Photo: Caroline Willis
New York City Mayor Eric Adams outlined on January 17, 2023, his vision for a ‘New York City Women’s Health Agenda’ aimed at dismantling decades of systemic inequity that have negatively impacted the health of women across the five boroughs. Joined by several health care leaders of his administration, Mayor Adams acknowledged the long-standing, persistent problems that plague women’s health care in a live address, and shared plans and ideas to close the gaps caused by long-standing structural inequities, including lack of access to care, lack of inclusion, and lack of innovation.
“For too long health and health care has been centered around men, but that changes today,” said Mayor Adams. “We have been standing on the sidelines of women’s health for too long, and I have personally seen firsthand how the health system is letting our women down. It is long overdue that we break taboos and make New York City a model for the future of women’s health care. We are going to build a city that is here for all women and girls.”
“This agenda will help us, as a city, prioritize and address the health needs of women across the lifespan and elevate the voices of women at every step along the way,” said Deputy Mayor for Health and Human Services Anne Williams-Isom. “The work to implement this agenda has already begun and I look forward to continuing to be part of that effort and doing so alongside so many dedicated and accomplished women inside and outside of government.”
Historically, women’s health has been rife with inequities in many areas ranging from disease prevention to maternity care to mental health and management. For example, in New York City, the average maternal mortality rate among Black pregnant people is more than nine times the rate of white pregnant people. Sadly, many of these deaths of Black people were preventable.
Mayor Adams’ vision to create a model for the future of women’s health in New York City includes:
Relaunching the Sexual Education Task Force: Convened by the New York City Commission on Gender Equity, in partnership with the New York City Department of Education (DOE) and the New York City Mayor’s Office of Equity, the task force will educate the youngest New Yorkers and create a culture of sexual wellness and inclusivity. Additionally, the task force will work to update and implement 11 recommendations in its 2018 report — including ensuring school staff have basic competencies around inclusivity and respect and that they can also link students to appropriate sexual health resources outside the school setting, as well as increasing broad community support of sexual health education through public awareness campaigns and information sessions. The task force will also provide an annual report of its activities.
Immediately Committing to Tracking Rates of Different Diseases: Diseases tracked would include cancer, mental health conditions, heart disease, and, possibly, additional conditions, as well as life expectancy and other key indicators differentiated by age, race, and additional key factors. The Adams administration will leverage findings to shape the work that city agencies carry out regarding women’s health. The city will also report on these indicators in an effort to ensure the tracking of progress regarding the state of women’s health in New York City. Additionally, the administration will continue to champion research in this space.
Convening a Variety of Thought Leaders to Create a Robust and Comprehensive Women’s Health Agenda: Thought leaders will include experts from different subject matter areas, including research, public health, health care, business, technology, and more, and will come together for a summit during Women’s History Month in March.
Building on Previous Successes for the City’s Workforce: The city will assemble a committee of experts to build on its past successes already achieved for its workforce, including increasing access to both lactation rooms and paid sick leave for cancer screenings. Work will include examining how to create more menopause-friendly workplaces and promoting access to health services by utilizing WorkWell — the workplace wellness programs specifically created for city employees — as well as other existing avenues. The committee will also look into how the city can achieve or develop accreditations around becoming more health friendly towards women. This effort will make New York City the first city in the nation to begin a framework that is focused on its employees. Recommendations made by this group of experts will additionally inform future work so New York City can become even friendlier to women’s health.
Expanding Access to Medication Abortion at New York City Department of Health and Mental Hygiene (DOHMH) Clinics: Starting January 18, 2023, the Morrisania Sexual Health Clinic in the Bronx, DOHMH will begin to provide abortion pills to individuals. Several additional neighborhood DOHMH clinics in Crown Heights (Brooklyn), Central Harlem (Manhattan), and Jamaica (Queens) are scheduled to begin dispensing this medication by the end of the year. New York City Health + Hospitals’ (H+H) 11 public hospitals citywide already offer medication abortion.
Launching a Provider Education Campaign on Maternal Health: The campaign will focus on supporting those with hypertension and diabetes and will entail direct outreach to providers in target neighborhoods in the Bronx, Brooklyn, and Manhattan that experience health and other socioeconomic disparities. The 20-week campaign will launch in the summer of 2023.
Launching of a Family-Based Substance Use Disorder Program at H+H: The substance use disorder program will focus on providing support to those who are pregnant and/or parenting and struggling with addiction, while additionally providing their children with mental health support and other services. The program will integrate family medicine, behavioral health, and addiction medicine across a continuum of care. Concurrently, the program will also address primary care, as well as psychosocial and mental health needs of children. In doing so, this model will support the healthy, long-term development of children affected by parental substance abuse.
Committing to Exploring the Expansion of and Access to Pelvic Floor Physical Therapy: Pelvic floor dysfunction can be caused by pregnancy, a traumatic physical incident, age, menopause, or obesity and can lead to a host of problems, including pain and bowel issues. One in three women will experience a pelvic floor disorder in their lifetime.
All these initiatives build off programs and services launched during Mayor Adams’ first year in office, including:
– A first-of-its-kind Abortion Access Hub that confidentially refers callers from across the country to abortion care providers in New York City, as well as connections to additional financial support, transportation, and lodging;
-A citywide expansion of doula services, expansion of the midwifery initiative, and expansion of a maternal health services program; and
-Signing a series of historic bills to promote education, increase transparency, and expand access to maternal health care for pregnant New Yorkers.
Many women, both in New York City and across the globe, suffer from preventable health conditions and face distinct health challenges. Heart disease continues to be a leading cause of death for women, while breast cancer is the second most common form of cancer for women (after skin cancer) and the second leading cause of cancer deaths among women (after lung cancer). An analysis by DOHMH shows that among women, rates of hypertension are highest among Black women in New York City (41.6 percent) and nationwide (39.9 percent), compared to Latina women (26 percent and 28 percent, respectively), white women (20.6 percent and 25.6 percent, respectively and Asian women (13 percent and 21.9 percent, respectively). These inequities stem from a range of causes, including medical training and quality of available services, as well as clinical research historically conducted with men and then having subsequent findings incorrectly applied to women.