In New York City, there are deeply entrenched health disparities present in lower-income communities compared to adjacent wealthier communities. Children in East Harlem, for example, are almost twelve times more likely than children living on the Upper East Side to visit the emergency room for asthma-related issues (NYC Community Health Profiles, 2018).
Once the epicenter of the Western world’s HIV/AIDS crises of the 1980s and 1990s, New York City’s rates of new diagnoses have been steadily declining. According to a report from the New York City Department of Health and Mental Hygiene, the rate of new HIV infections decreased by an estimated 36 percent in New York City between 2013 and 2017. The most recent data shows that there were 1 ,917 new HIV diagnoses in 2018 (NYC HIV/AIDS Annual Surveillance Statistics, 2018).
In New York City, the enormous range of cuisines served in restaurants and cooked in people’s homes reflects the cultural diversity of the city’s residents. In an effort to promote nutrition while celebrating this gastronomical range, the Institute created “Healthy Plates around the World.” These educational tools, modeled after the government’s MyPlate, offer patients healthy food choices that align with traditional Puerto Rican, Dominican, West African and Mexican diets.
As a center of creative opportunity, New York attracts aspiring artists, writers and entrepreneurs. The Institute’s health center at 17t St serves many of these freelancers and self-employed individuals, some of whom are uninsured or underinsured for stretches of time.
Over the course of the year, in 2019, 132,660 different homeless men, women, and children slept in the New York City municipal shelter system (Coalition for the Homeless, 2020). The homeless have a higher incidence than the general population of nearly every health condition. Many in the target population present with extremely complicated histories and conditions that are often exacerbated by mental illness. The Institute operates six part-time Health Care for the Homeless sites, which provide medical care, behavioral health care, discounted medications, and referrals to other services.
New York City is home to the largest LGBTQ+ population in the country. The Institute’s LGBTQ+ Taskforce was established in 2012 to serve the unique health care needs of this community. Each summer the city hosts an enormous, weekend-long Pride celebration, pictured here.
New York City is home to great wealth and deep poverty – and the income gap continues to widen.. In Manhattan, where the inequality is most striking, the average income of the top 1 % ($8.1 million) was 116 times that of the 99% ($70,500) (Fiscal Policy, 2016). This leaves the most at-risk residents in dire need of accessible and affordable healthcare and other basic services. The Occupy Wall Street movement in 2011, pictured here, brought media attention to this severe, ongoing inequality.
As in most of the U.S., obesity is on the rise in New York City, particularly in lower-income neighborhoods. The highest obesity rates are in Bed-Stuy-Crown Heights and East Flatbush-Flatbush (Brooklyn), Rockaways (Queens) and the South Bronx, Fordam-Bronx Park and Pelham-Throgs Neck (the Bronx) (NYC Environment & Health Data Portal, 2017). Programs that promote healthy eating and exercise are expanding across the city.
With around 800 languages spoken and over 200 nationalities represented, New York is one of the most diverse cities in the world. To best serve the community, cultural competency is paramount at the Institute’s health centers.
In a city of 8.4 million, 12% of New York City residents were uninsured in 2017 (NYC Epiquery, 2017). That number has likely increased since the onset of the COVID-19 pandemic, making the Institute’s mission, to serve all patients regardless of their ability to pay, all the more critical.
