(photo via NYC Mayor's Office)
Latinos make up nearly a third of New York City’s eight million residents. But even though we are a large part of New York’s present and a rising population that’s crucial to the city’s future, we are completely invisible.
We are invisible in large part because we are different. And because of those joined factors, our health care is in a state of crisis. Compared to our fellow New York neighbors, we lack access to quality, culturally competent care, and we face a shortage of high-quality family care options. In fact, we sometimes encounter unique barriers that make us even more susceptible to illnesses than our neighbors and tend to experience worse health outcomes.
After decades of efforts to bring health care to underserved Latinos across the city, we set out to answer crucial questions: Why do great disparities in health care remain? And why do our families lack the health care services they need?
Why are Latinos far less healthy than our neighbors?
In a new report put out by my organization, a nonprofit network of over 2,000 providers who treat over 650,000 patients largely from lower income immigrant communities, we talked to hundreds of Latino doctors and patients across New York City to compile a first-ever poll.
We hope it spurs a movement.
We set out to bring to light health disparities and the cultural, economic, and institutional barriers that diminish access to even basic health care services -- leading to devastating health outcomes for many in our communities.
So what did we learn about the state of Latino health in New York City in 2018?
First, we learned that there is a wide gap between Latino patients and their physicians over what constitutes good health. While a majority of Latinos think they are healthy, their doctors disagree by vast margins. And only one-third of Latino patients think they are not receiving the care they need while two-thirds of doctors think Latinos experience persistent barriers to care.
Second, transportation and child care pose major barriers to health care access in Latino communities. Language is another major issue: in the Bronx, home to the city’s largest Latino population, only 10% of doctors speak Spanish, compared to 60% of residents. In fact, immigrants interviewed stated that language barriers kept them from telling their health care providers all of their symptoms – leading to unnecessary emergency room visits, avoidable crises, and uncontrolled chronic conditions.
Finally, too many health problems are going untreated in the Latino community. Smoking, asthma, obesity, diabetes, and hypertension are prevalent problems but health education has not kept up and health education materials are often not available in Spanish. In addition, mental health and substance abuse challenges are stigmatized and remain taboo to discuss, going undertreated or even untreated.
In short, our report showed us that we have much more work to do to lift up and improve health outcomes in the Latino community, but we can make progress if we are willing to put in the work.
Together, by prioritizing community engagement, we can build and scale a sustainable architecture of innovation to confront and solve these problems. We can and must develop and sustain strong community, public health, and health care strategies to improve access to quality, culturally competent, and much needed care.
Additionally, we also need a serious investment in health education on the part of policy-makers to address not only these conditions but also the lack of health education resources offered. And language matters. Understanding these nuanced, culture-specific disparities will help us build a system that combines high quality with more effective care that reduces costs for patients, institutions, cities, states, and the federal government.
The Latino community is growing faster in New York than in Nevada or California. Over the next few years, through intervention, innovation, and integration, we will use the findings of this report to partner with the state and city to better deliver culturally-competent care and build a stronger, healthier Latino community in New York.
The need is urgent, the path forward clear – now it’s time for action.
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Dr. Ramon Tallaj is the founder and chairman of SOMOS Community Care.
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Gov. Cuomo pushes for a higher Port Authority minimum wage (photo: Mike Groll/Governor's Office)
Last week, Governor Cuomo publicly called on Port Authority of New York and New Jersey's Board of Commissioners to pass a higher minimum wage for airport workers. While I, other elected officials, and numerous nonprofit advocates were pleased to see this increase approved, Governor Cuomo has still not fulfilled his commitment to another vital workforce in our state, the human services sector.
Hundreds of thousands of human service employees – the vast majority of whom are contracted by the state – remain unbelievably underpaid, making approximately $23,000-$29,600 per year, with no wage increases since 2010. These rates fall well below the $19 hourly wage the governor called for at the Port Authority, and are also below the average income required to meet the basic living needs of a family. The human services sector is a group comprised of approximately 332,000 New Yorkers – 80% of whom are women, and 50% individuals of color – who provide life changing services to New Yorkers from all walks of life, and are essential to our communities.
These are workers who care for our children, assist those with mental health issues, ensure survivors of domestic violence can rebuild their lives, and care for our aging relatives. Yet they are left with a wage that does not provide economic security of their own. For years, the work of employees in the nonprofit sector has been undervalued; the salaries in the sector are lower than comparable positions in other fields, many of the positions require a college degree but do not compensate accordingly, and stagnant wages result in high turnover.
Not only have state contracts failed to fully fund the wages of these employees, but Governor Cuomo refuses to include common-sense cost of living adjustments (COLA) that would allow these employees to earn a livable wage.
We have fought every single year since Governor Cuomo took office in 2011 for a statutory cost-of-living-adjustment (COLA) for human services employees. To this end, our chief executive has consistently and uncompromisingly deferred from providing any support in this initiative. This inaction has cost the human services workforce almost $500 million in lost wages. We have seen a largely consistent public commitment from the governor in his support of raising wages across New York. This was demonstrated in his remarks last week, in his championing of the $15 minimum wage, and through his outspoken support of pay equity for women. In light of these strong positions, we expect Governor Cuomo to apply this effort to increase the very limited salaries of human service workers.
When this wage increase for Port Authority workers was enacted, the governor stated that “it is paramount that we have a well-trained, secure, stable workforce…Invest in your most important asset, which is your workforce. Fairness, diligence, good business practices all bring one to the same obvious conclusion. Invest in the workforce, raise the minimum wage to $19 over five years. It is the right thing to do. It is the smart thing to do."
We agree, Governor Cuomo. It is time for our state’s leader to make good on his own words, and fund the human services COLA in the next state budget to ensure living wages for this workforce which we our state depends on so heavily in order to build strong communities.
The governor said it best himself: “It is the right thing to do. It is the smart thing to do.”
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Andrew Hevesi is a member of the New York State Assembly, representing parts of Queens in Assembly District 28. On Twitter @AndrewHevesi.
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Kings County Democratic Committee meeting (photo: James Boo, New Kings Democrats)
This summer I collected signatures from neighbors to represent my election district, an area of a few blocks, as a member of the Kings County Democratic Committee (KCDC), the Brooklyn denomination of the New York State Democratic Party.
I had signed up with the #RepYourBlock campaign, convened by New Kings Democrats (NKD), one-and-a-half years earlier for this purpose. I handed in my petitions in June and a few months later I received a postcard informing me of KCDC’s bi-annual rules meeting, on September 27 at Kingsborough Community College. This postcard let me know that if I signed and returned it to Frank Seddio, the Democratic County Chair, there would be no need for me to attend. Despite this “helpful” suggestion that I turn over my vote through this proxy before ever even participating in a meeting, I made plans to be there.
The hundreds of people gathered in the Leon M. Goldstein Performing Arts Center on September 27 ranged from newly-minted members like myself to people who had been attending for decades. From the beginning, it was clear that the party leadership was overwhelmed by the turnout. It was less clear whether that was by design or by incompetence.
We waited two-and-a-half hours past the posted start time for the meeting to begin. It was standing room only, and the people around me were palpably excited to participate in this most local form of government. When the meeting finally began, it got off to a contentious start. KCDC members heckled from the back of the room. The person leading the meeting, former State Senator Martin Connor, never introduced himself and was immediately defensive. Many of us had trouble following what was happening in a poorly-mic'd room with a lot of background noise.
In the weeks leading up to the meeting there had been heightening tension around the efforts of NKD, a reform club trying to increase the participation of everyday Brooklynites through the #RepYourBlock campaign. NKD had reached out to Democratic County Committee members encouraging them to attend the meeting and if they couldn’t, asking that they give their proxy to someone they know or one of the #RepYourBlock partners, in an attempt to counter the juggernaut of the party leadership proxy-collection machine. Many committee members received multiple requests for their proxy (a way to allow someone else to vote in your absence), including a misleading one from party leadership that purported to be signed by one’s state Assembly member and district leaders (many of whom claimed this happened without their permission). Partially in response to this, there was a proposal to reform the proxy system introduced by my own Assembly member, Robert Carroll, which was overwhelmingly supported.
Then the time came for the vote that is one of the only real roles for members like me – voting for the officers of the executive committee. This year an actual competitive election was possible, because an alternate “reform” slate had been proposed by #RepYourBlock. The voting began, and an already tense meeting unmistakably changed.
Because we didn’t even get the chance to vote!
It was over before it started. Party leadership had waited to start the meeting until they were sure that Frank Seddio had enough proxy votes to overrule anything that happened. The voting began with a vote on the complete executive committee slate, and motions for a vote on each individual position were overruled or just flat out disregarded. When the vote was called for the establishment slate, about 50 people stood up. Martin Connor said those 50 votes, plus the more than 500 proxies held by Frank Seddio, meant the establishment slate won.
Even when those numbers were questioned, or when it was pointed out that the numbers didn’t seem to add up, or when it was clear that the numbers being reported were actively changing as more proxies appeared with every challenge, we were told “It’s done” and the meeting moved on.
In that room there were hundreds of people like me who had petitioned to be on County Committee, some of whom had competed in primaries. Over 500 people had left work early, skipped dinner, planned for childcare, carpooled, rode a subway to a bus, or made countless other arrangements, all to come to Manhattan Beach on a weeknight and attend a five-hour meeting. And the overwhelming majority were not even able to stand up and be counted in favor of a candidate they supported. Their questions and requests for explanation or clarification were dismissed and they were scolded from the lectern for daring to even ask them.
When a motion was made to recount the vote, after a member pointed out that the numbers given did not add up to an establishment victory, the vote in favor of recount was overwhelming. That vote was also unsuccessful, as Seddio’s proxies still outnumbered those in attendance. But the room had shifted, and even people who had voted for the establishment slate saw what was happening as counter to a democratic process. NKD and #RepYourBlock had inspired us to show up and be a part of our local political process, and the Kings County Democratic Party saw us as an obstacle.
The Brooklyn Democratic Party leadership did more for reform with its actions in that auditorium than years of organizing could have.
It is a testament to the efforts of #RepYourBlock that so many people were there. And by being so entrenched, and so unwilling to allow for anything that might dilute their stranglehold on Brooklyn politics, party leadership ensured that the proxy abuse they are so reliant on is in its final days.
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Nicole Hunt is a member of New Kings Democrats, on the Executive Committee of Brooklyn Voters Alliance, and a member of the Kings County Democratic Committee. On Twitter @msnicolemh.
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