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We’re Divided: Health Care Inequity in Syracuse, New York
From childbirth to access to Covid-19 treatment and vaccines, black communities in Syracuse and across the country face inequities.
Robert Bell, Rochester Democrat and Chronicle
- Covid-19 devastated New York’s low-income neighborhoods and communities of color.
- NY officials are seeking federal approval to spend $13.5 billion through Medicaid to address long-standing systemic inequities that have exacerbated the epidemic’s suffering disparities.
- The spending spans five years and supports efforts under Medicaid, a health program for low-income and disabled Americans that covers one in three New Yorkers.
After Covid-19 devastated New York’s low-income neighborhoods and communities of color, state officials are seeking federal approval to spend $13.5 billion through Medicaid to address long-standing systemic racism and inequality that has fueled disparities in the epidemic’s suffering.
From improving access to health care and medicine to revamping housing and food insecurity programs, the plan targets deficits. The complex web of social, economic, and medical factors that determine the health and well-being of New Yorkers.
The spending spans five years and supports efforts under Medicaid, a health program for low-income and disabled Americans that covers one in three New Yorkers.
The federal Centers for Medicare and Medicaid Services is now considering approving a plan that calls for a federal freeze to adopt new approaches to Medicaid, which is funded by local, state and federal budgets. If approved, the effort will begin next year.
In addition, the plan is budget neutral by necessity, meaning it will not increase Medicaid spending any more than it would without the exemption.
How is New York aiming to address health disparities?
Called New York’s Health Equity Reform, it includes nearly 80 detailed proposals to change how Medicaid spends tax dollars in New York.
Examination: In an unequally divided Rust Belt city, people are fighting for health care justice.
health care: Patients may experience reduced services at upstate NY hospitals as costs rise.
Some of the larger projects are aimed at improving safety-net hospitals that serve large Medicaid populations, which have historically struggled to fund hospitals for wealthier patients with private health plans. Other investments go to various social and health programs.
Among the plans are:
- $1.5 billion to mobilize funding and workforce training at safety net hospitals and nursing homes.
- $1.5 billion in various other initiatives to address health care workforce shortages.
- Nearly $1.6 billion for an improved transitional housing initiative to help reduce the number of patients in health facilities and unstable housing conditions.
- $748 million for additional medical care for New Yorkers released from state and county prisons and jails.
- $300 million for telehealth initiatives that build on the digital health advancements that have occurred during the pandemic
What are the determinants of social health?
Some of the Medicaid spending seeks to extend the benefits of previous efforts in New York to establish regional networks of health providers focused on reducing health disparities over the past decade.
That push, in many ways, involves addressing the social determinants of health—the conditions in which people are born, live, learn, work, play, worship, and age that affect broader health, functioning, and quality—of life outcomes and risks.
Examination: As Covid rages through New York hospitals, executives pocket $73 million in bonuses.
The state announced that the new spending will create new regional networks of evidence-based success stories targeting social determinants of health in local communities.
Key interventions include home-delivered medically tailored meals, food pharmacies, housing exploration, eviction prevention, social isolation interventions, high-risk maternal involvement, and childhood asthma education and trigger avoidance.
Among the processes are:
- Pediatric asthma: In one group, three months post-intervention data showed a 46% reduction in inpatient admissions and a 43% reduction in ED visits.
- In that same group, primary care use increased by about 17 percent over the same three-month period. For 2018 and 2019, the asthma drug ratio increased by 32.5%.
- Medically Customized Meals: 15,900 meals have been served to date. ED visits decreased from 160 visits to 60, urgent care visits decreased from 30 visits to 10 visits, and inpatient emergency department visits decreased from 200 visits to 110.
To read the full release, visit the state Department of Health’s website at at health.ny.gov. There is also a federal public comment period open until October 19. Through the Medicaid.gov website.
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