To fully recover from COVID-19, we must focus on preventative care
access to preventative care, or
other resources or information that
support better health outcomes.
These are the factors that have
worked against government and
health care responders. And this is
where a long-term preventive strategy
that’s a smart use of public resources
For five years before the pandemic,
doctors and policymakers united
to focus on boosting care quality
while driving down costs — a formula
that has consistently eluded national
politicians, but that we’ve been able to
get right here in New York. With the
state’s support, doctors took on a challenge:
how to drive down avoidable
hospital visits, which cost taxpayers
billions and distracted emergency
room providers away from focusing
on actual emergencies. The effort has
been successful.
In focusing on five chronic conditions
that plague poor communities
including obesity, hypertension, asthma,
heart disease and sicknesses related
to smoking, we have used a culturally
competent, community-based
outreach and care delivery strategy
focusing on meeting patients where
they are to get them in front of primary
care doctors before they get sick.
At SOMOS, the network I lead, that
works primarily in some of New York’s
poorest neighborhoods, we have been
able to raise outcomes while saving
the state over $340 million.
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TIMESLEDGER | QNS.COM | MARCH 4 - MARCH 10, 2022 13
OP-ED
BY DR. RAMON TALLAJ
For the last two years, the COVID
19 pandemic has effectively pulled
the curtain back on longstanding
health inequities across the United
States. Now that we are entering a
tentative recovery phase, it is critical
that we learn from the past two years
— and, to ensure that we are ready for
any future variants and that we as a
city seize the opportunity to rebuild
stronger, that we focus on applying a
preventive care strategy.
From the beginning of the pandemic,
New York City saw immense
disparities in not just who got infected,
but which of our friends and
neighbors needed to be hospitalized,
and ultimately who died. Today, out
of the 39,192 people who have died
from COVID in New York City, 841.6
per every 100,000 are Latino, 809.0 are
Black, 449.89 are Asian and 493.3 are
white.
These trends reflect the longstanding
disparities caused by language
and cultural barriers, racism
and discrimination, and already disproportionate
poor health.
It’s not just that a delivery worker
in Jackson Heights, the school cafeteria
worker from the South Bronx
or the nurse from East Flatbush had
to go to work while so many had the
privilege of staying home. They also
likely did not have health insurance
and may lack a primary care physician,
comes into play.
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This has meant reintroducing
family doctors who speak patients’
languages to neighborhoods that are
otherwise health deserts or only have
large, corporate hospitals where care
is impersonal and intimidating — especially
for immigrants — and, frequently,
where staff doesn’t speak the
same language as the highest-need
patients.
To reach patients, we have used
community organizing strategies
that are normally associated with political
campaigns to switch emphasis
off crisis management and to get them
in front of doctors early. We focused
on partnering with trusted neighborhood
figures such as pastors and
teachers, and we even joined up with
popular entertainers to penetrate
hard-to-reach communities using
in-language content. And in a revolutionary
formula, doctors are now
being reimbursed by the state for the
total health of a patient, not fee-forservice.
These non-traditional strategies
have worked: by focusing on total
health and on prevention, we have
driven unnecessary hospital usage
down by more than 25% in five years.
Back to the recovery from COVID-19.
Let’s use this moment to dramatically
accelerate vaccination in all
hesitant communities to prevent serious
illness in case of another wave,
and adopt a wraparound care strategy
to do so. We must meet these New
Yorkers where they are, not where
we want them to be. We must partner
with public housing, neighborhood
media outlets and even social media
influencers and well-respected local
politicians, principals, pediatricians
and pastors and use them to educate
and encourage. Authenticity and access
are crucial.
And while any strategy must be
led by doctors, an effective preventive
response cannot be limited to the
healthcare sector only. That’s why I
am encouraged that Mayor Adams
has filled his new COVID-19 task
force with diverse leaders from labor,
homeless services, faith, hospitality,
teachers, media, representatives of
businesses large and small, real estate
and the disability community.
Our focus will be on rebuilding a city
with a stronger social fabric, longterm.
We will live with COVID-19 in
some variation for the foreseeable future.
But we need to prevent it from
ravaging our city or bringing it to a
standstill. A total-health, preventive
strategy and a focus on long-term
health equity can prevent future episodes
from quickly becoming tragic
or overly disruptive.
Dr. Ramon Tallaj is the co-chair
of Mayor Adams’ COVID-19 Recovery
Roundtable and Health Equity Task
Force and the chairman of SOMOS
Community Care.
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