With Black and brown populations bearing the brunt of the COVID pandemic, NYC Health + Hospitals, New York City's public hospital system, has been reflecting on the role it can play in addressing racial health inequities.
"Last year made things obvious how much health inequity there is," said Dr. Nichola Davis, vice president and chief population health officer at the health system. "If we don't talk about it, we're not acknowledging that it's there."
Part of that conversation occurred during a Physicians Standing Up for Racial and Social Equity forum the health system held Wednesday—an early Juneteenth celebration.
"As physicians, we've been taught to think about race but in ways that are not productive," Davis said.
That includes implicit bias and medical algorithms that make inaccurate assumptions, she said. Although race does not beget worse health outcomes by default, she said, the lived experiences of Black and brown communities do often lead to poorer health, as made clear during the pandemic.
"Because we're in such a diverse community with many people of color, when they suffered the most, it was not a surprise," said Helen Arteaga Landaverde, CEO of Health + Hospitals/Elmhurst, located in a Queens neighborhood reported to have been the city's coronavirus epicenter at one point. The hospital serves patients who speak more than 120 languages and practice 93 different cultures and religions, Arteaga Landaverde said.
The community already faced disparities in underlying chronic conditions and access to health literacy; COVID just put them more in the limelight, Landaverde said.
The Elmhurst hospital's leaders said they learned important lessons during the pandemic and have been working to implement initiatives so that future crises do not land as heavily on their community.
"During Covid our doctors also reached out by telephone with case managers following up, especially for the Black and Latinx communities because they were too afraid to see a doctor," Landaverde said. With many of those populations experiencing diabetes or other chronic conditions, the hospital launched a telehealth program to reach them, she said.
The outreach program is not going away, Landaverde said, but will be transformed so it can reach homebound patients, those without money for transportation and patients with irregular work schedules. That includes many people of color, she noted.
Looking after people's health involves more than just providing medical care, Davis said, and Elmhurst and other safety-net hospitals are well-positioned to address the other social determinants.
Across the health system's 11 hospitals, a screening process for the social determinants of health has been built for patients seeking primary care, she said. Patients can be connected to resources for food insecurity and housing, legal and immigration services, she said, adding that some are available at the hospital.
Addressing structural inequalities also means paving a better way for future generations of Black and brown medical staff, Landaverde said.
"How can we get more Black and brown people to apply for healthcare jobs?" she asked. "Do we need to become mentors so that these dreams are possible?"
To that end, the Elmhurst hospital recently conducted a virtual job fair with Newtown High School in the neighborhood, said Dr. Marlon Brewer, head of primary care. The facility also has tapped college students to serve as patient navigators and act as role models to inspire young people to consider a healthcare career.
"During the pandemic, a lot of people saw the lines outside [Health + Hospitals/Elmhurst] as a bad thing, but those lines were a testament of trust communities of color had in us," Brewer said. That trust, he said, is built on the hospital staff reflecting the diversity of patients. Increasing minority representation in healthcare makes it more accessible to underserved communities, he added.
"During this period of reflection," Landaverde said, "we want to tell [the community] that Covid might have paused our dreams, but let us show you that they are possible."
This story first appeared in our sister publication, Crain's New York Business.