Working Toward a Brighter Future

For many, 2020 will be remembered for unprecedented pain and suffering. Not only for the 20 million U.S. cases of COVID-19 and 350,000 deaths just last year alone, but also for the widespread misery caused by the economic recession and social isolation. And unsurprisingly, this pain was not shared equally. The disproportionate impact on Black and Brown communities was just one more example of the outcomes of structural racism in this country, as were the deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless others last year. On top of all of this, we ended the year with one of the most vicious election cycles in our history, in which some went far beyond civil debate on ideological differences.

In the midst of all this turmoil, many of us asked ourselves: What can we each do to get through the crisis and create a better future for all Americans? For some, the answer was clear. Essential workers, like health care professionals, grocery store employees, public transit workers, sanitation workers, and many others, all worked tirelessly to ensure that the basic infrastructure of our country continued. Neighbors looked out for one another like never before. And many individuals put aside their own desires and wants for the greater public good.

At United Hospital Fund, we responded to the challenges of 2020 by using the tools available to us. Our mission is to build an effective and equitable health care system for all New Yorkers. We are not a clinical service provider, but a force for health care improvement through research and policy analysis, promoting dialogue among health care stakeholders, and fostering innovations to improve individual and community health.

The pandemic-induced recession caused large-scale unemployment, and so we stepped in quickly in the spring to help educate the 1.4 million New Yorkers who lost their job-based health insurance coverage about other coverage options in the state. We targeted the hardest-to-reach communities, disseminating materials in English, Spanish, Chinese, Russian, Bengali, and Haitian Creole. And, with the shift to public insurance coverage, we continued our efforts to strengthen the state’s Medicaid program, which has seen rapid growth in enrollment in 2020. Our summer Medicaid Conference, which convened state officials, researchers, and community leaders, focused on fostering health equity, particularly in the context of COVID-19 health disparities.

As the pandemic accelerated, we responded to needs identified by the pediatricians working with us in our Children’s Health Initiative and built a COVID-19 resource center to help pediatricians support their patients and families. And although the pandemic had a disproportionate impact on the elderly, we observed that there were many young parents who also passed away. We decided to explore this further and, in partnership with the Boston Consulting Group, conducted new research on the number of children in New York State who lost a parent or guardian to COVID-19. Our resulting report helped draw policy attention to long-term consequences and potential solutions.

Throughout the year, COVID-19 was constantly in the news cycle. But we noticed that although the coverage of the hospital response was robust, other perspectives on the pandemic were being lost. To help inform the public dialogue, we launched a new commentary series highlighting issues not otherwise well covered by the general press. Experts from other care settings and disciplines weighed in on a wide variety of topics in the context of COVID-19, such as community health centers, primary care, home health, mental health, disparities, equity, and telehealth—just to name a few.

The social justice movement and the disparities in COVID-19 health outcomes among Black and Brown communities mutually reinforced how inequitable health in our country is. The health disparities are not limited to COVID-19 but cut across almost all medical conditions and are largely a result of differences in the social determinants of health—housing, nutrition, employment, etc.—which in turn have their roots in structural racism. At UHF we have been looking inward at our own organization’s efforts to promote diversity, equity, and inclusion, as well as externally at all our programs and activities. We will continue our long-standing efforts to expand health insurance coverage and improve quality of care, but perhaps more importantly for the long term, we will also double down on our work to address the social determinants of health at the intersection of the health care delivery system and the community. This is critical to achieving an equitable and just system in which everyone has the opportunity to live a long and healthy life.

It has certainly been a challenging year, and I’m proud of our team at UHF and how they have responded in their work toward a brighter future. Thanks to all our friends and partners, and I look forward to working together on our shared goal of advancing health for all members of our society.

This commentary is featured in United Hospital Fund's 2020 annual report. 

March 11, 2021