The COVID-19 pandemic has revealed that residents of disinvested neighborhoods not only face the health impacts of poor housing conditions, but they also have the least access to hospital care. High real estate values encouraged by city policies and rezonings have created incentives for hospitals to sell their land and for landlords to evict long-term tenants — creating a feedback loop that disproportionately harms Black and brown residents.

COVID-19 Cases and Hospital Closures. Map by Association for Neighborhood & Housing Development.

Epidemiologists have long regarded housing as a key determinant of public health. Neighborhoods that have already suffered decades of disinvestment in housing and essential services also suffered the highest rates of positive COVID-19 cases over the last year. Even before the pandemic, low-waged essential workers were often rent-burdened and living in overcrowded spaces, facing building neglect and harassment by landlords seeking to increase profits. Numerous health issues are caused and exacerbated by unsafe housing conditions such as exposure to lead poisoning, and inadequate cooling and heating, which can trigger asthma and respiratory illness. Chronic stress caused by the psychological turmoil of unstable living and working environments can lead to a surge of related chronic conditions, increasing risk factors for mortality from COVID-19. Data released by the City’s Department of Health showed that Black and Latinx New Yorkers faced mortality rates significantly higher than that of white New Yorkers.

Hospital Closures and Income. Map by Association for Neighborhood & Housing Development.

The pandemic’s tragic impacts on communities of color was specifically intensified by widespread hospital closures, the direct result of real estate lobbying and reckless policymaking. Since 2000, 28 hospitals have closed throughout New York State. Over 40% of NYC’s shuttered hospitals have been replaced by housing at rental and sales prices far out of reach for the average New Yorker. Manhattan’s St. Vincent’s Hospital is one example of a site that delivered crucial treatment and support for low-income New Yorkers during the AIDS epidemic. In 2007, St. Vincent’s Hospital was sold for $84 million to make way for luxury condos.

Hospital Closures and Race. Map by Association for Neighborhood & Housing Development.

At least 18 hospitals have closed all of their inpatient services in New York City, with two-thirds of them in the outer boroughs, leading to the loss of thousands of hospital beds in high risk areas where people are often under-insured and lack consistent access to medical care. In Queens, where the number of hospital beds per capita is lowest in the city (1.4 beds per thousand residents compared with 5.3 in Manhattan), public hospitals like Elmhurst Hospital and Queens Hospital Center experienced massive understaffing, lack of equipment, and inadequate space to care for patients during the first wave of the pandemic. The Bronx witnessed the highest number of COVID-19 hospitalizations and deaths (2.2 deaths per thousand in April 2020) compared with significantly lower mortality rates in Manhattan (1.2 per thousand). Residents of the hardest hit neighborhoods that lack hospital access are now four times more likely to face impending eviction due to pandemic rent debt. The continued push by mayors Bloomberg and De Blasio to increase land profitability by constructing large luxury residential towers has led to the displacement of both people and the services they need. Land use policy that further commodifies real estate not only impacts access to affordable housing, but also exacerbates health conditions and directly threatens the public’s access to medical care, revealing that housing justice is a public health issue.

“Whether it’s access to critical infrastructure, good paying jobs, or truly affordable housing free from the risk of displacement and overcrowding, the failures of our planning processes have exacerbated inequality within New York City in a way that is playing out in life or death terms today,”

– Lena Afridi & Chris Walters, Association for Housing & Neighborhood Development

Sources

• “Closures are Causing A Full-Blown Mental Health Emergency in New York” by New York State Nurses Association.
• “Covid-19 has exposed the consequences of decades of bad public housing policy” by Gillet Gardner Rosenblith.
• “COVID-19 and Hospital Closures in NYC” by Association for Neighborhood & Housing and Development.
• “COVID-19 in New York City: An Ecology of Race and Class Oppression” by Deborah Wallace, Rodrick Wallace.
• “Decades of Shrinking Hospital Capacity ‘Spelled Disaster’ for New York’s COVID Response” by Jeanmarie Evelly.
• “Frontline Communities Hit Hardest by COVID-19” by Lena Afrida and Luci Block.
• “Housing and Health: Time Again for Public Health Action” by James Krieger, MD, MPH and Donna L. Higgins, PhD.
• “Land Use Decisions Have Life and Death Consequences” by Lena Afridi and Chris Walters.
• “New York Renters in Covid Hot Spots Are Four Times More Likely to Face Eviction” by Stefanos Chen.
• “NYC Department of Health nd Mental Hygiene’s COVID-19 Data on Case, Hospitalization and Death Rates by Race/Ethnicity” by NYC Department of Health and Mental Hygiene.
• “Our Vow: No More Closings” by New York State Nurses Association.
• “Overview of the NYC Department of Health and Mental Hygiene’s COVID-19 Equity Action Plan” by NYC Department of Health and Mental Hygiene.
• “Residential buildings replaced nearly half of NYC hospitals shuttered in last two decades” by Devin Gannon.
• “St. Vincent’s Midtown Outpost Finally Reborn as Luxury Condos” by Tanay Warerkar.
• “A Terrible Price: The Deadly Racial Disparities of Covid-19 in America” by Linda Villarosa; L. Kasimu Harris.
• “Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs.” by Rishi K. Wadhera, MD, MPP, MPhil; Priya Wadhera, MD, MS; Prakriti Gaba, MD; Jose F. Figueroa, MD, MPH; Karen E. Joynt Maddox, MD, MPH; Robert W. Yeh, MD, MSc; Changyu Shen, PhD.
• “Why Surviving the Virus Might Come Down to Which Hospital Admits You” by Brian M. Rosenthal, Joseph Goldstein, Sharon Otterman and Sheri Fink.