The Partnership for New York City, the city’s leading business organization, in collaboration with Deloitte, today released Toward a Resilient System of Health, a report that details changes in New York’s health care planning, financing and delivery system that are necessary to achieve sustained economic recovery from COVID-19 and a more equitable society.
The pandemic experience has made it clear that community health cannot be left solely to medical institutions and health care providers. Poverty, housing, access to public transportation, education and healthy food ─ the so-called “social determinants of health” ─ can dictate 80%-90% of health outcomes for a population. At the beginning of the pandemic in New York City, regions with a high concentration of at-risk individuals – including underlying health conditions such as hypertension, obesity and diabetes – also had higher minority populations. The Bronx had the highest mortality rate of any county with 3.2 deaths per 1,000 people followed by Queens and Kings counties with 2.8 and 2.7 deaths per 1,000 people, respectively.
The findings in the report are based on Deloitte’s research and interviews with hospital and business leaders, government officials, entrepreneurs, investors, insurers, nonprofit directors and frontline health care workers. It concludes that New York should undertake fundamental reforms in health care programs and policies, including:
- Establish an accredited rating system to set health standards for indoor spaces and a labeling system that affirms to the public that these spaces are safe to enter;
- Organize community health hubs that increase access to preventative health care;
- Reform laws, regulations and health care financing programs to encourage a shift from fee for service to value-based care;
- Leverage the buying power of health care systems to expand local capacity to produce personal protective equipment and other medical supplies; and
- Preserve the regulatory flexibility developed during the pandemic, such as increased use of telehealth and allowing health care providers to practice across state borders.
Most important, Toward A Resilient System of Health calls for better integration of the health care system with social, environmental, housing and economic development initiatives, following up on the Partnership’s A Call for Action and Collaboration, an analysis of COVID-19’s impact on the metropolitan region that was published in July. It concludes that just as the different challenges of COVID-19 are interconnected so are the solutions: an effective and resilient health care ecosystem will require a multi-sector approach that deals with all the factors that make populations more vulnerable to disease.
The infrastructure to support and fund a multi-sector approach to the health of the city does not currently exist, making a coordinated response to a health crisis very difficult. Technology makes it possible to build such an infrastructure, providing access to interoperable data among health care providers, as well as educational and human services agencies. To restore the confidence of New Yorkers in the safety and health of the urban environment, these reforms and investments should be a top priority.