With black and brown populations carrying the brunt of the COVID pandemic, NYC Health + Hospitals, New York’s public hospital system, has reflected on the role it can play in tackling racial health inequities.
“Last year it made things clear how much there is health inequity,” said Dr. Nichola Davis, vice president and head of population health at the health system. “If we don’t talk about it, we don’t recognize that there is.”
Part of that conversation happened during a Doctors Forum standing by the Racial and Social Equity Forum that the health system held Wednesday – an initial celebration of January.
“As doctors, we’ve learned to think about race but in ways that aren’t productive,” Davis said.
This includes implicit bias and medical algorithms that make inaccurate assumptions, he said. Although the race does not generate worse health outcomes by default, he said, the lived experiences of black and brown communities often lead to worse health, as is clear during the pandemic.
“Because we’re in such a diverse community with so many people of color, when they suffered the most, it wasn’t a surprise,” said Helen Arteaga Landaverde, CEO of Health + Hospitals / Elmhurst, located in a Queens neighborhood that said it was the epicenter of the city’s coronavirus at one point. Arteaga Landaverde said the hospital serves patients who speak more than 120 languages and practice 93 different cultures and religions.
The community has already faced disparities in the underlying chronic conditions and access to health literacy; COVID only puts them in the center, Landaverde said.
Leaders of Elmhurst Hospital said they have learned important lessons during the pandemic and that they have worked to implement initiatives so that future crises do not land so hard on their community.
“During Covid, our doctors also met by phone with the case managers who followed, particularly for the Black and Latinx communities because they were too scared to see a doctor,” Landaverde said. With many of those populations suffering from diabetes or other chronic conditions, the hospital has launched a telecare program to reach them, he said.
Landaverde said the outreach program will not go away, but will be transformed to be able to reach patients returning home, those who do not have money for transportation and patients with irregular work schedules. That includes many people of color, he said.
People’s health care involves more than just providing medical care, Davis said, and Elmhurst and other safety net hospitals are well positioned to address other social determinants.
In all 11 hospitals of the health system, a screening process for social determinants of health has been constructed for patients seeking primary care, he said. Patients can be connected to resources for food insecurity and housing, legal and immigration services, he said, adding that some are available in hospitals.
Landaverde said tackling structural inequality also means paving a better way for future generations of black and brown medical staff.
“How can we get more Black and Brown people to apply for health jobs?” he asked. “Do we need to become mentors so that these dreams are possible?”
To that end, Elmhurst Hospital recently held a virtual work fair with Newtown High School in the neighborhood, said Dr. Marlon Brewer, head of primary care. The facility has also leveraged college students to serve as patient navigators and act as role models to inspire young people to consider a healthcare career.
“During the pandemic, many people saw the lines outside [Health + Hospitals/Elmhurst] as a bad thing, but those lines were a testament to trust in the communities of color we had in us, “Brewer said. That trust, he said, is built on hospital staff reflecting diversity. Increasing the representation of minorities in health care makes it more accessible to underserved communities, he added.
“During this period of reflection,” Landaverde said, “we want to count [the community] that Covid could have paused our dreams, but let me show you that they are possible. ”
This story first appeared in our sister publication, Crain’s New York Business.