News Release
FOR IMMEDIATE RELEASE

Contact:  Julie Rowe
The Opportunity Agenda
jrowe@opportunityagenda.org
212-334-5321
347-556-1896

NEW REPORT:  New York State Health Care System Violates Human and Civil Rights Laws

Underserved, Low-Income and Communities of Color Face Dangerous and Unlawful Barriers to Receiving Care; Further Cuts Would Constitute Additional Violations of the Law

NEW YORK – November 28, 2006.  A report released today by The Opportunity Agenda found that the inequitable distribution of health care services across New York communities violated state, federal, and international laws protecting residents’ right to health care.  The report, Dangerous and Unlawful:  Why Our Health Care System is Failing New York Communities and How to Fix It, also noted that many neighborhoods with the highest health care needs, which are disproportionately low-income and communities of color, often have the fewest health care resources. 

Prompted by the release of the recommendations of the New York State Commission on Health Care Facilities in the 21st Century – commonly known as the Berger Commission or the Hospital Closing Commission – the report notes that any further cuts to services in underserved communities exacerbating these conditions would constitute new and independent violations of the law.

According to the report, the law requires that state, federal, and municipal governments take steps to guarantee everyone an equal opportunity to access health care.  For example, the race or limited English-language skills of a person cannot limit his or her access to care, nor can the racial character of a community determine its residents’ access.  The report also notes that international human rights laws indicate that protecting the health of mothers and children is an especially important obligation of governments.

In listing violations, the report focused on several areas in which the current system fails New Yorkers, including a lack of adequate and equally distributed primary and prenatal care.  Specifically, the report noted:

• In 2001, an estimated 1.8 million New York State residents were designated by the U.S. Department of Health and Human Services as living in medically underserved communities.
• Almost 60% of New York City’s zip codes have an inadequate supply of primary care physicians who are willing to see Medicaid patients. 
• Nearly one in four New York City residents do not have a regular doctor.  More than half a million New York City residents reported needing but not receiving medical care in a twelve month period in 2002-2003. 
• Thirteen geographic areas in New York City are designated as health care professional shortage areas, including:
  • Port Richmond and St. George in Staten Island;
  • Long Island City and South Jamaica in Queens;
  • Washington Heights-Inwood and West Central Harlem in Manhattan;
  • Williamsburg, East New York, Crown Heights, Bushwick and Bedford-Stuyvesant in Brooklyn; and
  • Hunts Point/Mott Haven and Highbridge in the Bronx. 

The report also found that the availability of obstetric and gynecologic (OB/GYN) physicians varies considerably across New York City’s five boroughs.  On average, low-income communities and communities of color have the fewest OB/GYN providers, and women in neighborhoods that have the lowest density of OB/GYN providers often have the highest rates of receiving late or no prenatal care. 

“This report’s findings are troubling because New York is synonymous with opportunity in the American vocabulary, but this opportunity is endangered if our health care system does not work for everyone,” said Alan Jenkins, executive director of The Opportunity Agenda. “More and more New Yorkers are finding that health care is too expensive, too far away, too inconvenient for working families, too insensitive to language needs and cultural differences – in short, too far out of reach for too many.” 

The report also found serious violations of New Yorkers’ right to equal access to health care services, finding that low income and communities of color face disproportionate difficulty in getting care, a circumstance that violates federal, state and local civil rights legislation.

“In New York City, areas with high concentrations of African-Americans, Latinos, and Asian-Americans are most likely to have serious shortages of primary care physicians,” said Brian Smedley, research director for The Opportunity Agenda.  “Hospital closures and downsizing in New York City have also disproportionately affected communities of color.”

Smedley noted that two-thirds of the 12 hospitals that closed between 1995 and 2005 in New York City served predominantly people of color.  In some cases, the patient populations served by those hospitals were more than 90% African American, Latino, and Asian American, he said. 

”It’s clear that the current state of care jeopardizes the health of New Yorkers and violates the law,” said Jenkins.  “And any downsizing, closures, or service changes that further diminish care will compound those violations and further threaten New Yorkers’ health.”

Jenkins also noted that these trends not only violated the law, but were contrary to New Yorkers’ values and beliefs.  Citing a recent poll conducted by The Opportunity Agenda and the Harvard School of Pubic Health finding that New Yorkers see health care as a fundamental human right, he noted that eighty-nine percent surveyed said that “everyone in New York has a right to health care.” 

According to that poll, New Yorkers also reject the idea of a health care system that overlooks those needing the most help.  For example, almost 75% of those surveyed held the state responsible for ensuring that racial or ethnic minorities and low-income New Yorkers have an equal chance to access health care as wealthy people. An overwhelming number of New Yorkers believe that all levels of government – local, state, and federal – are responsible for ensuring that everyone in New York gets the health care they need. 

The report also included a number of recommendations for improving the system.

“We need a health care system that provides coverage to everyone, emphasizes preventive and primary care, and addresses the needs of diverse groups in order to improve the health of the state’s population while corralling costs,” said Jenkins.  “We’ve offered some practical ways to achieve these goals.” 

Among the report’s recommendations to the state legislature:

• Implement a moratorium on hospital closures and service reductions in medically underserved communities;
• Establish statewide health care planning;
• Expand Community Health Centers, which have proven effective in expanding access to care in underserved communities and can help reduce racial disparities in health care outcomes.
• Move to universal coverage, reducing financial barriers to effective and equitable distribution of health care resources by equalizing incentives for hospitals, health care systems, and private providers to serve a range of communities, regardless of their wealth or poverty.
  Among the report’s recommendations to the governor:
• Delay implementation of the Berger Commission recommendations while the potential effects on community health care needs are assessed. 
• Establish a task force to review the Medicaid reimbursement system and increase reimbursement rates for crucial primary, prenatal and maternal health care services. 
• Collect data and monitor for disparities in health care access and quality on the basis of income, race, ethnicity, gender, primary language, and immigration status, as required under federal civil rights laws. 

The report also included a list of recommendations for New York City officials, Mayor Bloomberg, the federal government, health care provides and New York residents, noting that New Yorkers should begin to claim and insist upon their right to quality health care in far greater numbers.  A full copy of Dangerous and Unlawful is available on the organization’s website at www.opportunityagenda.org. 

The Opportunity Agenda is a communications and research organization whose mission is to build the national will to expand opportunity in the United States.  The organization is privately funded by foundations and individual donors.  The Opportunity Agenda is a project of the Tides Center.

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