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THE BX PLAN: What is the future of health in the Bronx?

Post #2 in a series on transforming the Bronx economy

With over 90,000 employees, the healthcare and social assistance ecosystem in the Bronx is our biggest and fastest-growing employer. From home health aids to laboratory technicians, registered nurses to emergency medical providers, healthcare work accounted for two out of every five jobs in our borough in 2020. This exists alongside well-known poor health conditions for many Bronxites. For 10 consecutive years, the Bronx has been ranked the least healthy county in New York. The average life expectancy in the Bronx is four years lower than Manhattan’s, and the Bronx has the highest rates of asthma hospitalizations, HIV/AIDS deaths, diabetes deaths, and drug hospitalizations. With the COVID-19 pandemic, Bronx health disparities were laid bare — higher rates of chronic diseases and other underlying conditions contributed to Bronx residents being twice as likely to die from COVID-19. All of these are symptoms of an economic system that does not support the well-being of poor folks, working class, immigrants, and Black and brown people.

There are opportunities to strengthen the economic and social ties between our major healthcare institutions, like Montefiore Medical Center and Bronx Lebanon Hospital, which serve as anchors for our community, as well as economic engines, by supporting employment, local spending, and other investments. Through these institutions, we can invest in local businesses, improve housing conditions, and address other root causes — what are called the social determinants of health — that drive health problems that are faced disproportionately by people of color.

We see an opportunity to improve health and economic outcomes simultaneously. In doing this, we can keep people healthy and out of hospitals, which saves the health system and the government money. Part of this will come from existing health institutions actively working to combat the root causes of the health problems we experience, rather than focusing on sick care like they do now. Possibilities include establishing programs like Boston Medical Center’s 2017 investments in affordable housing initiatives or the Bronx Healthy Buildings Program, which finances building upgrades to prevent avoidable hospitalizations for conditions like asthma, for which Bronx sees hospitalization rates at five times the nationwide average. The Healthy Buildings Program also can be leveraged for additional local economic development opportunities for local cooperative and democratic enterprises in the energy efficiency, construction, and building services industries.

Part of transforming this sector includes planning for the future of jobs in healthcare in the process, focusing on building community health workers that are unionized and offer opportunities for shared ownership and control between workers and community, rather than wealthy investors and stockholders. One clear pathway forward is to build on the national leadership of the Bronx’s very own Cooperative Homecare Associates, which through both unionization with 1199 SEIU Healthcare Workers and through worker ownership, shows us that it is possible to create good jobs with worker voice in this critical and globally growing industry of the care economy.



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