David Sandman

This year began with great optimism, as COVID-19 vaccines became available and an end to the pandemic seemed within reach.

And with vaccines, treatments, and continued behaviors like masking, hand-washing, and social-distancing, we’ve made strides in putting the worst of the pandemic behind us. But the rise of new viral variants, vaccine hesitancy, misinformation, and the politicization of public health have resulted in swings of the pendulum and continuing uncertainty. For better and for worse, we’ve all learned to live with new realities in the COVID era.

It has become an annual tradition for me to share a wish list for the coming year. Wishes can come true, if you make them so. In 2021, an item that had been on the list for years came to pass: New York State enacted universal access to Veterans Treatment Courts for every veteran who needs one. Veterans dealing with mental health and/or substance use issues will receive treatment and an opportunity to get their lives back on track, instead of being trapped in the revolving door of a justice system that is not equipped to meet their needs. I’m optimistic that more wishes can come true.

Here are my wishes for 2022:

1. An end to COVID and the building of a more equitable health system. I don’t know if we’ll ever be able to fully end COVID, but I’m hopeful we can at least get it under control. And as we emerge from the pandemic, we must address the structural challenges and failures it glaringly revealed. The pandemic is just the most recent example of racial health inequities, with death rates and hospitalization rates roughly twice as high for Black residents as for their white counterparts. Black and Hispanic New Yorkers are also less likely to have health insurance and adequate access to care and more likely to experience food insecurity, complications with childbirth, chronic health conditions like diabetes and asthma, and premature death. These disparities have long existed, but the pandemic and our national reckoning on racial equity have laid them bare and made them impossible to ignore. As we rebuild our health care and public health systems, we need to do so in a way that prioritizes and ensures equity.

2. A rebalanced health system built on primary care. We also need to build a system that emphasizes and invests adequately in primary care. A slew of research (which I outlined in a blog post earlier this year) supports the benefits of primary care: more access to preventive services and screenings; fewer hospital visits; fewer emergency department visits; and fewer surgeries, to name just a few. And yet we chronically underinvest in primary care even as we extol its virtues. New York can strengthen and invest more in primary care without increasing the total cost of health care. Proposals are circulating in Albany to define and measure our baseline spending on primary care, set targets for enhanced investments in primary care, and test out pilot programs to identify the most promising models. There’s no reason to wait; this work needs to happen now so we can start putting our money where our mouth is.

3. Healthy food for all, aided by collective purchasing power. Healthy food is a necessity, but too many New Yorkers lack stable access to affordable nutritious food. Through its agencies and public institutions, New York State purchases and serves hundreds of millions of meals annually in venues like schools, hospitals, correctional and long-term care facilities, homeless shelters, and senior and childcare centers. Before the COVID-19 pandemic, the State spent more than $957 million a year on food to feed 6.6 million people; New York City alone spends more than $500 million a year. Given their massive scale, public institutions can harness their purchasing power to buy foods of higher nutritional value, lower costs, and transform the State’s food systems. We’re seeing progress at the local level — including in New York City and Buffalo — through a model called the Good Food Purchasing Program. Implemented well, this approach will allow municipalities to provide healthier meals to millions of New Yorkers.

By David Sandman, President and CEO, New York Health Foundation
Published in Medium on December 15, 2021

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