Real equity in New York starts with access to preventative health care | Opinion

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Pamela Quintero, Outreach Enrollment Specialist for the Open Door Medical Center in Ossining, hands Covid-19 home tests and an informational flyer to Jorge Belloso of Ossining on Feb.1, 2022. The Open Door Medical Center is handing out Covid tests and encouraging residents to get vaccinated in several communities of color with low vaccination rates.
Pamela Quintero, Outreach Enrollment Specialist for the Open Door Medical Center in Ossining, hands Covid-19 home tests and an informational flyer to Jorge Belloso of Ossining on Feb.1, 2022. The Open Door Medical Center is handing out Covid tests and encouraging residents to get vaccinated in several communities of color with low vaccination rates.

Early on a weekday morning two years ago this week, 50 doctors attached signs in Spanish, Chinese and English to the chain-link fence surrounding parking lots at Lehman College, placing the finishing touches on what would be the first COVID-19 testing site in the Bronx.

By the end of the first wave of the pandemic, the borough, home to hundreds of thousands of poor and undocumented New Yorkers, would be the hardest hit locality in the country: but we didn’t know it that morning.

What we did know was that the communities where we treat children and in modest family clinics were scared, isolated, and already starting to get very sick. Outside the gates, lines of cars and people on foot, including many pushing wheelchairs and strollers were lining up for the day’s supply of tests. Some were already sick, many had already lost their hourly and shift jobs, and many were hungry.

Over the coming months, the numbers of casualties and heartbreaking stories out of New York and other cities with significant lower-income communities of color shocked and riveted the country. Doctors like us and the patients we treat were devastated - but not surprised. That is because the inequities we observed in our patients and their families before the pandemic, which made COVID-19 so much more devastating in places like the Bronx, were the comorbidities of poverty that had revealed a tattered safety net and made people sicker for decades.

Fast forward to today and the kids we take care of are back in school, the masks of kids ages 5 and above in school are coming off, small businesses are starting to reopen, jobs are bouncing back, and tourists are returning. A high (but not nearly high enough) number of New Yorkers are vaccinated. And policymakers are placing the term “health equity” - a previously obscure phrase mainly used by activists at the top of their agendas. These are all positive steps.

But, to turn health equity from a political goal to service delivery means policy. And while devoting more resources, better spent to rebuilding poor communities, is important, there is enormous hope that officials at the city, state and federal level are finally looking at what prevention means and what strength means in a sustainable way, including in the recent state budget - which, for community doctors, was highly encouraging. Take it from us: keep the focus on equity during implementation.

For our patients, this is what an equity agenda looks like: no matter their race, language, income, zip code, education level and immigration status, all families have a right to affordability. So many of our patients don’t have private insurance. They use Medicaid or Medicare, and some families don’t have any insurance at all.

Patients also need to access the many forms of health care including telehealth, and medical services delivered in their spoken language and to facilities with flexible hours, so our patients can access care regardless of work, caregiving responsibilities, or other time constraints - and to consistent health options and no health deserts. Patients also need access to proper treatment, especially for diabetes that is so prevalent in our communities and has been an important contributor in about 40% of COVID-19 deaths and even more so in communities of color.

All New York patients deserve the right to prevention, including preventive care from before birth – too often, preventive care is the purview of the affluent, while the poor use the emergency room. No more. And all patients must have the right to culturally competent health care that services their health needs within the context of their family, community, in their own language that is free of discrimination and bias.

An equity agenda also must have doctors' needs in mind. We serve poor communities, and we can no longer do more with less. We deserve the right to access government support for delivering quality care and for the work we do helping to lower costs, and for protecting our clinics and patient pools, since these are our small businesses. And providers must have the right to access government investments for innovative care delivery to meet growing needs for vulnerable populations. We want to see policies and investments in providers who stay in underserved neighborhoods. We want to be able to do our part in breaking barriers on behalf of the patients we treat with the support of local, state, and federal government leaders.

Taken together, this is what health equity looks like.

Two years ago, we were in the streets, fighting for our lives and the lives of our patients. Now that we are in a new phase of recovery, it’s time to take the long view and focus on what can be done to help community doctors like us do the job more effectively and serve our patients and their families better. That’s where equity comes in. We hope that every move is dictated by the push towards equity – in fact, we hope, that politicians think of equity as a litmus test. If a policy point increases equity, and access, and makes poor communities healthier, stronger, and more prosperous, keep it. If it doesn’t – throw it out.

Dr. Nuñez and Dr. Tapia are pediatricians who run family clinics in the Bronx and Upper Manhattan, respectively, and are both members of SOMOS Community Care.

This article originally appeared on Rockland/Westchester Journal News: All New Yorkers deserve the right to preventative health care