The current state of healthcare access in New York City is a complex issue, with disparities between different communities and populations. Latino New Yorkers, for example, have reported losing health insurance nearly four times more than white New Yorkers (23 percent compared to 6 percent). The age-adjusted mortality rate per 100,000 inhabitants was 122 for whites and 109 for Asians, while it was 238 for Latinos and 244 for African-Americans. The Neighborhood and Housing Development Association has mapped hospital closures in communities of color in New York City and the communities most affected by COVID-19 to show this overlap. The COVID-19 pandemic has had a substantially disparate impact on New York's low-income communities of color.
The New York State Department of Health has reported that, outside of New York City, the age-adjusted mortality rate per 100,000 inhabitants among white New Yorkers is 27, while this same rate doubles or even quadruples for African-American, Latino and Asian New Yorkers (109, 99 and 58, respectively). In Onondaga County (Syracuse), 14 percent of residents in white communities had been collected due to medical expenses, but in communities of color, 41 percent of residents did. Structural deficits in the New York health system have exacerbated the impact of the COVID-19 pandemic on low-income communities of color. This thematic summary describes the cumulative impact of these decisions, in particular health policy and funding decisions in New York over the past 30 years. Between 1983 and 1997, New York used a rate regulation system for all payers called New York Prospective Hospital Reimbursement Methodology (NYPHRM).
In recent years, the New York State Department of Health has assigned CPS results at the state level to counties based on the Census Bureau's national regression model. New York must take immediate steps to reduce the impact of COVID-19 on communities of color. This includes ensuring that all New Yorkers have affordable health insurance and that resources are distributed to providers based on needs, not community wealth or the provider's ability to lobby. It also means protecting New Yorkers from medical debt collection actions. Unlike any other state in the country, New York does not allocate these funds to hospitals in the safety net, which are defined as the top quartile of hospitals in a state that serve Medicaid and uninsured patients. To address these issues going forward, it is essential that policymakers take into account the unique needs of different communities when making decisions about healthcare access.
This includes ensuring that all New Yorkers have access to affordable health insurance and that resources are distributed to providers based on needs rather than community wealth or provider ability to lobby. Finally, it is important to ensure that hospitals in safety nets receive adequate funding from the state.
