Gotham Gazette

The Place for New York Policy and politics

Opinion

Opinion

Health and Housing are Inextricably Linked; My Patients Need Home Stability Support


rafael sala holds

A push for a new state homelessness-housing voucher continues (photo: John McCarten/City Council)


As a doctor in the hospital, I bear witness to some of the most severe downstream effects of health inequity in our community. In my field, I care for any person who presents to the emergency room and is then deemed too sick to be discharged. Through years of clinical service, I have come to appreciate housing as the most vital component of a person’s ability to stay well.

More recently, research surrounding individuals experiencing homelessness has highlighted the increased risk of trauma, rapid aging and development of geriatric syndromes, and increased risk of death at an earlier age compared to people who have stable housing.

In essence, people in our community who are experiencing homelessness are becoming sicker faster and dying at an alarming rate. Compounded with the fact that we are facing the worst homelessness crisis since the Great Depression, our state needs to act now.

A proposed statewide rent subsidy program known as Home Stability Support would be a critical step forward in changing the trajectory of so many people and families struggling with one of the most basic human needs. The proposal would help individuals and families who are homeless or at risk of becoming homeless in providing realistic rental assistance that would result in successful housing. 

The majority of my patients are highly medically complex and experiencing social struggles that complicate their recoveries. I have the privilege and honor of hearing people’s stories while working in my field and am humbled each time a person describes the painful experience of attempting to maintain their health while concurrently managing an unstable living situation or navigating the shelter system.

Being discharged from the hospital with a new list of medications and follow-up instructions after a severe disease state can be complicated in otherwise ideal situations. For a person experiencing homelessness, who is tasked with the additional worry of safety, exposure, or navigating the housing system, we can easily see their diseases rapidly worsen after leaving the hospital and see them end up back in the emergency room. This is no cycle that any human being should experience. 

Even if not homeless at the time, my patients have additionally asked to leave the hospital before medically treated because missing another day of work would put their ability to pay rent in jeopardy. As a doctor, tasked with attempting to alleviate suffering and treat disease, it pains me to witness people having to choose between keeping their housing and their health. With 23,000 more New Yorkers becoming homeless than leaving homelessness each year, Home Stability Support would critically address people at risk of eviction in addition to people currently homeless, preventing so much of the endless suffering and potential health complications that accompany losing your home.

Homelessness, while not officially recognized as an Adverse Childhood Experience (events linked to increased risk of numerous conditions including cancer, lung disease, heart disease and early death), does place children at higher risk of ACE exposure and poor health outcomes later in life. In hearing frequent stories of childhood trauma amongst my patients with high biopsychosocial complexity, I can only think of the needless suffering that a program like Home Stability Support would prevent. We already know, but clearly don’t fully appreciate, the potential risk we take allowing 150,000 children in our state to experience homelessness, as was the case in the last two years.

In hearing the critical steps this statewide proposal would take to effectively alleviate and prevent immediate homelessness, this is our chance to speak out as citizens and urge our State Legislature and Governor to work together to pass, fund, and quickly implement this initiative and help move people from the shelter systems to homes where they can begin to heal. I encourage any healthcare provider who has had the privilege of caring for patients with unstable housing to speak out similarly and support the Home Stability Support proposal.

***
Amanda Ramsdell, M.D., is an Internal Medicine Physician at New York Presbyterian in New York City and Assistant Professor of Clinical Medicine at Weill Cornell Medical College. On Twitter @ARamsdell3.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Renewable Delusion: Let's be Real About Power Production in New York


cuomo indian point

Gov. Cuomo outside Indian Point power plant (photo: Governor's Office)


Richard Webster, attorney for Riverkeeper, a principal advocate for closure of Indian Point power plant, has written a deeply misleading response to an opinion piece in which Herschel Specter and I urged that the Indian Point nuclear plant, the largest source of carbon-free energy in the downstate region, be kept open.

Mr. Webster, probably speaking for the Cuomo Administration as well, has attempted to refute our assertion that the closure of the Indian Point nuclear plant will lead to the burning of huge amounts of natural gas, vastly increase the emission of greenhouse gases, and raise the levels of air pollution in low-income neighborhoods and communities of color in New York City and elsewhere.

In the very first paragraph, he claims that NYISO, our grid operator, says that once Indian Point closes, electric demand can be met with “combinations of clean energy sources, transmission improvements, and energy efficiency.” In fact, the source he cites says they will be relying on three natural gas-fired plants to supply the electricity we need. In fact, the words “clean” or “renewable” do not even appear in the NYISO report.

He goes on to assert that “clean energy and efficiency” can “replace” one of Indian Point’s two reactors. The Indian Point plant runs 24/7 providing “baseload” power to the region. Weather-dependent solar and wind sources provide energy when the sun shines and the wind blows, not the full scope of when we need it. Nor are they even available downstate in the quantity needed to power this dense, high-utilization region.

Mr. Webster believes – and we know this belief is shared by many others – that Indian Point poses great risks to our region. My colleague Herschel Specter has shown in two guides – here and here – that scientific studies and worldwide experience demonstrate that these fears are unfounded. Reactors have been operating safely in the United States for more than 50 years, and they continue to do so. Residents of the Metro area can relax; any problems at Indian Point will be localized and easily dealt with.

Websters treats the generally laudable goals of New York’s 2019 landmark climate legislation as if they are on the way to being achieved. In fact, the prestigious Citizens Budget Commission has shown that the early goals in this legislation are “likely infeasible.” Mr. Specter and I have demonstrated elsewhere that attempting to meet the new law’s 2030 goal with only renewable sources would cost more than $100 billion and is completely impractical. In both the short and long term, nuclear power must be a part of New York’s energy future if we are to end the use of fossil fuels. Closing Indian Point will be a giant step backwards, setting us back a decade and probably more.

One further point: The 2017 Indian Point Closure Agreement may actually be illegal. The State’s Environmental Quality Review Act (SEQR) requires that all discretionary decisions of an agency like the Department of Environmental Conservation that may affect the environment are subject to an environmental assessment under SEQR. In fact, on p. 137, in an Environmental Impact Statement regarding water use permits, DEC recognizes the deleterious effects that even a temporary closure would have. Certainly, the permanent closure of Indian Point will have substantial environmental impacts, and no such review of this closure has ever been performed. 

***
Leonard Rodberg is a physicist who taught climate change and public policy at Queens College/CUNY until his retirement in 2017.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Take It from Someone Who Connects People Socially: Now’s The Time for Social Distancing


daily life imagery

It's time for social distancing in New York (photo: Benjamin Kanter/Mayoral Photo Office)


Much of my life’s work has been about building in-person social connections. Now, I'm wrestling with how to understand and participate in "social distancing" as a way to confront the spread of the new coronavirus, COVID-19.

I help run a network of hundreds of political social events around the country that has created friendships and solidarity through face-to-face gatherings. I'm also chair of the board of The Tank, a Manhattan theater that runs 20 shows a week and supports 1,000 performers every year while welcoming tens of thousands of audience members through its doors. I'm a parent whose kids need affirming contact and need to run as free as city life allows. I once gave a speech about the importance of hugs.

And as a candidate for public office, I'm in the handshake and house party game.

Yet, the way we slow or stop the spread of a virus is by reducing the number of people each of us—even those of us who are healthy and less at risk—come into contact with. In addition to measures like washing our hands, staying home if we're sick, and working from home, "social distancing" is the recommendation by public health officials to ultimately do less harm to the community around us.

It’s a frustrating irony that at the moment of a public health crisis—when there's fear and isolation and stigma and misinformation, and when community, friendship, solidarity, neighborliness, personal connection, and social capital may be more critical than ever for many of us—we have to distance ourselves from each other, at least physically.

My mind goes to the individuals who already feel isolated or alone and for whom this moment could intensify those feelings. To those who need others, physically or emotionally, to get through the day. And to those whose roles—at work or at home—demand they care for others.

And then it goes to those people whose fields are about creating community spaces and connections: coffee shop owners and staff, folks who run recreation leagues and gardening clubs and afterschool activities, and of course those in the performing arts who deliver the electric thrill of live performance in an era dominated by screen time.

“Social distancing” is hard for some of us—but nearly impossible for others—and a quarantine is a real physical, emotional, and financial risk to many. And yet, far from being anti-social, social distancing is the most pro-social act we can take, because those of us who have the privilege to do it are able to help those who can’t.

Social distancing is a reduction, not the elimination, of human contact. And it shouldn’t mean checking out of society or hiding away in a bubble. Check on your elderly neighbors and offer to shop for them, because it may be important that they not shop on their own. When you shop, take what you need, but don't hoard months of supplies and add to an amplified panic. 

Be kind and grateful to the folks who continue to do their jobs, cashing you out, delivering your mail, stocking shelves, driving a cab, signing you in at the doctor. That means following their rules, respecting their space, asking before you make contact, covering your mouth, avoiding them if you're sick, and saying thank you. And I'd even suggest that if you're not sick, you should continue to patronize restaurants and cafes and bars that aren't crowded, because if they aren't crowded, you can keep a social distance from others—and the venue can probably use your money.

As the weather gets nicer, get outside if you can. 

Yes, wash your hands, carry tissues, cough into your elbow—literally the least you can do. 

And when social distancing has helped level out this coronavirus, get ready for serious socializing: Show up at birthday parties and school functions, and take in a night of theater (or several!) to bring back that joy and vibrancy that we'll miss.

We need government to act to ensure the social safety net, from health care to paid sick leave to unemployment insurance, and we need employers to do what they can to support their employees' health and well-being. There are myriad policy solutions at this moment, and many more that we need long-term to address the societal weaknesses this emergency has laid bare. But even while we demand that our government and businesses do more, we need to act as individuals for the sake of the larger society—reducing contact where we can and ensuring connection where it's most needed.

I once gave a graduation speech about the importance of hugs. Now, I'm facing a few weeks of waves, nods, and elbow bumps. It's not because I don't care about you but because I do. And we'll be back to hugging soon.

***
Justin Krebs is director of campaigns at MoveOn and a candidate for City Council in Brooklyn’s District 39. On Twitter @justinmkrebs.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.



Print Friendly and PDF

Editor's Choice


Gotham Gazette: New York Voters Approve $4.2 Billion Environmental Bond Act
New York Voters Approve $4.2 Billion Environmental Bond Act
Gotham Gazette: 
New York City Voters Approve Racial Justice Ballot Measures
New York City Voters Approve Racial Justice Ballot Measures
Gotham Gazette: 
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Gotham Gazette: 
City Council Examines Low Voter Turnout, Moving Local Elections to Even Years City Council Examines Low Voter Turnout, Moving Local Elections to Even Years