sidewalk streets.” – Kensington/Ocean Parkway resident The majority (65%) of survey participants reported safe and well-lit streets and intersections that were “very available” and “available.” Only 10% selected “unavailable.” This may be attributable to the large number of responses received from the Bedford-Stuyvesant neighborhood (25%), which was a 2017 Senior Pedestrian Focus Area. Safe and well-lit streets and intersections 1,787 answered/108 did not answer 800 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Sidewalks Improving sidewalk conditions can help to prevent falls, the second leading cause of accidental death worldwide, with older people at highest risk.9 Nearly half of all falls occur outdoors, and features of the physical environment account for between 30-50% of falls among older people worldwide.10 The chart below shows the Brooklyn neighborhoods with the highest rate of falls hospitalizations among people aged 65 and over per 100,000 people (annual average over a three-year period). 13 Falls Hospitalization Rate Among People 65+ per 100,000 population, averaged over three years 3000 2500 2000 1500 1000 500 0 Data source: NYC Department of Health and Mental Hygiene, based on SPARCS data 2012- 2014 “86th St. leaves much to be desired as far as housekeeping." – Bensonhurst/Bath Beach resident Over 42% of survey participants felt that clean and well-maintained sidewalks were “very available” or “available,” and another 44% of survey participants selected “somewhat available.” However, 14% stated they were “not available.” Clean and well-maintained sidewalks 1,746 answered/149 did not answer 800 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Parks and Public Areas Proximity to green space has been shown to increase physical activity among children and adults.11 For older people, access to green space has also been linked to increased social interaction and improved self-reported health status.12 14 The New York City Department of Parks and Recreation (NYC Parks) has worked to increase access to parks and recreational facilities for older New Yorkers through strategies such as free programming (Senior Splash swimming, yoga, walking clubs, etc.), the installation of adult fitness equipment, and improved accessibility, safety, and amenities at parks in high-density neighborhoods with large concentrations of poverty. “Von King Park is closed. St. Johns closed, too. We need places to socialize.” – Crown Heights resident Respondents most frequently (37%) described accessible and clean parks and public areas as “somewhat available.” They lamented the closure of parks for renovations, as well as parks/public seating areas that have been locked for an extended period of time. With respect to fitness activities, survey respondents who described their health as “excellent,” “very good,” or “good” were more likely to report satisfaction with the availability of fitness programs than respondents who described their health as “fair” or “poor.” Accessible and clean parks and public areas 1,720 answered/175 did not answer 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Recommendations:  Install more CityBenches throughout the borough, prioritizing neighborhoods with large concentrations of older people reporting ambulatory difficulty, including Starrett City (49%), Sea Gate-Coney Island (47%), Brighton Beach (46%), West Brighton (43%), and Gravesend (42%).  Ensure clean and well-maintained sidewalks and well-lit intersections, prioritizing neighborhoods with high rates of falls hospitalizations, such as Sheepshead Bay- Gerritsen Beach, Midwood, Ocean Parkway South, and Sea Gate-Coney Island.  Assess the need for additional garbage cans, prioritizing neighborhoods with a high number of rodent complaints to 311.  Work with business improvement districts to install more benches in their corridors.  Install additional public water fountains and restrooms. 15 Findings: Transportation To what extent do older people have access to public transportation? Transportation is essential to older adults’ quality of life, health, independence, social interaction, and ability to contribute to their communities. This includes their ability to participate in the local economy, both as consumers and workers. 13 The number of chronic health conditions often increases with age, and New Yorkers over age 65 experience various disabilities at four to ten times the rate of people under age 65. 14 Transportation services should be accessible, affordable, and reliable in order to keep older people engaged. “Have more local buses from Parkside to Grand Army Plaza to get to the library.” – Prospect-Lefferts Gardens resident Over 80% of survey respondentsfelt that public transportation they could use was “very available” or “available.” Public transportation that you can use 1,763 answered/132 did not answer 1200 1000 800 600 400 200 0 Very Available Available Somewhat Not Available Available Comments referenced the need for elevators at subway stations and accessible buses. ** In addition, survey participants who were caregivers were more likely to report that public transportation they could use was “not available.” For the 30% of older Brooklynites who report ambulatory difficulty, the city’s public transportation system is largely inaccessible, and a recent audit by the City Comptroller of Access-a-Ride (AAR), the city’s paratransit system, found the service frequently unreliable and in some cases, unsafe.15 Neighborhoods with the largest concentrations of older people with ambulatory difficulty include Starrett City (49%), Sea Gate- Coney Island (47%), Brighton Beach (46%), West Brighton (43%), and Gravesend (42%). **Visit NYAM’s IMAGE:NYC map (www.imagenycmap.org) to view the population of older adults reporting ambulatory difficulty overlaid with subway entrances 16 Recommendations:  Provide additional training for bus drivers to pull up to the curb to allow people to safely embark/disembark without difficulties.  Train New York City Taxi and Limousine Commission (TLC) drivers to handle older adult and disabled riders.  Expand investment in CROSS (Connecting Residents on Safer Streets) Brooklyn, Borough President Adams’ initiative to improve safety with sidewalk extensions that reduce the distance required to cross intersections.  Expand the number of Citi Bikes with pedal assist.  Develop a ride hailing app for Access-A-Ride expansion.  Use FASTRACK (temporary suspension of train service to more quickly perform subway repairs and upgrades) to more quickly improve subway accessibility and comply with Americans with Disabilities Act (ADA).  Expand dedicated bus lanes.  Expand Fair Fares (half-price discount to MetroCards for New Yorkers who are at or below 100% of the federal poverty level) to Access-A-Ride. Findings: Housing To what extent do older people have housing that is safe, accessible, and affordable? Safe, adequate housing is essential to the well-being of everyone, regardless of age.16 There is considerable evidence to suggest that the physical conditions and quality of the home environment impact both physical and mental health.17,18 But older people face unique challenges with finding or keeping housing that is affordable and continues to meet their needs as their health and bodies change. Older people in Brooklyn have high rates of housing cost burden. Across the borough, 46% of people aged 65 and older spend 35% or more of their income on housing. Older people in North Bushwick have the highest rate of housing cost burden, with 57% of residents spending 35% or more of their income on housing. “Worried about rising rent stabilization rate increases. Worried potential changes to social security and Medicaid. Worried about the rising cost of food. Worried about will there be enough senior housing if needed.” – Kensington/Ocean Parkway resident Housing accessibility is also a challenge. Of the housing units in multistory residential buildings, nearly 56% are in walk-up buildings with two or more floors, as compared to 43% of units throughout the entire city. While nearly all Brooklyn neighborhoods are projecting an increase 17 in the population aged 65 and over by 2030, the neighborhoods of Dyker Heights (94%), east Sunset Park (94%), and North Bushwick (94%) have the highest concentration of units in walk- up buildings. Close to 46% of survey respondents reported that affordable housing was not available, and of the 10% who reported they would likely not be living in the same place a year from now, a third said it was because their housing was “too expensive.” Another 12% said they anticipated having to move because their housing was “not accessible or appropriate for my current needs.” “Rents, bills, and mortgages are too high. There would be some cheaper places for seniors to live in.” – Bedford-Stuyvesant resident While 90% of respondents said they planned to stay in their current housing a year from now, among those who planned to move, affordability was the most commonly reported reason, and gentrification and new development were mentioned as threats to housing security in several comments. Housing that you can afford to live in 1,662 answered/233 did not answer 900 800 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Do you think you will be living in the same place a year from now? 1,722 answered/173 did not answer 2000 1500 1000 500 0 Yes No 18 If you are not staying in your home, why? n=188* 80 70 60 50 40 30 20 10 0 Too Wrong size Not Not Other, please expensive (too small or accessible or convenient explain: too large) appropriate for me for my current needs *This sample size is larger than the number of “No” responses in the previous question. This survey was self-administered, which may have led to this response. We are reporting survey responses for each question as reported. Recommendations:  Promote the “right to counsel” in neighborhoods where it is currently available: Bedford-Stuyvesant, Flatbush, Bushwick, Prospect-Lefferts Gardens, and Crown Heights.  Promote home sharing options to a greater number of older adults.  Expand grandparent housing.  Expand supportive housing for individuals aged 55 and over. Findings: Respect, Social Inclusion, and Social Participation To what extent are programs, services, and amenities inclusive and welcoming of a diverse older population? Social connection is not only good for health but is also a priority for older people. According to a 2013 national survey of 4,000 people aged 60 and over, 40% rated “staying connected with friends and family” as the most essential component of a high-quality later life.19 Social connection is associated with better physical and mental health. However, according to the American Time Use Survey, older people spend more of their leisure time engaged in solitary and sedentary activities such as watching television and reading, and less of their time engaged in socialization and recreation.20 Social isolation predicts morbidity and mortality from cancer and cardiovascular disease,21 re- hospitalization,22 and depression and cognitive impairment.23 Social isolation is also a risk factor for elder abuse,24 as well as negative health outcomes (including death) following emergency events.25,26 19 Older people in Brooklyn who may be at greater risk of isolation include those who live alone (48%); live in poverty (22% live below 100% of the federal poverty level); have mobility impairment (31%), are divorced, separated or widowed (43%); and “speak English less than very well” (36%).1 27 Ageism, defined as “stereotyping and discrimination against individuals or groups on the basis of their age,”28 may also result in social isolation. When older people experience exclusion— purposeful or unintentional—or internalize feelings of inadequacy, they may withdraw from civic life.29 With one of the most diverse older populations in the world, ageism in Brooklyn is compounded by other forms of discrimination related to race, ethnicity, immigration status, sexual orientation, gender, and functional capacity. 30 Safety Although actual crime rates against older adults are relatively low (about 5,000 serious crimes citywide in 2016 31††), older adults have higher perceived risk of serious crimes, and are at greater risk of injury during those crimes as compared to younger populations. 32 Perceptions of safety can influence social and physical participation. One study found that among older people, safety was the most significant factor associated with limited walking for everyday activity, as well as exercise.33 “Lack of NYPD presence.” – Bay Ridge resident With respect to public safety, 64% of survey respondents reported adequate police presence was “very available” or “available.” However, our sample included very few respondents from neighborhoods with the highest rates of felony assault including Brownsville (70 felony assaults per 10,000 residents) and East New York (66 felony assaults per 10,000 residents). Adequate police presence to feel safe 1,775 answered/120 did not answer 800 600 400 200 0 Very Available Available Somewhat Not Available Available †† Brooklyn-specific data unavailable 20 Places to Socialize Opportunities for social connection are especially essential for those who live alone. The largest concentrations of older people living alone in Brooklyn are found in the following neighborhoods: CONCENTRATIONS OF OLDER ADULTS LIVING ALONE IN BROOKLYN 1 Starrett City 64.0% 2 Brooklyn Heights-Cobble Hill 63.6% 3 Brighton Beach 60.1% 4 Sea Gate-Coney Island 57.0% 5 Windsor Terrace 56.8% Senior centers work to prevent social isolation through affordable recreational and cultural programming and congregate meals. Nearly 30,000 people aged 60 and over attend Department for the Aging-funded senior centers daily. ‡‡ Of the 287 senior centers and associated sites throughout the city, 79 (about 28%) are in Brooklyn. Neighborhoods range from having zero senior centers, such as in Erasmus, to five senior centers, such as in Brownsville. Though beloved by their participants and, in some communities, very well- attended, senior centers do not appeal to many older people, who often prefer to socialize in multigenerational environments, such as libraries, museums, and restaurants. Two-thirds of survey participants said that places to socialize that are accessible and welcoming (like community centers, community organizations, or religious organizations) were “very available” or “available.” However, because significant survey outreach was conducted at Brooklyn senior centers, as well as other public venues, such as libraries and faith-based organizations, our sample may be biased toward those who are already socially engaged. Interestingly, those who described their health as “good” or “very good” were more likely to report that places to socialize were “unavailable,” perhaps indicating a desire for more varied opportunities for participation among those who are more active. ‡‡ Brooklyn-specific data unavailable 21 Places to socialize that are accessible and welcoming, like community centers/community organizations, or religious organizations 1,600 answered/295 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available “I am so thankful for my senior center. It keeps me active both mentally and physically.” – Coney Island resident “More funding for our center for music, dance.” – Flatbush/Ditmas Park resident Arts and Cultural Institutions A recent study found that the presence of cultural institutions is associated with social connection and better neighborhood health and well-being, even within lower-income communities.34 Another study found that older adults who participated in arts programming experienced less cognitive and physical decline, had fewer doctor visits, needed fewer prescription medications and had fewer falls.6 Intergenerational arts programming, one study found, is associated with reduced ageism, improved well-being, confidence, and self-esteem; and a heightened sense of social justice, empathy, and support for others. 8 In determining whether to patronize arts and cultural institutions, older people are likely to consider the following35: o Type of programming o Culturally- and linguistically-appropriate o Availability of transportation o Timing of events o Affordability o Physical environment (e.g. seating, bathrooms) o Access to information (e.g. signage, marketing) o Someone to go with Along with implementing ADA requirements, arts and cultural institutions can adjust lighting, include seating in exhibits and gallery spaces, increase the size and clarity of signage, train staff 22 to be more communicative and proactively helpful, prioritize restroom access, and provide promotional information in a variety of formats to become more age-friendly.35 In Brooklyn, the highest rates of participation in arts and culture (among people of all ages) are in Prospect Heights, DUMBO-Vinegar Hill-Downtown Brooklyn-Boerum Hill, Park Slope- Gowanus, Brooklyn Heights-Cobble Hill, and Clinton Hill, all neighborhoods with high levels of cultural resources.34 Older people, who are more likely to experience mobility impairment, may have difficulty accessing cultural resources that are not in close proximity to where they live. Brooklyn neighborhoods with fewer cultural resources include East New York, Cypress Hills-City Line, Rugby-Remsen, Starrett City, and Gravesend. “More public library programs for children and adults. Thank you.” – Bensonhurst/Bath Beach resident Free or affordable opportunities to attend educational or cultural institutions 1,464 answered/431 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available While 47% of survey respondents reported free or affordable opportunities to attend educational or cultural institutions were “very available” or “available,” 34% reported only “somewhat available,” and 18% reported that these types of opportunities are “not available.” These results may have been skewed more positively by the large number of respondents from Bedford-Stuyvesant, a neighborhood with a relatively high number of cultural assets. 34 Several respondents mentioned the critical role of libraries and senior centers in providing information and activities, as well as the need for more free programs. Local Business Local businesses enable older people, some of whom have a limited catchment area for activity, to meet their basic needs, to socialize, and to support the local economy. Local businesses also depend on older people, who account for nearly 50% of consumer spending in NYC ($70.1 billion annually).36 In Brooklyn, older adults contributed $4.2 billion to the local economy in 2015.5 Barriers to patronizing local businesses include accessibility, affordability, and lack of appropriate products and services. While about half of respondents reported that welcoming 23 and accessible local businesses were “available” or “very available,” numerous comments mentioned the need for increased access to supermarkets and other venues to purchase affordable, healthy food. “Dine in Brooklyn!!! When it is happening, publish it!” – Carroll Gardens/Red Hook resident One-third of survey respondents stated that “stores and restaurants that are easy to enter and move around in” were “not available” and an additional 32% stated that accessible stores and restaurants were only “somewhat available.” When asked about the availability of supermarkets that were accessible, welcoming, and offered discounts, nearly 57% of respondents selected “very available” or “available” across the borough. Interestingly, of respondents who identified as being from Bedford-Stuyvesant, which has a robust grassroots age-friendly local business initiative that garners commitments from businesses to offer discounts on “Elder Wednesdays,” only 34% selected “very available” or “available.” Almost 58% selected “somewhat available.” One possible explanation for this difference is that residents of Bedford-Stuyvesant may possess a higher level of knowledge of the characteristics of an age-friendly business, and as a result, they may have higher expectations than residents of other neighborhoods. Stores and restaurants that are easy to enter and move around in 1,736 answered/159 did not answer 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available 24 Supermarkets or other businesses that are accessible, feel welcoming to you, and offer discounts 1,731 answered/ 164 did not answer 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Fitness It is well-documented that a physically active lifestyle (that includes walking) is a key contributor to healthy aging.37–41 Since the start of Age-friendly NYC, NYC Parks has been working to increase older people’s utilization of recreational resources through discounts at recreation centers; free yoga, tennis, and walking clubs; and senior-only swim hours at public pools. Through its network of senior centers, DFTA offers opportunities for fitness classes and falls-prevention programs. In addition, opportunities for physical activity can sometimes be found in nontraditional spaces such as Brooklyn Public Library, which offers dance classes. “Outdoor pickle ball court.” – Bay Ridge resident Over half (56%) of survey respondents said that appropriate fitness activities were “available” or “very available.” Survey respondents who described their health as “excellent,” “very good,” or “good” were more likely to report satisfaction with the availability of fitness programs than respondents who described their health as “fair” or “poor.” Fitness activities appropriate to you 1,530 answered/365 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available 25 Technology Technology has the potential to increase social participation and connectedness among older people. However, many may have difficulty learning to use technology without assistance. A survey conducted by Older Adults Technology Services (OATS) found that only 18% of older adults reported feeling comfortable learning to use new devices (such as smartphones or tablets) on their own, while 77% indicated that they would need someone to help walk them through the process.42 Among older adults currently online, 56% also said they would need assistance to use new social networking sites to connect with friends or family.42 “A real need for tech and computer help.” – Sunset Park resident Of Age-friendly Brooklyn survey respondents, close to half said that free or affordable opportunities to learn about computers and the internet were “very available” or “available,” 33% said “somewhat available,” and 16% said “not available.” Free or or affordable opportunities to learn about computers and the internet 1,460 answered/435 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Recommendations:  Encourage arts and cultural institutions to prioritize older people as consumers and producers of arts and culture. o Along with implementing ADA requirements, arts and cultural institutions can adjust lighting, add seating to exhibits, increase the size and clarity of signage, train staff to be more communicative and proactively helpful, prioritize restroom access, and offer promotional information in a variety of formats (e.g. digital, print, radio) to become more age-friendly.  Partner with the Brooklyn Chamber of Commerce to promote age-friendly business practices, discounts, and “Older Americans Month” activities. 26  Assess access to green space across the borough, prioritizing neighborhoods with large concentrations of older people at risk of social isolation.  Develop a multimedia marketing strategy to promote ongoing free fitness activities offered throughout the borough through NYC Parks, DFTA, and community-based providers.  Establish “Adopt-A-Senior Center” program through public and private partnerships.  Increase library programming for older adults, especially for those with Alzheimer’s disease and other forms of dementia.  Increase funding for programming for older adults at cultural institutions, community- and faith-based organizations, parks and recreation centers.  Increase funding to expand computer and tech classes administered by DFTA, BPL, NYC Parks, and OATS.  Increase digital accessibility and literacy for homebound older adults and nursing home residents. Findings: Civic Participation and Employment To what extent do older people have opportunities to contribute their experience and skills to the community in paid or unpaid work? Civic Participation: Evidence suggests that volunteering among older people is associated with reduced mortality,43 improved perceptions of well-being,44 and increased physical, cognitive, and social activity.45 However, meaningful volunteer opportunities may be difficult for older people to find. Respondents most frequently described places to volunteer as “somewhat available” (38%); however, 11% described them as “not available.” Civic participation refers to the activities of personal and public concern that are enriching both individually but also benefit the community. These roles take a myriad of forms, including both paid and unpaid work. They benefit the community as well as offer an opportunity to help older adults remain engaged, prevent social isolation and challenge stereotypes of aging. Older adults make up 24% of volunteers nationally and tend to have the highest number of weekly volunteer hours.46,47 Volunteers help build more cohesive, safer and stronger communities. Older Brooklynites, with their high rates of civic engagement, are a critical resource to the Borough, providing significant contributions through leadership in campaigns, advisory councils, tenant associations, and non-profit boards. Fifty-two percent of our survey participants felt that opportunities to volunteer were “very available” or “available” while 10% felt that volunteer opportunities were not available. 27 Places to volunteer 1,429 answered/466 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Workforce Participation: Older workers have been found to be more engaged in their work than their younger counterparts, and higher levels of employee engagement are associated with greater revenue growth.48 Studies have also shown that an age-diverse workforce may be more creative, productive, and better at solving problems.49,50 As the general population ages, those 55 and older have become the fastest growing portion of the population. In addition, the expansion of knowledge-based jobs with few physical demands, along with greater workplace flexibility (such as part-time and consultant roles) have helped increase the number of older adults who remain in the job market. 51 Employers find older workers highly motivated and responsible, and they value their expertise and experience. 52 The Center for an Urban Future reported on a growing “encore entrepreneur” population among those over age 60, with a 44% increase in self-employed status.53 BPL’s PowerUP!, a start-up competition for first-time entrepreneurs, has also seen an increase in older entrepreneur applicants since its inception in 2003. In addition, the Women’s Brooklyn Enterprise Center at the East New York Local Development Corporation estimates 25% of its members are over age 50. Brooklyn’s Business Outreach Center, which provides technical support to small businesses, reports that 30% of their clients are older entrepeneurs.53 Approximately 15% of people aged 65 and older in Brooklyn are actively in the labor force.§§ Residents in Park Slope-Gowanus showed the highest rate of workforce participation at one- third.53 Some older adults may work out of a desire to stay engaged and active, but many work out of economic necessity.*** Nearly one in four older adults (23%) live in poverty, and close to one-third benefit from the support of SNAP.54 §§ Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of adults over age 65 in the labor force, by neighborhood *** Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of households receiving SNAP with at least one resident over 60 years old 28 “More paying jobs for seniors…Not just volunteer but paying or stipend jobs.” – Flatlands resident When asked about employment, 21% of our survey participants were currently in the workforce, and nearly 10% were seeking employment. Are you employed? 1,773 answered/ 122 did not answer 1600 1400 1200 1000 800 600 400 200 0 Yes No Are you currently looking for work? 1,747 answered/148 did not answer 1800 1600 1400 1200 1000 800 600 400 200 0 Yes No The majority of respondents reported they were not in the workforce or looking for work; however, because surveys were primarily administered during the day, we did not adequately capture the feedback of those who are employed or actively looking for work during the day. Within our sample, respondents who were not employed were more likely to report that job opportunities for people of all ages were “not available.” More than 14% of survey participants reported a lack of access to job opportunities. 29 Job opportunities for all ages 1,287 answered/608 did not answer 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Recommendations:  Partner with existing entrepreneur and workforce-development programs (such as Brooklyn’s Business Outreach Center or the East New York Local Development Corporation) to support older adults seeking work.  Partner with organizations that employ older people, such as ReServe, throughout the borough.  Cultivate and promote opportunities for volunteerism.  Advocate for companies to hire and retain seniors.  Increase employment opportunities, including but not limited to job sharing, flex- time, training/apprenticeships, paid internship opportunities, consulting, and working from home. Findings: Access to Information and Services To what extent are older adults aware of the diverse range of programs and services available within their community? Is information readily available, appropriately designed and delivered to meet the needs of older people? Accessing information, especially in an increasingly digital landscape, can be challenging for older people. The City’s 311 system, as well as the NYC Connects Program, provides information and referral services to older people and their caregivers. However, many people remain unaware of these services and how to effectively use them. “My local library is Sheepshead Bay P.L. It is very nice and comfortable for my neighborhood. It is really [an] information center for newcomers and elders.” – Sheepshead Bay/Madison resident Over two-thirds (68%) of survey respondents felt that access to news and information in their native language was “available” or “very available.” Nearly 25% said this access was “somewhat available” and 8% said “not available.” The survey also asked about the availability of “places to 30 get information about benefits in your native language,” and the responses results were almost identical. Information about events and news in your native language 1,598 answered/297 did not answer 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Places to get information about benefits in your native language 1,578 answered/317 did not answer 700 600 500 400 300 200 100 0 Very Available Available Somewhat Not Available Available Language barriers can also limit access to resources. While our survey was available in Spanish and Chinese, the majority completed the survey in English, which may have skewed our results, given that 47% of people aged 65 and over in Brooklyn speak a language other than English, and 34% speak English “less than very well.” In addition, most of our respondents were surveyed at senior centers that provide benefits and entitlements counseling, so our sample may have been better informed than the average older Brooklynite. Additional research is needed to accurately assess the extent of need among older Brooklyn residents who speak languages other than English. Recommendation:  Expand access to information about news, events, health services and public benefits, particularly in neighborhoods with large concentrations of older people with language 31 challenges, such as North Side-South Side (Spanish), Brighton Beach (Russian), and east Sunset Park (Chinese). Findings: Community Support and Health Services To what extent do older people have access to services and supports they need to stay healthy and independent? Survey participants were asked about the availability of primary care, specialty care, and mental health services in their native language. As previously stated, our survey population was primarily English-speaking, and languages and English proficiency vary throughout the borough among older people. For example, in North Side-South Side, 35% of older adults speak Spanish and speak “no English or English less than well.”††† In Brighton Beach, 54% of older adults speak an Indo-European language and speak “no English or English less than well.”‡‡‡ Sunset Park East has the highest number of Asian language speakers, with 35% who speak “no English or English less than well.”§§§ Survey respondents generally felt they had language access to primary and specialty care (72%) and mental health services (63%). However, one in ten did not feel they had mental health services available in their native language. Health services, such as primary care and Mental health services, for issues like specialty care, in your native language depression, in your native language 1,647 answered/248 did not answer 1,515 answered/380 did not answer 700 700 600 600 500 500 400 400 300 300 200 200 100 100 0 0 Very Available Somewhat Not Very Available Somewhat Not Available Available Available Available Available Available Recommendation:  Expand language access for mental health services. ††† Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of older adults who speak Spanish and who speak English "less than well," by neighborhood ‡‡‡ Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of older adults who speak Indo-European languages and who speak English "less than well," by neighborhood §§§ Visit NYAM's IMAGE:NYC map (www.imagenycmap.org) to view the percentage of older adults who speak Asian languages and who speak English "less than well," by neighborhood 32 Next Steps To address the challenges identified through the Age-friendly Brooklyn survey, Brooklyn Borough President Eric Adams has committed to the following:  Schedule a full briefing on this report and recommendations for aging service providers, the Brooklyn-wide Interagency Council on Aging, the Brooklyn Public Library, LiveOn NY and AARP membership, and older Brooklynites.  Engage agencies and community boards on relevant recommendations through Borough Service Cabinet.  Define budgetary needs in greater specificity and advocate for funding-related recommendations through city, state, and federal budgetary processes.  Leverage the Uniform Land Use Review Procedure (ULURP) process to make neighborhoods more age-friendly.  Optimize 2020 Census participation among hard-to-count older people.  Establish an Age-friendly Brooklyn Task Force to advance implementation of recommendations and consideration of additional initiatives. 33 Appendix A: Survey Age-Friendly Neighborhoods Feedback Form Please complete this form to help us learn about your community. Feedback is being collected to inform the Age-FriendlyNYC Neighborhood Initiative by the New York Academy of Medicine (the Academy ) and the Office of the Brooklyn Borough President. The information that you share is important to help the City better serve its diverse communities and make our neighborhoods more inclusive from the perspective of older adults. All of the information provided will be kept anonymous and confidential. Please rate each of the following resources or services on whether they are available in your community based on the following scale: Very Available Available Somewhat Available Not Available 1 2 3 4 Circle the most appropriate number or mark the “Don’t Know” box. Specific comments on resources or services should be made at the end of this survey. Very Not Don’t Community resources or services Available Available Know 1. Accessible and clean parks and public areas 1 2 3 4 2. Benches for resting or sitting 1 2 3 4 3. Clean and well-maintained sidewalks 1 2 3 4 4. Safe and well-lit streets and intersections 1 2 3 4 5. Adequate police presence to feel safe 1 2 3 4 6. Public transportation that you can use 1 2 3 4 7. Job opportunities for all ages 1 2 3 4 8. Stores and restaurants that are easy to enter and move around in 1 2 3 4 9. Supermarkets or other businesses 1 2 3 4 34 Community District #:________ Very Not Don’t Community resources or services Available Available Know that are accessible, feel welcoming to you, and offer discounts 10. Housing that you can afford to live in 1 2 3 4 11. Places to get information about benefits in your native language 1 2 3 4 12. Health services, such as primary care and specialty care, in your native 1 2 3 4 language 13. Mental health services, for issues like depression, in your native language 1 2 3 4 14. Places to socialize that are accessible and welcoming, like community centers/community organizations, or 1 2 3 4 religious organizations 15. Fitness activities appropriate to you 1 2 3 4 16. Free or affordable opportunities to learn about computers and the 1 2 3 4 internet 17. Free or affordable opportunities to attend cultural or educational 1 2 3 4 institutions 18. Places to volunteer 1 2 3 4 19. Information about events and news in your native language 1 2 3 4 The following questions are to help us learn a little bit about you. We hope you will choose to answer them. 20. Age: Over 85 80 – 84 75 – 79 70 – 74 65 – 69 60 – 64 55 – 59 50 – 54 45 – 49 40 – 44 35 – 39 30 – 34 25 – 29 18 – 24 21. Gender: Male Female Other 35 22. Ethnicity/Race: (check all that apply) Asian Black/African-American Latino/Hispanic White Multiple Races Other (please describe): ______________________ 23. What is the five-digit ZIP code where you live? ________________ 24. Do you think you will be living in the same place a year from now? Yes No 25. If no, why not? (check all that apply) Too expensive Wrong size (too small or too large) Not accessible or appropriate for my current needs Not convenient for me Other (please explain): ____________________________________ 26. Are you employed? Yes No 27. Are you currently looking for work? Yes No 28. Do you receive Medicaid? Yes No 29. How would you describe your health? Excellent Very good Good Fair Poor 30. Do you depend on a family member, friend, or home care worker to help you meet your daily needs? Yes No 31. Do you provide care for a family member or friend? Yes No 32. Sexual Orientation Heterosexual Homosexual Other Bisexual Prefer not to answer 36 Anything else that you think we should know? SURVEYS WILL BE COLLECTED AT ______________ OR MAIL ORIGINAL OR EMAIL SCANNED FORMS TO: Eileen Newman Office of the Brooklyn Borough President 209 Joralemon Street Brooklyn, NY 11201 programs@brooklynbp.nyc.gov If you have any questions or concerns about this form, please contact: Lindsay Goldman, MSW Director Elaine Larson, RN, Healthy Aging Chair, Institutional Review Board Center for Health Policy and Programs The New York Academy of Medicine The New York Academy of Medicine 1216 Fifth Avenue, New York, NY 10029 1216 Fifth Avenue, New York, NY 10029 212-822-7287, ell23@columbia.edu 212-822-3562, goldman@nyam.org 37 Appendix B: Classification of Brooklyn Geography Central Brooklyn: Zip codes: 11213, 11216, 11233, 11238, 11203, 11210, 11225, 11226, 11218, 11230 East Flatbush-Farragut Crown Heights North Rugby Kensington-Ocean Parkway Erasmus Ocean Parkway South Flatbush Prospect Heights Midwood Prospect Lefferts Gardens-Wingate Crown Heights South Remsen Village North Brooklyn Zip codes: 11201, 11205, 11215, 11217, 11231, 11211, 11222, 11206, 11221, 11237 Carroll Gardens-Columbia Street- Red Hook Bushwick South Clinton Hill Brooklyn Heights-Cobble Hill DUMBO Fort Greene Vinegar Hill Bedford Downtown Brooklyn Stuyvesant Heights Park Slope-Gowanus Ocean Hill Greenpoint North Side-South Side East Williamsburg Boerum Hill Williamsburg Bushwick North East Brooklyn Zip codes: 11207, 11208, 11234, 11239, 11212 Cypress Hill-City Line Brownsville Starrett City Georgetown East New York Marine Park Bergen Beach Mill Basin 38 South Brooklyn Zip codes: 11209, 11214, 11228, 11204, 11219, ,11236, 11223,11224,11229,11235, 11220, 11232 Borough Park Sunset Park West Dyker Heights Sunset Park East Sheepshead Bay-Gerritsen Beach-Manhattan Windsor Terrace Beach Flatlands Madison Canarsie Homecrest Gravesend Bensonhurst East Brighton Beach Bensonhurst West West Brighton Bath Beach Seagate Coney Island Bay Ridge 39 Appendix C: Survey Responses by Community District Community District % # 1 / Flushing Avenue, Williamsburg, Greenpoint, North Side, and South Side 2% 42 2 / Brooklyn Heights, Fulton Mall, Boerum Hill, Fort Greene, Brooklyn Navy Yard, Fulton Ferry, and Clinton Hill 3% 48 3 / Bedford-Stuyvesant, Stuyvesant Heights, and Ocean Hill 25% 475 4 / Bushwick 5% 94 5 / East New York, Cypress Hills, Highland Park, New Lots, City Line, Starrett City, and Ridgewood 1% 12 6 / Red Hook, Carroll Gardens, Park Slope, Gowanus, and Cobble Hill 1% 18 7 / Sunset Park and Windsor Terrace 0% 8 8 / Crown Heights, Prospect Heights, and Weeksville 1% 12 9 / Crown Heights, Prospect Lefferts Gardens, and Wingate 0% 9 10 / Bay Ridge, Dyker Heights, and Fort Hamilton 1% 10 11 / Bath Beach, Gravesend, Mapleton, and Bensonhurst 3% 53 12 / Boro Park, Kensington, Ocean Parkway, and Midwood 0% 3 13 / Coney Island, Brighton Beach, Bensonhurst, Gravesend, and Seagate 6% 104 14 /Flatbush, Midwood, Kensington, and Ocean Parkway 1% 17 15 / Sheepshead Bay, Manhattan Beach, Kings Bay, Gerritsen Beach, Kings Highway, East Gravesend, Madison, Homecrest, and Plumb Beach 2% 44 16 / Brownsville and Ocean Hill 0% 9 17 / East Flatbush, Remsen Village, Farragut, Rugby, Erasmus, and Ditmas Village 0% 7 18 / Canarsie, Bergen Beach, Mill Basin, Flatlands, Marine Park, Georgetown, and Mill Island 3% 56 19/Unknown 46% 871 40 Bibliography 1. 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Population 65 Years and Over in the United States 2013-2017 American Community Survey 5-Year Estimates. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS _17_5YR_S0103&prodType=table. Accessed February 26, 2019. 44 About NYAM The New York Academy of Medicine (NYAM) tackles the barriers that prevent every individual from living a healthy life. NYAM generates the knowledge needed to change the systems that prevent people from accessing what they need to be healthy such as safe and affordable housing, healthy food, healthcare and more. Through its high-profile programming for the general public, focused symposia for health professionals, and its base of dedicated Fellows and Members, NYAM engages the minds and hearts of those who also value advancing health equity to maximize health for all. For more information, visit NYAM.org. 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