Quality of Care: An Overlooked Factor in the NYC Healthcare System

Written by: Pauline Francez Gordula

 
Hailed as the United States of America’s Melting Pot, New York City is known for its unique blend of nationalities, ethnicities and cultures. To give a taste, there are over 800 languages spoken throughout the city. When COVID-19 struck the United States in March, the melting pot became the epicenter of the pandemic. New York City's healthcare system was immediately put under pressure as hospitals swarmed with patients. It is vital to examine the demographics that comprise the New York City healthcare workforce and how this impacts the quality of healthcare that minorities received during the pandemic.

For the past five months, I received news that some of my friends’ parents and family friends have contracted the virus -- a few of them passed away. Living and studying in a predominantly South Asian and Caribbean neighborhood, most of my friends and family friends are non-White. I began to express concern about the disparities in healthcare especially among minorities during this unprecedented time.

Every time I read the news on COVID-19, I often see that the Black and Hispanic communities have the highest case and death rates in New York City. 704.53 of African-Americans and 671 of Hispanic/Latino per 100,000 are hospitalized. Meanwhile, 259.83 of Hispanic/Latino and 244.77 of African-Americans per 100,000 people die. The racial makeup of New York City is as follows: 42.7% White, 24.3% Black or African American, 0.4% American Indian, 13.9% Asian, 0.1% Native Hawaiian or Pacific Islander, 3.5% two or more races, 29.1% Hispanic or Latino and 32.1% White non-Hispanic. This made me wonder: if New York City is predominantly White, then why are the Black and Hispanic communities being devastated the most by the virus?'

The most logical answer would have to be income. The median household income for New York City between 2014 to 2018 was $60,762. From 2011 to 2015, the poverty rates by racial groups differed significantly from the national trends: 20% of Asian New Yorkers are poorer compared to 14% nationally; 22% of Black New Yorkers live below the poverty line in comparison to 27%; 29% of Hispanic New Yorkers are poor while 25% nationally; and 12% of White New Yorkers were living below the poverty line as to 1% nationally.

However, I digress. While household income plays a huge role in surviving the pandemic, I think that the quality of care that minorities (specifically, the Black and Hispanic communities) receive is also an important factor that people overlook. Annually, New York City Health + Hospitals receive a budget of $8 billion, which funds 11 public hospitals in four boroughs.

At the peak of the pandemic in the melting pot, NYC Health + Hospital at Elmhurst was besieged by the virus. The hospital once reported 13 coronavirus deaths within 24 hours back in March. Situated along Broadway, Elmhurst Hospital has garnered over 2.1 stars out of 5 stars from 518 users on Google reviews. User Leo Lu left a comment 4 months ago saying, “Not the best hospital. They need more professional personal here and they really need to work on cleaning. I see blood stains on some surfaces, which it quite scary. People who goes to hospital are people who are sick and u have no idea what disease they might carry, they leaving blood unclean that is already a bad sign of sloppy work and carelessness. It does seem to me this place is more about making profit as a business than a professional medical center. I do blame lack of management for sloppiness and carelessness.”

I found that the Allerton/Baychester/Pelham Gardens/Williamsbridge neighborhoods in the Bronx are the one of the groups of neighborhoods with the highest case rates in New York City. One of the hospitals in Pelham Bay, NYC Health + Hospital at Jacobi, has accumulated 2.3 stars out of 5 stars on Google reviews from 519 users. One user, Nadine Thomas, left a Google review about 4 months ago: “If I could give zero star I would. The doctors are very unprofessional and do not know how to talk to people. Worst hospital ever..” On March 29, nurses at Jacobi Medical Center spoke out about the lack of medical equipment to treat their coronavirus patients. Staff used money from their own pockets to buy their own medical gears, which speaks volumes about the insufficiency of resources that the hospital receives. Additionally, the sudden influx of patients forced the nurses to work for 12 or more hours three or four days a week. Sadly, one of the nurses in the hospital, Freda Ocran, contracted the virus and passed away.

On the other hand, I observed that most neighborhoods in Manhattan have low case rates. Around the Upper East Side and Lenox Hill area, there are about 15 hospitals -- most of them nonprofits. For instance, Weill Cornell Medical Center -- a NewYork-Presbyterian hospital -- has 4.0 stars out of 5 stars from 426 users on Google reviews. User blackorpheliac1 left a review 4 months ago: “Best Hospital I’ve been to in New York. I usually head to Harlem Hospital, and I guess I thought it was normal to wait 4 hours to be seen on an empty day. I was in and out of imaging here in 13 minutes. Shocking how friendly, responsive to questions and happy the staff is here (both administrative and medical). Clean too. I highly recommend.” The comparison of Weill Cornell to Harlem Hospital struck me as interesting. I decided to look up Harlem Hospital to get an overview of this hospital’s overall performance. To my surprise, NYC Health + Hospitals at Harlem’s overall reviews on Google reviews are on the opposite side of the spectrum -- 2.6 starts out of 5 stars from 254 user reviews.

I observed that Elmhurst, Allerton/Baychester/Pelham Gardens/Williamsbridge and Harlem neighborhoods are predominantly Black and Hispanic. Some of the trends on the hospital reviews within these areas are the lack of medical equipment, unprofessional staff and dirty environment. With such a large budget, the NYC Health + Hospitals should properly allocate their funds to better suit their patients’ needs especially during such turbulent times. People in their communities have the highest poverty rates in the city; as a result, more funding should be allocated to these neighborhoods to help improve their quality of life. Unfortunately, the poor quality of care that minorities receive mirrors the catastrophic case and death rates among the Black and Hispanic communities throughout the pandemic.

On the exterior, New York City may be this dazzling city with a conglomeration of cultures and lavish establishments. In reality, the melting pot still has a long way for improvement: public hospitals’ quality is terrible compared to hospitals run by nonprofits. I demand that healthcare in neighborhoods dominated by minorities be one of the top priorities to help sustain the quality of living in such a densely populated city.
 
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Sources: 
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Comptroller.nyc.gov, comptroller.nyc.gov/reports/new-york-citys-frontline-workers/.
Brecher, Patrick Orecki and Charles. “A New Approach to Funding New York City Health   Hospitals.” Citizens Budget Commission of New York, 16 Dec. 2019, cbcny.org/research/new-approach-funding-new-york-city-health-hospitals#:~:text=New York City Health + Hospitals (H+H),,the local health care system.
“COVID-19: Data.” COVID-19: Data Details on Deaths - NYC Health, www1.nyc.gov/site/doh/covid/covid-19-data-deaths.page.
“Focus on Poverty in New York City.” NYU Furman Center, furmancenter.org/thestoop/entry/focus-on-poverty.
“Health Care Locations.” NYC Health Hospitals, www.nychealthandhospitals.org/hospitals/.
Ray, Esha, and Michael Gartland. “'We're on a Suicide Mission': Jacobi Hospital Nurse Charges Lack of Coronavirus Protective Gear Endangers Health Care Workers' Lives.” Nydailynews.com, New York Daily News, 1 Apr. 2020, www.nydailynews.com/coronavirus/ny-coronavirus-jacobi-kelley-cabrera-personal-protective-nurse-doctor-20200401-sa5mpgvvqvhnzh7qwh2znnbo3m-story.html.
“U.S. Census Bureau QuickFacts: New York City, New York.” Census Bureau QuickFacts, www.census.gov/quickfacts/fact/table/newyorkcitynewyork/PST040219.
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