Healthcare in New York City

Last updated

Healthcare in New York City describe the health care services available in New York City, the largest US city with a population of over eight million. [1]

Contents

Many health care systems in place in New York developed from nonprofit charitable organizations. [2]

Insurance

The US health system does not provide health care to the country's entire population. [3] Instead, most citizens are covered by a combination of private insurance and various federal and state programs. [4] As of 2017, health insurance was most commonly acquired through a group plan tied to an employer. [5]

NY State of Health is the health insurance marketplace for city residents aimed at lowering costs. [6] [7] NYC Health + Hospitals has the MetroPlus health insurance plans for lower-income residents, and NYC Care for no- or low-cost services for residents who do not qualify for or cannot afford health insurance. [8]

Health infrastructure

Hospitals

Government

The NYC Department of Health and Mental Hygiene is the primary local government body and one of the largest local public health organizations in the world. [9] The State Department of Financial Services regulates health insurance. NYC Health + Hospitals is a public benefit corporation that operates hospitals and clinics and serves over one million residents annually. [10]

Medical schools

Medical schools in New York City include:

Health and healthcare disparities

In 2010, the health department began a program to document health disparities. The first report focused on disparities in life expectancy and death, and stated that death rates were 30% higher in the poorest New York City neighborhoods than the wealthiest. [11] A 2011 report examining breast, colorectal, and cervical cancer stated that while breast cancer diagnoses were highest among high-income white women, low-income Black women had the highest rate of death. [11]

Emergency care

In 2000, a report from The Commonwealth Fund found that nearly three-quarters of emergency room visits in New York City were for non-emergent healthcare needs or could have been treated in a primary care setting. The report concluded that reducing strain on hospital emergency departments, the city's primary care system required significant expansion and barriers to care for low-income patients and those without health insurance needed to be reduced. [12]

Access

Access to healthcare continues to be an issue. The cost of living in the city has forced many New Yorkers to opt out of insurance because of the high costs.[ citation needed ] New Yorkers living in low-income communities or who are unemployed have limited access to quality healthcare. [12] The NYC Health + Hospitals program attempts to improve healthcare availability for these residents. [13]

COVID-19

The first case of the COVID-19 pandemic was confirmed in March 2020. [14] [15] By April, the COVID-19 pandemic in New York City had more confirmed coronavirus cases than China, the U.K., or Iran, and by May, had more cases than any other individual country. This created a scarcity of hospital beds and available intensive care unit space. NYC instituted emergency measures, including the deployment of the hospital ship USNS Comfort, and the creation of temporary field hospitals, although these were little used. [16] [17] [18] The ongoing pandemic is the deadliest disaster by death toll in the city's history. [19] [20]


Early pandemic

The pandemic exposed health care disparities. Prior to the pandemic, the Upper East Side of Manhattan had 27 times more primary care providers than Elmhurst and Corona, or eight times the city average. The same Queens communities had a COVID-19 infection rate four times that of Manhattan's East Side and a death rate six times higher. [21] Multiple reports showed that minority communities in New York City were severely affected by COVID-19, partially due to higher population density in minority-dominated neighborhoods and a higher rate of comorbidities. [22] [23]

COVID-19 testing

A 2020 study found that COVID-19 testing in New York City was more egalitarian than income distribution. However, the same study found significant disparity in test results across income levels. Comparing the poorest ZIP codes to the wealthiest revealed a 38 to 65 percent difference in negative tests. [24]

Vaccination

Early distribution of COVID-19 vaccines faced logistical obstacles including supply issues. [25] In some cases, concerns over eligibility led vaccine doses to be discarded. In early January 2021, New York State responded by expanding its eligibility criteria. [26] Despite this, short supply, extended wait times, and difficulties with eligibility and registration remained obstacles. [27] In addition, early data showed demographic disparities in vaccine distribution. As of January 31, 2021, 48% of people receiving vaccine doses were reported as white, compared with 11%, 15%, and 15% of Black, Asian, and Latinx individuals respectively, though 40% of vaccine recipients at the time had not had demographic data collected. [28] Vaccine hesitancy has been an issue, especially in low-income neighborhoods. Many Black New Yorkers cited fear and suspicion of the government entities advocating vaccination. [29] Vaccination rates improved significantly with city and state mandates. [30]

See also

Related Research Articles

The NewYork-Presbyterian Hospital is a nonprofit academic medical center in New York City affiliated with two Ivy League medical schools, Cornell University and Columbia University. The hospital comprises seven distinct campuses located in the New York metropolitan area. The hospital's two flagship medical centers are Columbia University Irving Medical Center and Weill Cornell Medical Center, situated on opposite sides of Upper Manhattan.

<span class="mw-page-title-main">NYC Health + Hospitals</span> Operator of public hospitals and clinics in New York City

NYC Health + Hospitals, officially the New York City Health and Hospitals Corporation (HHC), operates the public hospitals and clinics in New York City as a public benefit corporation. As of 2021, HHC is the largest municipal healthcare system in the United States with $10.9 billion in annual revenues, serving 1.4 million patients, including more than 475,000 uninsured city residents, providing services interpreted in more than 190 languages. HHC was created in 1969 by the New York State Legislature as a public benefit corporation. It is similar to a municipal agency, but has a board of directors. It operates eleven acute care hospitals, five nursing homes, six diagnostic and treatment centers, and more than 70 community-based primary care sites, serving primarily the poor and the working class. HHC's own MetroPlus Health Plan is one of the New York area's largest providers of government-sponsored health insurance and is the plan of choice for nearly half a million New Yorkers.

<span class="mw-page-title-main">Healthcare in Europe</span>

Healthcare in Europe is provided through a wide range of different systems run at individual national levels. Most European countries have a system of tightly regulated, competing private health insurance companies, with government subsidies available for citizens who cannot afford coverage. Many European countries offer their citizens a European Health Insurance Card which, on a reciprocal basis, provides insurance for emergency medical treatment insurance when visiting other participating European countries.

<span class="mw-page-title-main">NYU Langone Health</span> Hospital in New York, United States

NYU Langone Health is an academic medical center located in New York City, New York, United States. The organisation consists of the NYU Grossman School of Medicine and NYU Grossman Long Island School of Medicine, both part of New York University (NYU), and more than 300 locations throughout the New York metropolitan area, including six inpatient facilities: Tisch Hospital, Kimmel Pavilion, NYU Langone Orthopedic Hospital, Hassenfeld Children's Hospital, NYU Langone Hospital – Brooklyn and NYU Langone Hospital – Long Island. It is also home to Rusk Rehabilitation. NYU Langone Health is one of the largest healthcare systems in the Northeast, with more than 46,000 employees.

Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance.

Healthcare in New York (state) refers to all health care available in the state of New York.

This article summarizes healthcare in Texas. In 2022, the United Healthcare Foundation ranked Texas as the 38th healthiest state in the United States. Obesity, excessive drinking, maternal mortality, infant mortality, vaccinations, mental health, and limited access to healthcare are among the major public health issues facing Texas.

<span class="mw-page-title-main">COVID-19 pandemic in New York (state)</span> Ongoing COVID-19 viral pandemic in New York state

The first case of COVID-19 in the U.S. state of New York during the pandemic was confirmed on March 1, 2020, and the state quickly became an epicenter of the pandemic, with a record 12,274 new cases reported on April 4 and approximately 29,000 more deaths reported for the month of April than the same month in 2019. By April 10, New York had more confirmed cases than any country outside the US. As of August 11, 2023, the state has reported 131.3 million tests, with 6,722,301 cumulative cases, and 79,960 deaths.

<span class="mw-page-title-main">Syra Madad</span> American pathogen preparedness expert

Syra Madad is an American pathogen preparedness expert and infectious disease epidemiologist. Madad is the Senior Director of the System-wide Special Pathogens Program at NYC Health + Hospitals where she is part of the executive leadership team which oversees New York City's response to the Coronavirus disease 2019 pandemic in the city's 11 public hospitals. She was featured in the Netflix documentary series Pandemic: How to Prevent an Outbreak and the Discovery Channel documentary The Vaccine: Conquering COVID.

<span class="mw-page-title-main">COVID-19 pandemic in New York City</span> Ongoing COVID-19 viral pandemic in New York City

The first case of the COVID-19 pandemic in New York City was confirmed on March 1, 2020, though later research showed that the novel coronavirus had been circulating in New York City since January, with cases of community transmission confirmed as early as February. By March 29, over 30,000 cases were confirmed, and New York City had become the worst-affected area in the United States. There were over 2,000 deaths by April 6; at that stage, the city had more confirmed coronavirus cases than China, the UK, or Iran. Bodies of the deceased were picked up from their homes by the US Army, National Guard, and Air National Guard.

Oxiris Barbot is an American pediatrician who served as the Commissioner of Health of the City of New York from 2018 to 2020. She was then appointed to public health positions with Columbia University and the JPB Foundation, and in 2022 became president and chief executive officer of the nonprofit United Hospital Fund.

<span class="mw-page-title-main">Medical deserts in the United States</span>

The United States has many regions which have been described as medical deserts, with those locations featuring inadequate access to one or more kinds of medical services. An estimated thirty million Americans, many in rural regions of the country, live at least a sixty-minute drive from a hospital with trauma care services. Limited access to emergency room services, as well as medical specialists, leads to increases in mortality rates and long-term health problems, such as heart disease and diabetes. Regions with higher rates of Medicaid and Medicare patients, as well those who lack any health insurance coverage, are less likely to live within an hour's drive of a hospital emergency room.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on other health issues</span> Health consequences of outbreak beyond the COVID-19 disease itself

The COVID-19 pandemic has had many impacts on global health beyond those caused by the COVID-19 disease itself. It has led to a reduction in hospital visits for other reasons. There have been 38 per cent fewer hospital visits for heart attack symptoms in the United States and 40 per cent fewer in Spain. The head of cardiology at the University of Arizona said, "My worry is some of these people are dying at home because they're too scared to go to the hospital." There is also concern that people with strokes and appendicitis are not seeking timely treatment. Shortages of medical supplies have impacted people with various conditions.

Medical desert is a term used to describe regions whose population has inadequate access to healthcare. The term can be applied whether the lack of healthcare is general or in a specific field, such as dental or pharmaceutical. It is primarily used to describe rural areas although it is sometimes applied to urban areas as well. The term is inspired by the analogous concept of a food desert.

<span class="mw-page-title-main">Dave A. Chokshi</span> American physician

Dave Ashok Chokshi is an American physician and former public health official who served as the 43rd health commissioner of New York City. He was the first health commissioner of Asian descent. Chokshi previously served as the inaugural chief population health officer for NYC Health + Hospitals and as a White House fellow in the United States Department of Veterans Affairs. Currently he is a practicing physician at Bellevue Hospital and the inaugural Sternberg Family Professor of Leadership at the Colin Powell School for Civic and Global Leadership, part of the City College of New York.

Black maternal mortality in the United States refers to the death of women, specifically those who identify as Black or African American, during or after child delivery. In general, maternal death can be due to a myriad of factors, such as how the nature of the pregnancy or the delivery itself, but is not associated with unintentional or secondary causes. In the United States, around 700 women die from pregnancy-related illnesses or complications per year. This number does not include the approximately 50,000 women who experience life-threatening complications during childbirth, resulting in lifelong disabilities and complications. However, there are stark differences in maternal mortality rates for Black American women versus Indigenous American, Alaska Native, and White American women.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on Native American tribes and tribal communities</span> Effects of the viral outbreak on tribal communities

The impact of the COVID-19 pandemic on Native American tribes and tribal communities has been severe and has emphasized underlying inequalities in Native American communities compared to the majority of the American population. The pandemic exacerbated existing healthcare and other economic and social disparities between Native Americans and other racial and ethnic groups in the United States. Along with black Americans, Latinos, and Pacific Islanders, the death rate in Native Americans due to COVID-19 was twice that of white and Asian Americans, with Native Americans having the highest mortality rate of all racial and ethnic groups nationwide. As of January 5, 2021, the mortality impact in Native American populations from COVID-19 was 1 in 595 or 168.4 deaths in 100,000, compared to 1 in 1,030 for white Americans and 1 in 1,670 for Asian Americans. Prior to the pandemic, Native Americans were already at a higher risk for infectious disease and mortality than any other group in the United States.

The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.

The following is a timeline of the COVID-19 pandemic in New York City.

Yvette Calderon is an American physician who is Chair and Professor of Emergency Medicine in the Icahn School of Medicine at Mount Sinai. Her research has focused on health disparities in Manhattan, with a particular focus on HIV and hepatitis C. She was elected to the National Academy of Medicine in 2022.

References

  1. "New York City, New York Population 2021". World Population Review. Retrieved 2021-12-21.
  2. Rosner, David (1982). A once charitable enterprise : hospitals and health care in Brooklyn and New York, 1885-1915. Cambridge [Cambridgeshire]: Cambridge University Press. ISBN   0521242177.
  3. Institute of Medicine. Committee on the Consequences of Uninsurance (January 13, 2004). Insuring America's health: principles and recommendations. Washington, DC: National Academies Press. p.  25. ISBN   978-0-309-52826-9.
  4. Access to health care in America. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Millman M, editor. Washington: National Academies Press; 1993.
  5. Blumenthal, David (2017). "The Decline of Employer-Sponsored Health Insurance". commonwealthfund.org. doi:10.26099/dnqz-4g48 . Retrieved 2018-11-25.
  6. "Frequently Asked Questions". New York State of Health. Retrieved 2021-12-21.
  7. "NY State of Health Awarded $1.1 Million to Help More New Yorkers Access Affordable Health Coverage". New York State Department of Health. 2021-09-17.
  8. Shi, L.; Stevens, G.D. (2021). "Current Strategies to Serve Vulnerable Populations". Vulnerable Populations in the United States. Wiley. p. 190. ISBN   9781119627647. LCCN   2021000699.
  9. "About the NYC Department of Health and Mental Hygiene". NYC.gov. Retrieved 2021-12-21.
  10. "About NYC Health + Hospitals". NYC Health + Hospitals. Retrieved 2021-12-21.
  11. 1 2 "Health Disparities". www1.nyc.gov. Retrieved 2021-02-06.
  12. 1 2 Billings, J; Parikh, N; Mijanovich, T (Nov 2000). "Emergency department use in New York City: a substitute for primary care?". Issue Brief (Commonwealth Fund) (433): 1–5. PMID   11665698.
  13. "NYC Care Expands to Manhattan and Queens, Guaranteeing Health Care to All New Yorkers". NYC Care. 2020-09-02. Retrieved 2021-12-21.
  14. Goldstein, Joseph; McKinley, Jesse (2020-03-02). "Coronavirus in N.Y.: Manhattan Woman Is First Confirmed Case in State". The New York Times. ISSN   0362-4331 . Retrieved 2020-11-21.
  15. Hansen, Sarah. "Coronavirus Crisis Has Cost NYC Up To $10 Billion: 'Basic Services' At Risk As De Blasio Pleads For More Federal Aid". Forbes. Retrieved 2020-11-21.
  16. "Coronavirus live updates: USNS Comfort arrives in New York City; Anthony Fauci defends social distancing; US death toll tops 3,100". news.yahoo.com. Retrieved 2020-11-21.
  17. Myers, Meghann (2020-03-27). "The Army Corps of Engineers has two or three weeks to get thousands of new hospital beds up and running". Military Times. Retrieved 2020-11-21.
  18. "Central Park And Home Of Tennis' U.S. Open To House Hospital Beds For New York". NPR.org. Retrieved 2020-11-21.
  19. "COVID-19: Data Main - NYC Health". www1.nyc.gov. Retrieved 2020-11-21.
  20. "The Flu Epidemic of 1918". NYC Department of Records & Information Services. Retrieved 2020-11-21.
  21. "Covid-19 sharpens focus on health disparities in New York". Crain's New York Business. 2020-11-18. Retrieved 2020-11-21.
  22. Renelus, Benjamin; Khoury, Neil; Chandrasekaran, Karthik; Bekele, Ezana; Briggs, William; Ivanov, Alexander; Mohanty, Smruti; Jamorabo, Daniel (2020-09-18). "Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic". Journal of Racial and Ethnic Health Disparities. 8 (5): 1161–1167. doi:10.1007/s40615-020-00872-x. PMC   7500250 . PMID   32946070.
  23. Arasteh, Kamyar (2021). "Prevalence of Comorbidities and Risks Associated with COVID-19 Among Black and Hispanic Populations in New York City: an Examination of the 2018 New York City Community Health Survey". Journal of Racial and Ethnic Health Disparities. 8 (4): 863–869. doi:10.1007/s40615-020-00844-1. PMC   7425794 . PMID   32794024.
  24. Schmitt-Grohé, Stephanie; Teoh, Ken; Uribe, Martín (April 2020). "Covid-19: Testing Inequality in New York City".{{cite journal}}: Cite journal requires |journal= (help)
  25. News, Eyewitness (2021-01-25). "COVID vaccination pace slows as New York awaits more supply". ABC7 New York. Retrieved 2021-02-06.{{cite web}}: |last= has generic name (help)
  26. Rubinstein, Dana (2021-01-10). "After Unused Vaccines Are Thrown in Trash, Cuomo Loosens Rules". The New York Times. ISSN   0362-4331 . Retrieved 2021-02-06.
  27. "'We had hope': Misinformation frenzy reveals NYC vaccine distribution challenges". NBC News. Retrieved 2021-02-06.
  28. Honan, Deanna Paul and Katie (2021-01-31). "Covid-19 Vaccine Distribution in New York City Skews Across Racial Lines". Wall Street Journal. ISSN   0099-9660 . Retrieved 2021-02-06.
  29. Goldstein, Joseph; Sedacca, Matthew (2021-08-12). "Why Only 28 Percent of Young Black New Yorkers Are Vaccinated". The New York Times. Retrieved 2021-12-21.
  30. "Vax Rate Increased Since 'Key to NYC' Mandate Went Into Effect Last Month: de Blasio". NBC New York. 2021-10-13. Retrieved 2021-12-21.