The State of the State’s Health

David Sandman
4 min readApr 24, 2023

Each year, the President of the United States delivers a constitutionally required “State of the Union” address to Congress. These days, it’s a staged television event wherein the President lays out their priorities and agenda, announces bold new initiatives, and tries to bolster public support. Invariably, they declare the state of the union to be “strong” while noting all the challenges facing the nation. It’s become such a popular platform for elected officials that now we get “State of the State,” “State of the City,” and “State of the Borough” addresses in New York.

What about the State of the State’s Health when it comes to New York? Are we preventing and treating illness? Is health care accessible, affordable, and equitable?

It’s a mixed verdict. We are national leaders on many measures and lag on others. The Commonwealth Fund’s 2022 scorecard ranks New York 10th among all states on overall health system performance. Compared with other states, New York performs better than average on measures of health insurance coverage, access to medical care, medical debt, premature avoidable death, and preventive services like primary care check-ups and cancer screenings. We can always do better; we can’t be complacent and risk losing ground.

In the plus column, here are some areas where New York State is doing especially well:

Healthy Lives
New York does especially well on measures that the Commonwealth Fund scorecard categorizes under “Healthy Lives,” including:

  • One of the lowest suicide rates in the nation (8 out of 100,000 people in 2020, the third-lowest rate among states);
  • One of the lowest rates of infant mortality (4 per 1,000 live births, the fifth-best among states); and
  • The sixth-lowest rate of adult obesity in the nation (although more than one-quarter of New York adults are obese, compared with one-third nationally).

Health Insurance Coverage

Children’s Health

In the minus column, New York is lagging in a few areas:

Opioids
Opioids are a five-alarm fire for New York. The latest figures show that:

  • Nearly 5,000 New Yorkers died of an opioid-related overdose in 2021 — a 14% increase over the prior year and the highest number on record.
  • More than 80% of overdoses statewide involved fentanyl.
  • Emergency departments statewide saw a 30% increase in opioid overdoses other than heroin between 2020 and 2021.

Racial Inequities
We have work to do when it comes to improving health equity and closing racial and ethnic disparities:

  • New York has one of the country’s lowest overall rates of infant mortality, but those rates are nearly 2.7 times higher for Black infants than for white infants.
  • Similarly, Black New Yorkers are 2.3 times more likely than their white counterparts to experience potentially life-threatening complications during or after childbirth.

New York is a large and diverse place. While statewide averages are informative, they can also mask wide variations across regions of the State. For example, according to the latest County Health Rankings report, life expectancy statewide is about 80 years, but that ranges from 76.4 years in Chemung County to nearly 84 years in New York County. And within smaller geographies, gaps persist across racial and ethnic groups. In Chemung County, Black residents’ life expectancy is more than two years shorter than white residents’. In New York County, that disparity is more than eleven years: Black residents there can expect to live only 75.4 years, whereas white residents can expect to live nearly 87 years.

New York will soon have a new State Health Commissioner, subject to confirmation. Earlier this month, Governor Hochul nominated Dr. James McDonald, who has served as Acting Commissioner since the beginning of this year, to the permanent role. It’s a big job with a vast scope of responsibilities.

In a prior blog post, I noted that State and local health departments need to monitor and address everything from disease prevention and mitigation to air and water quality to maternal and child health to mental health — and so much more. Identifying areas for improvement and setting priorities for attention and resources are critical first steps for any incoming commissioner. Our next Commissioner has many strengths to build on and a lot of work to do. We all do.

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