Advancing Equity on the Frontlines of the COVID Pandemic By Paige Ryland, Equity Liaison for the Division of Finance, NYC Department of Health and Mental Hygiene, and Sami Jarrah, Chief Financial Officer and Deputy Commissioner for the NYC Department of Health and Mental Hygiene
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ublic health and public health systems across the nation face a multitude of challenges including a loss of personnel, historic disinvestment, the ongoing COVID-19 pandemic, and continued racial disparities. The 2019 National Profile of Local Health Departments compiled by the National Association of County and City Health Officials revealed that Local Health Departments (LHDs) lost 21% of their workforce in the past 10 years and 15% of LHDs had decreased budgets compared to the previous fiscal year. In October 2021, the New York City Board of Health (BOH) passed a resolution declaring racism a public health crisis and calling on the New York City Department of Health and Mental Hygiene (Health Department) to expand its anti-racism work to, among other actions, “develop priorities and next steps for a racially just recovery from COVID-19 and other actions – including resource allocation – to address this public health crisis in the short and long-term.” A similar position was taken at the state level, when at the end of 2021, Governor Kathy Hochul authorized legislation targeting discrimination and racial injustice including the declaration of racism as a public health crisis and creation of a working group to promote racial equity throughout New York. These declarations offer a chance for LHDs to act on addressing racism in every aspect of the work they do. Race to Justice, launched in 2016, is the Health Department’s ongoing internal reform process for advancing racial equity and social justice. At a high level, this process involves building staff awareness of racism and the skills needed to address it, examining how structural racism and other systems of oppression shape our work and implementing policies and practices to counter their effects, and strengthening collaborations with New York City’s communities to share in the work. Another way the Health Department has been successful in addressing racism in the COVID-19 response is by designating the neighborhoods known to have faced historic disinvestments and an outsized COVID-19 burden to receive targeted services aimed at improving rates of testing and vaccination.
For example, during the pandemic, equity-focused public health work has focused on Black communities who have endured systemic racism as well as Orthodox Jewish neighborhoods that included community members who have lacked vaccine confidence. This program is a partnership between the Health Department and New York City’s Taskforce on Racial Inclusion and Equity, which has identified neighborhoods for special focus using data and community priorities. Coupled with efforts to collect complete race and location data, the Health Department has been able to track testing and vaccination by race and place and direct resources to populations in need. A key requirement of the BOH resolution is for the Health Department to make recommendations on revisions to the NYC Charter related to anti-racism and health. If approved, the recommendations will codify the jurisdiction’s commitment to anti-racist work ensuring it will continue over time and across administrations. More work is needed but in order to expand this work in New York City and other localities, LHDs require additional funding for staff and material resources. As part of this work, it is important that the resources needed for ending racial disparities are available and dedicated for equityfocused work. Dedicated funding is crucial for successfully meeting the expectations of public health agencies to meet the unique needs of the communities they serve, in New York City and beyond.
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