Just in Case: Emergency Preparedness and the Role of the Health Department as First Responder

When it comes to disasters there is one indisputable fact: they happen whether we are ready or not. New York City is no stranger to natural or man-made disasters. In the last two decades we experienced Hurricane Sandy, which was the second largest storm to make landfall in US history, and the September 11 terrorist attack on the World Trade Center.

When it comes to disasters there is one indisputable fact: they happen whether we are ready or not. New York City is no stranger to natural or man-made disasters. In the last two decades we experienced Hurricane Sandy, which was the second largest storm to make landfall in US history, and the September 11 terrorist attack on the World Trade Center.

Despite the inevitability of hurricanes and other catastrophes, most individual citizens probably don’t spend a lot of time thinking about the next disaster much less preparing for it. I have lived in New York City for over thirty years and for the past 23 I have been married to a New York City firefighter. My husband’s three brothers are NYC police officers so you might say I have had a fairly up close and personal view of the life of a first responder. If any family should have an emergency plan we should. To be completely honest, we don’t.

So it is good to know that behind the scenes at the federal, state, and local levels there is a network and system for emergency response and preparedness at work around the clock. They work in tandem to anticipate and prepare for a multitude of different scenarios, natural and man-made, that are unlikely to cross our conscience except in our darkest nightmares.

The Federal Emergency Management Agency (FEMA) takes the lead nationally. FEMA’s mission is to support both citizens and first responders to build, sustain, and improve our capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards. It is a huge job and one that continues to grow in importance as we manage more and more weather events, disease outbreaks, and terrorist threats. It’s why the proposed 900 million cut to FEMA that Congress was considering for the 2018 federal budget must be reconsidered!

To do its work, FEMA collaborates with both elected officials and state and local agencies like NYC Emergency Management (NYCEM). In planning for and responding to city-wide emergency events, NYCEM is responsible for organizing and coordinating with all other New York City agencies, some like Police and Fire that one might expect to be on the front lines of a wide-scale emergency but others that you may not consider like Department of Buildings, Department of Citywide Administrative Services, Department of Parks and Recreation and the Department of Health and Mental Hygiene.

The NYC Health Department, which most of us associate with birth certificates, smoking restrictions, restaurant grades, and other local health-related issues, will take on the role of first responder in the event of a major emergency such as a coastal storm, a biological attack, or a disease outbreak. Like Police and Fire, the Health Department is constantly preparing and training behind the scenes for any number of emergency scenarios. And in New York City, with its 8.4 million residents, this is a tall and expensive undertaking. It’s also a critical one that must be built and sustained with adequate Federal funding.

When Hurricane Sandy caused the East River to flood the generators that kept the Neonatal Intensive Care Unit of NYU Langone Medical Center running, an established protocol and trained staff made sure that all patients were safely transferred to other hospitals.

In the instance of a biological attack like anthrax, taking certain medications after exposure before the disease develops can keep people from getting sick. To prepare, the Health Department has identified 165 Points of Dispensing (PODs), temporary sites that can be activated within hours to provide life-saving medications city-wide. Rapid, city-wide mobilization requires practice and continued support for complex exercises to continually test and improve plans.

When the first Ebola patient was admitted into a city hospital, the Health Department’s Public Health Laboratory was able to confirm the diagnosis in less than three hours. The Health Department lab is an essential part of controlling potential outbreaks as highly trained and practiced technicians are constantly at the ready to test and detect a variety of infectious diseases and minimize the spread.

In 2004 when FEMA marked September as National Preparedness Month (NPM), it did so to coincide with the onset of hurricane season and to elevate the importance of emergency preparedness. This September, as we bear witness to the damage of hurricanes Harvey and Irma and mark the 16th anniversary of the 9/11 attacks, it is essential that we realize that our country’s and city’s readiness is the result of foresight, planning, and coordinated training which requires sustained attention and funding over time.

Often times, and thankfully, many major emergencies never come to fruition, but we must prepare nonetheless. It is critical that our federal government maintain the investments necessary so that we can continue to plan and respond in ways that save lives and protects the health and wellbeing of all of us.

Urban Farms Provide Promising Pathways for Young People

It’s a hot, muggy Thursday morning in Brownsville, Brooklyn and there is already a small group of people gathering in the cul-de-sac of Howard Houses. At first glance, it just appears to be a group of friends, but just beyond the crowd, a burst of green comes into view—a tomato plant juts outward, looming large over the other crops.

It’s a hot, muggy Thursday morning in Brownsville, Brooklyn and there is already a small group of people gathering in the cul-de-sac of Howard Houses. At first glance, it just appears to be a group of friends, but just beyond the crowd, a burst of green comes into view—a tomato plant juts outward, looming large over the other crops.

There in Howard Houses, an area some residents liken to a “food swamp,” members of Green City Force have helped transform what was once a bare field into twelve plots of vegetables and herbs ranging from collard greens and cilantro to bok choy and kale. The harvest has been so reliable that upwards of 70 people come each week to collect their share of the weekly harvest  and most of the goods are gone hours before the farm stand closes for the day.

The Corps Members are from Green City Force, an AmeriCorps organization that engages, recruits, and trains 18- to 24-year-old NYCHA residents and pays them a stipend to volunteer on environmentally sustainable and energy-efficiency service initiatives at Housing Authority sites. Over the course of 10-months, Urban Farm Corps Members provide 40 hours a week in service where they receive rigorous job training and career planning support.

At Green City Force, they serve full-time on teams, gaining work-like experience in the field four days a week and acquire academic skills in the classroom one day a week as they work toward technical certifications and success on college exams. They earn a monthly stipend, support for finding a job or getting into college, and membership in an active alumni community after they graduate. Many go on to careers in farming, composting, and other environmentally-friendly careers.

“There are so many specializations and trainings,” said Carson Ross, Team Leader for Green City Force. “Corps Members working on the farms learn maintenance, planting, water management, compost, and food production.”

The Howard Houses farm, one of four throughout Brooklyn and Manhattan, produces more than 250 pounds of produce a week for distribution to neighboring residents. The farms are one component of Building Healthy Communities, a multimillion-dollar public-private partnership led by Mayor Bill de Blasio’s Office of Strategic Partnerships and the Fund for Public Health in New York City to increase access to physical activity and healthy food, and improve public safety in 12 densely populated and historically underserved New York neighborhoods.

And at Howard Houses, the desire to learn new skills is palpable. While some Corps Members collect produce and work closely with volunteers, others pick produce and share tricks of the trade with their peers.

Today, Daniel Silva, 19, Corps Member, is working closely with Corps Member Nordesia Bowman, 23, as they pick a second round of crops. They discuss the difference between male and female green peppers and imagine which misshapen eggplant would be the best mascot for Green City Force.

“It’s better than a lot of jobs someone my age can find nowadays,” said Bowman. “Most gigs would have me working a register or standing in one spot all day.”

Silva, who has a son on the way, only has praise for the program. He lists the benefits in rapid succession: “full-time training, certifications, skills building, and you meet new people and make friends.” He lugs the batch of peppers to the assembly line. “Where else is a 19-year-old from NYCHA going to get that kind of job?”

That list of benefits is the backbone of the Green City Force program and what ultimately makes it so successful. Even though Silva’s service time is limited and he and the rest of his 35-member cohort will graduate next spring, he isn’t worried about the next steps.

“By the time I graduate, I’ll either have a job, or I’ll create one for myself.”

FPHNYC Receives Funding to Support Farms at NYCHA

The Fund for Public Health in New York City (FPHNYC) has been awarded funding from the Target Corporation for the second year in a row to support Farms at New York City Housing Authority (NYCHA) which engages NYCHA youth to build, plant and cultivate one-acre farms in underutilized public space at NYCHA developments. The project brings job opportunities and training, fresh produce, beautification and opportunities for safe, outdoor activity to residents at sites.

The Fund for Public Health in New York City (FPHNYC) has been awarded funding from the Target Corporation for the second year in a row to support Farms at New York City Housing Authority (NYCHA) which engages NYCHA youth to build, plant and cultivate one-acre farms in underutilized public space at NYCHA developments. The project brings job opportunities and training, fresh produce, beautification and opportunities for safe, outdoor activity to residents at sites.

The Farms are one component of Building Healthy Communities (BHC), a public-private partnership led by Mayor Bill de Blasio’s Office of Strategic Partnership and FPHNYC to increase access to physical activity, healthy food, and improved public safety at 12 densely populated and historically underserved New York neighborhoods.

The one-year award will support the overall Farms at NYCHA initiative, which launched in 2013, with a pilot farm in Red Hook Houses. Since then, the City has expanded the program to include three new sites in Brownsville, Canarsie, and East Harlem. The farm sites are now accessible to almost 17,000 public housing residents. After the initial build and planting, community-based organizations help to manage and maintain the farm with community residents.

This fall, FPHNYC and BHC will begin construction of two new farms located at NYCHA developments in Staten Island and the Bronx. The addition of these two farms, which are expected to open in 2018, will bring this program to four out of five of the city’s boroughs.

“The Farms enable communities and local organizations to work together to increase access to healthy food options in some of New York’s most underserved neighborhoods,” said Sara Gardner, Executive Director, Fund for Public Health in New York City. “This is an incredible opportunity to improve and green underutilized space while engaging the broader community.”

An Idea Whose Time Has Come: The Opioid Epidemic is a National Emergency

On July 31st, the Trump Commission on Combating Drug Addiction and the Opioid Crisis issued their interim report. Their first recommendation was to urge the President to declare a national emergency under either the Public Health Service Act or the Stafford Act. The report goes on to recommend five additional immediate steps to combat the epidemic with the promise of a fuller report and additional strategies to be released this fall.

Sara Gardner, MPH
Executive Director

On July 31st, the Trump Commission on Combating Drug Addiction and the Opioid Crisis issued their interim report. Their first recommendation was to urge the President to declare a national emergency under either the Public Health Service Act or the Stafford Act. The report goes on to recommend five additional immediate steps to combat the epidemic with the promise of a fuller report and additional strategies to be released this fall.

My initial reaction was to think, it’s about time!

My second was to wonder, what took them so long?

And my third thought was, how did we get to this place?

The report paints a compelling picture of an epidemic that started to unfold over a decade ago and grew throughout the early 2000s because of overprescribing of prescription drugs, which were heavily marketed by pharmaceutical companies as non-addictive treatment for chronic pain. By the time doctors, patients, and the government began to realize the issues with prescription meds, opioid misuse was rampant and people were turning to drugs such as heroin because it was cheaper and easier to obtain.

Though I work in Manhattan I live in the borough of Staten Island. Staten Island, like thousands of other communities across the nation has been fighting this opioid epidemic for almost 10 years. No one has to tell us that this epidemic has reached emergency proportions. For years now the local paper has shone a spotlight on the epidemic from all angles including weekly reports of overdoses as well as the community, City, and State response. The recommendations in the Trump Commission’s report that relate to increasing treatment capacity; prescriber education; expansion of medication assisted treatment; and widespread dispensing of the overdose reversing drug naloxone are already underway in Staten Island and throughout  New York City.

Today, drug overdoses have become the leading cause of death among Americans under the age of 50, with two-thirds of those deaths attributable to opioids. In 2016, 62,000 Americans died from overdoses, 19 percent more than 2015. While NYC’s overdose rate is lower than other regions, in 2016, NYC lost an estimated 1,300 people (3-4 per day) to drug overdose. An estimated 80 percent of those overdose deaths—approx. 1,075—involved an opioid.

Since 2011, heroin and subsequently, fentanyl—a powerful synthetic opioid 50 to 100 times stronger than the painkiller morphine—have driven the increase in overdose deaths. Almost 90 percent of the fatal opioid overdoses in NYC involved heroin and fentanyl. Eighteen percent involved prescription opioid painkillers. Before 2015, fentanyl was involved in fewer than five percent of all overdose deaths in NYC. In 2016, fentanyl was involved in approximately half of NYC overdose deaths.

This year, the de Blasio administration launched a comprehensive, multifaceted initiative called HealingNYC: Preventing Overdoses, Saving Lives, to address the rising epidemic of deaths from opioid drug overdoses. The initiative, which will ramp up evidence-based efforts already underway, will spend $38 million annually with the goal of reducing opioid overdose deaths by 35 percent over five years. The initiative has four overarching goals: preventing overdose deaths; preventing opioid misuse and addiction; protecting New Yorkers through effective drug treatment; and protecting New Yorkers by reducing the supply of dangerous opioids.

HealingNYC will build on a record of leadership and innovation by expanding what we know works and implementing 12 separate strategies that in addition to preventing opioid misuse, expanding treatment and reversing overdoses, will also expand efforts to reduce the availability of illegal opioids, particularly those involving fentanyl to support our ultimate goal of saving lives and reducing overdoses.

So, how did we get to this place? For more than one hundred years, death rates have been dropping in the United States but because of opioid overdoses and the rise in other deaths of despair such as suicides and alcohol-related deaths, the trend is reversing. More federal dollars are definitely needed to expand what we know works to scale in order to successfully stem the current epidemic.

The bigger question is how do we prevent future ones? How do we prevent the next generation of addicts? More and more addiction experts are pointing to the many social, environmental, and psychological issues that contribute to drug use.  Addiction is a symptom of despair and a sign that something is really going wrong in our country. We need to get to the root cause and address the underlying issues. We owe that to the thousands who have died and the families that loved them.

Fighting Obesity, One Step at a Time

This summer, two outdoor stairways in the South Bronx received unusual upgrades. The concrete steps, once the typical, drab gray are now covered in brightly colored, nature-inspired images designed and painted by Bronx-based artists Diana Perea and Josie Gonzalez.

This summer, two outdoor stairways in the South Bronx received unusual upgrades. The concrete steps, once the typical, drab gray are now covered in brightly colored, nature-inspired images designed and painted by Bronx-based artists Diana Perea and Josie Gonzalez.

These new murals are located in the South Bronx neighborhoods of Morrisania and Crotona where obesity rates, at 35 percent, are the highest in the city. The project is based on research findings that open, engaging and attractive public spaces foster healthy behaviors.

“Exercise is essential for good health, and taking the stairs is a quick and easy way to incorporate exercise into a busy day,” said Dr. Mary T. Bassett, New York City Health Commissioner. “Adding colorful murals is a way to encourage people in the South Bronx to take the stairs every day.”

Selected through an open call by the nonprofit ArtBridge, the artists worked with the South Bronx-based organization DreamYard to host youth workshops and develop the final design. The end result is two works of art that reflect the vibrancy of the surrounding communities. Perea’s mural, “Blue-Winged Warbler,” is located at Third Avenue and Weiher Court. It features birds and tessellated patterns found in nature. Gonzalez’s mural, “Rise Up,” depicts the legendary quetzal bird, a symbol of “liberation and movement.” It is located at Third Avenue and 164th Street in Morrisania.

Funded through KaBOOM!’s Play Everywhere Challenge, this project is the result of an innovative, multisector relationship between the New York City Health Department, the New York City Department of Transportation, ArtBridge, DreamYard, the Fund for Public Health in New York City, local communities and artists.

The murals will remain open through July 2018.