A recent community health study determined that residents of Community District 9, which encompasses 110th to 155th Street on the West Side of Manhattan, experience significant barriers in access to health care. The study reported that slightly over one-sixth of the CD9 population was unable to get medical attention when they needed it. If there is a world-class hospital located at the center of CD9, why are so many people who desperately need medical attention unable to receive it? As Spectator reported last week, West Harlem residents lack sufficient access to medical facilities and hospitals. This challenge is due to the impoverished state of about one-fifth of CD9 residents, the district’s disproportionate number of people with medical conditions, and the presence of only one hospital in the district.
Half of all CD9 residents are rent-burdened and a fifth of them are severely rent-burdened. CD9 is ranked among the top 20 districts with the worst maintenance defects in New York City—15th out of 59. Compared to borough averages, CD9 has a greater number of low-income residents and poorer quality housing. Additionally, the district’s adult obesity rate is 25 percent, which is much higher than the 16 percent rate across Manhattan.
On top of all this, health studies have repeatedly demonstrated that a disproportionately greater number of poorer residents and people of color will struggle with asthma. These factors all contribute to the health conditions that make CD9 residents especially susceptible to COVID-19.
There are few health care provider options available within the district, and even fewer health care options accessible to its individual residents. It isn’t that CD9 has the greatest number of poor people, sick people, or people without healthcare in the city. But it does have many of those people and only one hospital with only 24 intensive care beds.
Mount Sinai Morningside, formerly known as Mount Sinai St. Luke’s, is the only major health provider in the area due to the closure of other smaller, independent options. In the late ’90s, New York decided to deregulate hospital reimbursement rates, allowing health care providers to negotiate directly with insurance companies. This favored large medical networks like NewYork-Presbyterian, NYU Langone, Northwell Health, and Mount Sinai, and forced many small medical facilities to close.
Medicaid reimbursement cuts in 2012 also had a disproportionate impact on smaller hospitals, leaving larger systems virtually unhurt. All of this negatively impacted independent health care providers in their battle to stay in business. Furthermore, the impact of hospital closures fell disproportionately on people of color, who were more likely to use emergency medical services.
What can be done? At present, there is no space, funding, or willingness to construct another hospital in CD9. We can expand community health clinics, for which the infrastructure is already in place. There are two public housing projects in CD9: Grant Houses and Manhattanville Houses. Grant Houses has a health clinic (that has just one doctor listed, a pediatrician), the Manhattanville Health Station has been closed for over a decade, and although Charles B. Rangel Community Health Center is around the block from Manhattanville, it is underfunded.
Expanding the existing clinic at Grant into a full-service medical center, re-opening the Manhattanville Health Station, fully funding Rangel, and opening a new clinic in the northern part of the district would provide more immediate medical access to underserved CD9 residents. It would extend health care services to reach deeper into the poorer sections of the community. If we cannot expand the capacity of hospitals to meet the needs of our neighbors, we must extend necessary medical assistance through community health clinics.
Daniel Marks Cohen is a candidate for the New York City Council in 2021, a member of the Mount Sinai Health System Community Advisory Board, a member of Community Board 9, and a lifelong Community District 9 resident.
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