Place Matters

A recent article in the American Prospect about the De-Facto Segregation of Health Care has been getting a lot of attention, at least in the media that we read, and for good reason.  It points out the uncomfortable truth that race matters in health care, which means, in part, that place matters too.  As the article notes:

Ongoing de-facto segregation has a profound effect on the quality of care to which people of color — insured or otherwise — have access. While the health-care bills being debated in Congress would expand access to and quality of care for people of color, ultimately racial health disparities can’t be eliminated without better distribution of health resources.

Consider a community in which we do a lot of work: Southeast Queens.  Take a look at this map, lifted from a website developed by our friends at the Opportunity Agenda:


This is a slice of Queens that represents the dividing line between the Northwest and the Southeast of the borough.  The darker an area is shaded, the higher the percentage of people of color living in that area.  De-facto segregation, anyone?  Now check out those little plus signs, which represent hospitals.  Notice how few–i.e. none–of them are actually located in the darker-shaded portion of the map.  And, in fact, one of the hospitals right on the border recently closed — a common occurrence in communities of color across the country.

Now compare the availability of hospitals and the demographics on the Southeast side of Queens to the east side of Manhattan:


The absence of hospitals in Southeast Queens, and their over-abundance in white communities of the city, would be less of a problem if people in the area could actually access the primary or preventative care they need to prevent hospitalizations and trips to the emergency room.   But, of course, the lack of hospitals isn’t the whole story.  The New York State Department of Health recently issued a report on health care services in Queens, which notes that Southeast Queens has the lowest ratio of doctors to population in the entire borough.  There are 48 full-time equivalent (FTE) primary care doctors per 100,000 population in Southeast Queens compared to 132 FTE’s per 100,000 in the Flushing/Clearview area.  This report also indicates that there are 75 primary care clinics in Queens, but of the 75 clinics listed only 40 could be confirmed as primary care clinics available to members of the community at large.  Several of the clinics are for special populations only (e.g. children, women), and of the remaining 40 primary care clinics, only 22 are located in Southern Queens.

Pointing out geographic and resource disparities like this isn’t just a complaint about who-gets-what; it is a matter of life and death for many.  As the American Prospect piece notes:

Even when people of color are covered [by insurance], their access to quality care is diminished heavily by ongoing segregation and poverty; in nonwhite neighborhoods, it’s simply harder to find a primary provider than it is in white neighborhoods. The facilities that exist are often of lower quality and lack the resources institutions located in primarily white areas have. What this means is that even when minorities are covered by health insurance, they’re less likely to have quality care and less able to afford the associated out-of-pocket expenses — and the results are staggering.  Children born to black women are more than twice as likely to die within their first year of life as are children born to white women. This disparity is unaffected by income or education level.

So, what can be done?  Well, many things, but in Southeast Queens the most immediate action is being taken by a community coalition we work with called Southeast Queens United in Support of Health Care (SQUISH).  When the State Department of Health published its report, it also announced that $30 million would be available in grants to develop health care services in the borough.  SQUISH is reaching out to elected officials, community residents, local health care providers and the media to raise awareness about the need for some of that funding to be directed toward Southeast Queens.  For a list of SQUISH’s asks, check out their talking points.  Because green shouldn’t always follow white, and where you live shouldn’t be one of the primary determinants for how soon you die.



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5 responses to “Place Matters

  1. Pingback: Squeaky Wheels: Community Advocacy and Healthcare in Southeast Queens « health justice NYC

  2. Pingback: Proton Beams or Primary Care « health justice NYC

  3. Pingback: Proton Beams or Primary Care « 3nutritions.Co.CC

  4. Pingback: Community Input When a Hospital Closes « health justice NYC

  5. Pingback: Community Input When a Hospital Closes « 3nutritions.Co.CC

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