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De Blasio administration seeks 'equity' in health policy

A five-year city health department blueprint to improve New Yorkers' well-being will set "equity targets" for closing gaps between the most and least healthy communities.

The initiative, the latest iteration of the Take Care New York program launched in 2004 under Mayor Michael Bloomberg, brings Mayor Bill de Blasio's campaign theme of tackling inequality into the health policy arena.

Take Care New York 2020, to be unveiled Thursday by Health Commissioner Dr. Mary T. Bassett, also seeks to gauge public health using social factors -- a neighborhood's incarceration and high school graduation rates, among others -- rather than just rates of risky personal behavior such as smoking and binge drinking.

"This speaks to the fact that we know that people's everyday lives are what so importantly affect their health and not only individual behavior," Bassett told Newsday Wednesday. "The emphasis on equity is certainly a first. That's obviously not surprising from this administration, which added an equity lens to the citywide plan."

The blueprint, for example, identifies a wide gap between citywide and black infant mortality rates. It sets an at-large target for reducing infant deaths by 4 percent by 2020 and an equity target for lowering it 8 percent among black New Yorkers, the "priority population" in the category. It seeks to reduce fall-related hospitalizations among adults 65 or older by 10 percent citywide and by 12 percent in Staten Island, the community most affected by such injuries.

Some social factors used in the plan are the rate of assault hospitalizations among youths and "social cohesion," or shared values and trust among neighbors -- a metric which will be measured through community surveys.

The 2020 plan will involve what health officials called an "unprecedented" level of community engagement, including an opportunity for residents to vote on health priorities for their neighborhoods.

"One of the things that is important about this approach is acknowledging that there isn't a one-size-fits-all for interventions," said First Deputy Health Commissioner Dr. Oxiris Barbot.

Take Care New York in 2004 acknowledged health disparities by community and race and ethnicity but did not target specific demographics. A 2012 version used poor housing quality -- alongside factors such as teen pregnancies and the consumption of sugary drinks -- as a metric of health.


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