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Internet resources for what you need to know about NYC Health
Five Favorite Sites For Beginners

The Topic
"Health" refers to the health issues facing the city, touching on everything from the mayor to Medicaid to managed care to mosquitoes.
The Context
New York City is one of the biggest public health challenges in the world. With 7 million residents--over 1 million of whom are uninsured--the city has the largest number of HIV cases and the largest number of intravenous drug users in the U.S. Efforts to contain a tuberculosis outbreak that threatened the city in the 1990's have been a major success--between 1992 and 1998, the deadly multi-drug resistant cases of TB declined by over 90 percent.

New York City has 20 public hospitals which served 1.5 million people in 1998 alone. Run by New York City's public Health and Hospitals Corporation, the hospital system now has a surplus of $21 million, following years of deficits and cutbacks.

The Reporter
Maia Szalavitz is author, with Dr. Joseph Volpicelli, of "Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems." She writes frequently on health, science and public policy for the New York Times, New York Magazine, the Village Voice, and other publications.

by Maia Szalavitz

Child Health Care Clinic Closings

(June '01) New York State's health care system seems to be unable to cure itself of the habit of being penny-wise and pound-foolish. The latest example: in May, the Health and Hospitals Corporation announced that it would close down 27 child health care clinics, some of which are located in public schools.

Ironically, the cutbacks were announced just weeks before Governor Pataki finally got federal approval for funding for his plan to expand Medicaid coverage to the working poor, Family Health Plus. This program is designed to increase health care access for the families served by the clinics and could actually help pay for them.

"These clinics are the heart and soul of New York City," says Judy Wessler, Director of The Commission on the Public's Health System (CPHS), a ten-year-old community-based membership organization, which is fighting to keep them open. "They have been around since 1908, they are free and they serve the poorest and most vulnerable people."

New York Times columnist Bob Herbert expressed concern that some of the clinics are antiquated and provide inconsistent care. "That's baloney," Wessler replies. "People think they need a pretty building to provide good care. There are hospitals in Europe that are 800 years old. New York has a big problem with its priorities when we are building fancy new hospitals but cutting clinics."

Dr. Carol Roye, Associate Professor of Nursing and Community Health Education at Hunter College, has worked at some of the school-based clinics. "For the most part, we see poor children who are very often not getting primary care elsewhere," she says, and explains that poor parents frequently focus on getting care for babies. As children get older, they may not recognize the need or may not believe that help is available.

"When school-based clinics are open, kids can come on their own," she says.

Roye adds that most of the children she sees are eligible for New York State's children's insurance program, Child Health Plus, but that parents often don't know about it or are daunted by the complicated paperwork. "In some hospitals and clinics, they will help parents fill out the forms," she says, "But without the school-based clinics, many of these kids would just stop getting primary care."

Roye has also seen how the clinics save money to other city agencies in unexpected ways. Many of the children she sees have serious asthma. "Asthma is a big deal," says Roye,. "Many parents are afraid to send their kids to school for fear that they will have an attack and won't get help, so they keep them home [a lot]. The nurse-practitioners at the clinic get the kids on an asthma management program and the parents who were staying home can go to work and the kids can go to school. It's very beneficial to the families." Children whose asthma is properly managed, of course, are also much less likely to turn up for expensive emergency room care.

After public outcry, the city decided not to close the 15 school-based clinics, recognizing belatedly that they have to provide school nurses anyway so cutting the clinics wouldn't really save much money.

The other clinics have received at least a 90-day stay of execution thanks to the efforts of the Commission on the Public's Health System and a large number of parents' groups, unions and other activist groups. They are hopeful that the state will not approve the clinics' closing and that the City Council will ensure funding for them. "The chances are pretty good," says Wessler, that the clinics can be saved if people continue to apply some pressure.

Maia's Favorite Five Sites For Beginners:

  • New York City Department of Health - Includes health alerts (including West Nile info), information on restaurant sanitary conditions and information on various health-promotion programs.
  • New York State Department of Health - More health data for New Yorkers including information on how to sign up for Child Health Plus and Family Health Plus-- the insurance programs for those who are presently not covered by other plans.
  • Medscape - This site, aimed at doctors, allows you to search Medline, the database of medical journals, for free. Abstracts of most journal articles are available for free as well. Once you have some basic knowledge about a condition you are researching, you can look here to get a sense of what is going on in terms of study in the area. There is a companion consumer-focused site, CBSHealthWatch, which is linked.
  • American Cancer Society - Half of all Americans will face cancer at some point in their lives-- and the New York and Washington-based American Cancer Society web site provides a wealth of information for those dealing with the disease. Includes links to other major cancer sites and resources.
  • AIDS Information - A sort of "AIDS central" for New York city with links to major HIV/AIDS organizations and information sites.

Other Recommendations:

  • Quackwatch - Debunks medical scams and inflated claims made by "alternative" medical practitioners.
  • - A consumer health information site, affiliated with CNN.
  • Citizen Action - Healthcare is one of the primary focuses of this New York advocacy group. Includes information on New York's health plans for low income people lacking insurance.
  • Oncolink - An incredible research resource for cancer patients and others concerned about this disease.
  • National Alliance for the Mentally Ill - An organization of advocates for people with mental illness which includes information on treatment and support for various disorders like depression, bipolar disease and schizophrenia.
  • Insure Kids Now - Information on New York state's insurance program for poor kids and information on other state's policies, from the federal government and the governors' association.

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Gotham Gazette is published by Citizens Union Foundation and is made possible by support from the Robert Sterling Clark Foundation, the John S. and James L. Knight Foundation, the Altman Foundation,the Fund for the City of New York and donors to Citizens Union Foundation. Please consider supporting Citizens Union Foundation's public education programs. Critical early support to Gotham Gazette was provided by the Charles H. Revson Foundation, Rockefeller Brothers Fund and the Alfred P. Sloan Foundation.

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