The future of Philadelphia does not look too bright for the health of Philadelphia.

According to the Philadelphia Department of Public Health’s 2016 Community Health Assessment, Philadelphia is beating out the other major cities for the highest rates of chronic diseases, including New York and Los Angeles.

With 11.5 percent of Philadelphia’s population being diagnosed with diabetes, in comparison to New York’s 12.5 and 10.2 for the Bronx and Kings, respectively and the 34.3 percent diagnoses rate in comparison to the the Bronx’s 29.2, our city tops the charts for poor cardiovascular health.

But the cause for concern doesn’t stop there, the data shows that some of the most at-risk groups to be affected by these diseases were the African-Americans and second, Latinos.

Coming in with some of the highest numbers, Latinos are affected by the effects of poor cardiovascular health in disheartening ways, such as shorter life expectancies and additional health problems due to interrelated diseases.

Just take a look at the numbers: the mortality rate for Philadelphian’s with premature cardiovascular disease is 59.6 percent, a fact that Dr. Cheryl Bettigole, the director of the chronic disease prevention division, supported when she spoke of how the disease affected the Latino community.

“One thing we have to mention is that Latinos may come in second to African-Americans for hypertension and diabetes, we see that their mortality rate once diagnosed is fairly high,” said Dr. Bettigole.

And with the diseases only steadily increasing in prevalence with 38.2 percent of hypertension prevalence in the city and Latinos taking 31.7 percent of that number.  

The same is true for diabetes. On a slight downturn from 2012’s 16 percent, 15.4 percent of those affected by diabetes are Latinos.

The factors that can lead to this problem are vast and varied but two that stood out were family factors and the ways in which economic status can alter the daily lives of Philadelphians to lead to more health issues.

And according to Dr. Bettigole, these two factors are more related than one would think.

“They certainly are connected. You’re more likely to be obese if you’re trying to save money and ordering fast food. But you’re also more likely to live below the poverty line if you develop these diseases because you’re not able to work due to your health problems and things that,” says Dr. Bettigole.

Calling it a vicious cycle, Dr. Bettigole went onto highlight that some of the city’s poorest zip codes were also those with the shortest life expectancies and those most likely to be affected by these illnesses at high rates.

So the city’s poorest are also the unhealthiest.

But even with those grim numbers, Dr. Bettigole has hope.

The pull is that these diseases, though chronic and harmful - especially when combined with the cycle of poverty - can be prevented or managed so that those at-risk or affected by them can live healthy and prosperous lives.

And the advice is to start as early as possible. If not in your childhood, as early as your 20s, “Your twenties are a good opportunity to set a precedent for the healthy habits that you want to follow for your whole life,” says Andrea Becker, MD, cardiologist, Lankenau Heart Institute at Lankenau Medical Center, part of Main Line Health. “Preventing heart disease starts by practicing these healthy habits from a young age.”

“Genetics and family play a huge role in the probability of contracting these diseases. I know that may sound discouraging, but there are plenty of ways to counteract or combat the influence of genetics in our life,” says Dr. Bettigole.

The health of entire families can also start as early as pregnancy with illnesses such as gestational diabetes passing along health complications before birth.

“Babies who are born to mothers with gestational diabetes have an increased risk for abnormal organ development, a heavier birth weight, and preterm birth, but the health risks extend to later in life, as well. These children can be at risk for health problems like low blood sugar, respiratory disease, obesity and metabolic problems, including Type 2 diabetes,” explains Peter Dahl, MD, endocrinologist with Main Line HealthCare Endocrinology at Riddle Hospital.

For this reason, the healthier you can start off your pregnancy, the better, says Dr. Dahl.

And once you’re there, be sure to stay updated on your current health: know what to look out for.

“The best way to prevent heart disease—to protect yourself from heart disease—is to know your numbers: cholesterol, blood pressure, weight, and blood sugar. These provide an indication of your heart health, and are all factors that can be managed with the help of your physician,” Sandra Abramson, MD, Lankenau Heart Institute cardiologist at Lankenau Medical Center, part of Main Line Health. “You may not be able to change factors like your family history or your age, but you can control your health.”

One key recommendation the doctor provided was that these diseases tend to affect entire families, so she suggested getting healthy as unit.

But in terms of what you can do daily to ensure total health, Dr. Bettigole says that it can start with the family at the kitchen table.

“When I tell women they need to lose weight, often their reply is how hard it is for them because of their families. When we recommend healthy eating, they’ll say, ‘Oh, my family wouldn’t like that’ so often they’re cooking two meals: a healthy one for themselves and the one they would typically make for their families,” said the doctor.

But she strongly recommends against this, returning to her original point that families must get healthy together. “Children do what we do, not what we say,” she continues.

From healthier dinners with vegetables and whole wheat to walking in the park, Bettigole says that children are more likely to develop a habit if they see it as normal based on the models they’re provided.

For some of the families Bettigole talks to though, choosing unhealthy food is a financial decision. Choosing cheaper fast-food over the price of expensive perishable fruits and vegetables is often a decision made to help the family survive.

“But it doesn’t have to be this way. One thing I like to suggest are frozen vegetables, they often cost less, are easier to preserve, and you can cook them fairly easily,” says Bettigole.

Economics aren’t only a factor at the dinner table though, finding safe places to exercise can also be a barrier to a healthier lifestyle.

Living in the lower-income zip codes, it may not be easiest to take a walk to or go to the park for lack of safety and green space, but resources such as Philly Powered, an online directory that helps you identify safe places to exercise in the city, are there to act as a guide.

Launched in Fall of 2015, well into the uptrend of rising obesity, diabetes and hypertension rates, the website was created to help those in any of the neighborhoods throughout the city find places to go to get active.  

Another initiative for those who need a little more help when trying to change their habits is The Food Trust.

In partnership with Get Healthy Philly, the Food Trust is a collection of farmer’s markets that accept SNAP and food stamp benefits as payment. The path to healthier food is more available than ever at different price points throughout the city.

Though the rates of these diseases are steadily on the rise, Bettigole and other health professionals are confident that a healthier Philadelphia, especially for the Latino community is possible, with little a little efforts and a little research.

For more information on Philly Powered, visit PhillyPowered.org, the website is available in English and Spanish.

For more information on the Food Trust, visit TheFoodTrust.org.