The bad news? Between 2005 and 2014, there were 3,007 pedestrian deaths in New York State. The good news? New York’s Pedestrian Death Index has decreased since 2014, meaning that it has become safer for pedestrians. This is despite the fact that, on average, states across the nation have actually become more dangerous for pedestrians since 2014. According to the Dangerous by Design 2016 Report, in 2016, New York State ranked as the 14th safest state for pedestrians. Great work New York State!
To celebrate the fact that New York has become a safer place for pedestrians, let’s take a look at some of the milestones we achieved over the past few years in terms of creating safe and complete streets for everyone to use, regardless of age or ability.
In August of 2011, the Complete Streets Act was signed by Governor Cuomo. It required agencies at the local, county, and state levels to take into account the safety, convenience, and mobility of everyone when they develop transportation projects using government funding.
In June of 2016, Governor Cuomo declared the very first New York State Pedestrian Safety Action Plan. The plan will span over five years, involve multiple-agencies, and provide $110 million for the improvement of pedestrian safety via three initiatives: improvements in infrastructure, public education, and enforcement. The New York State Department of Transportation is taking lead on the infrastructure improvements, the State Department of Health is working to implement awareness campaigns and public education programming on pedestrian safety, and the Governor’s Traffic Safety Committee is focusing on increasing law enforcement.
In 2014, Mayor Bill de Blasio of New York City created the Vision Zero program, which aims to reduce traffic fatalities by 50% by 2025. The Vision Zero Action Plan outlines 121 initiatives on making our streets safer. Initiatives that have been successfully completed thus far include incorporating a Vision Zero curriculum for students in grades 4-6, standardizing signage regarding vehicle safety, increasing enforcement on impaired driving, providing focused training on safety awareness to bus operators, and expanding the use of technology around collision avoidance among many others.
As highlighted in this prior DASH-NY blog post, Ogdensbury, NY ranked number one in its policies on Complete Streets in 2014!
Complete Streets is an integral part of DASH-NY’s priority to create Active Communities. We are excited by the progress that has been made and proud of New York for becoming a safer place for pedestrians. As part of DASH-NY’s 2017 policy priorities, we hope to establish dedicated state funding for Complete Streets and continue the great work that’s been done.
As reported by the County Health Rankings, only 20% of our health is determined by the clinical care that we receive. The remaining 80% is based on our health behaviors (30%), socioeconomic factors (40%), and physical environment (10%). With factors like education, employment, income, social support, community safety, housing, transit, and capacity to eat healthy and exercise impacting 80% of our health and wellbeing, we cannot ignore these determinants of health. A major way we can address these determinants of health and create healthier communities is through placemaking.
According to Melody Goodman from the Washington University in St. Louis, “Your zip code is a better predictor of your health than your genetic code.” Low-income communities are more likely to lack features that support walking and exercise, like well-maintained sidewalks, parks, trees, and recreational facilities, as well as those that support healthy eating, like supermarkets and places that sell fresh fruits and vegetables. Although there is no one definition for it, placemaking is all about redesigning a community space to encourage healthy behavior, build social capital, promote local economic growth, improve safety, reduce crime, boost civic engagement, and reduce health disparities.
Social Support & Interaction: Having good social support helps create a feeling of belonging and promotes mental health. Examples of placemaking initiatives to increase social support include pavement painting and garden projects led by community residents.
Play & Active Recreation: Physical activity helps people reduce their risks of chronic disease, stay healthier both mentally and physically, and live longer. Placemaking can engage the community in efforts to create public spaces and activities that encourage physical activity on a regular basis.
Green & Natural Environments: Natural green places have many health benefits. Greenery has been shown to increase exercise, cardio-metabolic health, attention, memory, and social capital, as well as reduce depression, anxiety, stress, and crime. Adding green, natural elements to a community space is a placemaking initiative that provides simple, low-cost, and immediate improvements.
Healthy Food: The accessibility and affordability of fresh, healthy food is important to promoting community health and preventing chronic disease. Placemaking initiatives that increase the accessibility of healthy food (like public markets and community gardens) not only increases the consumption of fresh produce, but they also provide greater opportunity for economic development, local entrepreneurship, environmental sustainability, community bonding, and nutrition-based education.
Walking & Biking: Efforts to make a community more walkable comes with many benefits, including enhancing street safety, reducing chronic disease, decreasing air pollution, bolstering local economies, encouraging physical activity, and improving cognitive function. Enhancing the aesthetics of sidewalks, improving the safety of streets and bike lanes, and creating new quality destinations within the community are all placemaking initiatives intended to make a more walkable/bikeable community.
The Supplemental Nutrition Assistance Program (SNAP) is supposed to help “low-income people and families buy the food they need for good health.” However, data shows that people who use SNAP not only consume less vegetables, fruits and whole grains than other consumers, but also buy over 40% more sugar-sweetened beverages. It is very unfortunate that SNAP benefit dollars are used for purchases that end up contributing to the risks of diet-related illnesses, and hurting the health of those who use them. In fact, studies have shown that food stamp programs may be associated with higher risks of obesity.
Why don’t we put restrictions on food stamp benefits that prohibit the purchasing of unhealthy foods and beverages? Restrictions have already been put on certain health-harming items like tobacco and alcohol, so why not just extend them to unhealthy food items as well?
Unfortunately, the efforts to place restrictions on unhealthy food and beverages face the following challenges and opposition:
Manufacturers who would lose sales from their biggest customers if these restrictions were put in place would leverage their political power to fight against the restrictions.
Antipoverty organizations oppose SNAP restrictions on the argument that such limitations can be discriminatory and patronizing towards the people who use SNAP.
Economists argue that SNAP restrictions are futile, stating that most people who use SNAP would likely just use their own dollars to purchase the items that cannot be bought with SNAP.
Grocery stores fear that the process of separating SNAP-eligible food from foods ineligible for SNAP would be very complicated and costly, especially if the store is small.
If there is so much opposition towards restricting the purchase of unhealthy items, then can we instead incentivize the purchasing of healthy items? Would such incentives be effective at encouraging healthier eating habits among SNAP users? A recent study done on the Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program evaluated the effectiveness of both incentives for healthy purchases and restrictions on unhealthy purchases in improving the health of diets. Unfortunately, the study’s results showed that only when incentives were combined with restrictions, were there significant improvements in diet. Therefore, incentivizing the purchase of healthy items may not be enough to promote healthier eating among SNAP users. We may have to go through the contentious battle of restricting unhealthy food and beverage items from SNAP if we want to significantly improve the health of the program’s beneficiaries.
DASH-NY supports policies that promote the consumption of healthy food for all. In fact, DASH-NY’s 2017 policy priorities include adopting food policies that set nutrition standards for all government funded foods and beverages, as well as investing money in both the Healthy Food and Healthy Communities Fund and Healthy Corner Store Initiative as an effort to improve access to healthy food for everyone. DASH-NY hopes to see advancement in the policies that will promote healthy eating among SNAP beneficiaries.
June Jackson Christmas, MD, is a psychiatrist and pioneer of urban health who was one of the first to address the impact of economic and social factors on mental health. As founder of Harlem Hospital’s Psychiatric Rehabilitation Center, New York City’s Commissioner of Mental Health and Retardation under Mayors Lindsay, Beame and Koch, a member of President Jimmy Carter’s transition team, vice-president of the American Psychiatric Association, the president of the Public Health Association of NYC and a three-time trustee of Vassar College (she was one of the first black graduates), Christmas maintained an unwavering commitment to equitable care for all. At 92, she is still active in her community.
In this Storycorp, Inc., interview for the Academy’s Age-friendly NYC Changemaker’s project, Christmas, shares her path to civil rights activism. She is interviewed by her son, Vincent.
Vincent: Mom, how were you and dad able to raise three children who seem to have the same sense of commitment social justice?
June: I have been thinking about that lately as I remember my own parents and my grandparents. They were more active in community affairs and in making things change than I realized. So it was sort of ingrained in me.
My mother, a middle class housewife, was involved in a group in Boston in Cambridge, along with Harvard white folks, in the 40s and 50s, that was trying to open doors closed by segregation. My father was involved in the National Alliance of Postal Employees who worked to fight to get black postal workers into the union. I remember seeing him at his typewriter, writing letters and complaints, he was an activist.
Then of course I married your dad, who was a progressive activist on the in the left, so it came from both our parents.
Vincent: Did you ask your father, what are you typing on the typewriter and why?
June: Daddy was doing things about postal workers being treated unfairly, and that was confidential, yet I knew something very important was going on because he and his buddies would talk.
For example, he took the postal exam to be promoted from a clerk to a supervisor over and over again. In the Civil service then, the top three people in the exam were the people to whom a job was given. Daddy would always get the highest score, often perfect, and never be offered the position. It took maybe 20 years of him taking exams and coming out high, until maybe the beginning of the WWII, when he got the promotions.
Vincent: How did that make you feel?
June: Oh I was excited about it — proud. I also knew that there was a lot that needed to be changed in Cambridge. One of my earliest memories … the minister’s wife headed our girl scout troop. And that year, the girl scouts who won the prize for selling the most cookies were Clarice Roberts, who was black, and me. The prize was two weeks away at a Girl Scout camp in another town.
But when it came time to claim our prize, she said, ‘well you know I’m very sorry girls, you’re not going to be able to claim your prize. Those camps they’ve really never taken any negroes. She used the expression, “I’m sorry June, that’s just the lay of the land.” I didn’t know what it meant, but I got the idea that was it.
That’s when I figured out we needed to do something, because when we told people discrimination was a problem, they was nothing they could do.
So, in my mid-teens, in Cambridge, we planned to go to the roller skating rink. Now we knew the rink didn’t accept blacks, but we planned to go because we wanted to go roller skating. About 13 of us went to this rink and stood in line to buy our tickets and they closed the window — they wouldn’t sell us tickets. Now, we had heard about the auto workers who had strikes — sit down strikes — so we decided we were going to sit down in this little anteroom and we sat down. We said we were going to wait until the window opened and they were going to sell us tickets.
Other people would come, so they would open the window [for whites] and then close it. They would not sell us any tickets at all, so we stayed. But it was back in the late 30s and we were about 14 and 15 years old, so we could only stay until it got dark, so we had to get home. So that brought a prompt finish to our first protest, but it taught us that still those people were very flustered.
Vincent: Did you try it again?
June: I didn’t try it again until I was in college.
Vincent: So you saw your parents fight, so you just took up the fight?
June: Well, I had some other examples. In high school, I was second in my class, the salutatorian, but I was not allowed to be a member of the national honor society. There were examples everyday of discrimination and segregation.
In grammar school, I hated the idea that there was a day called “I am an American Day.”
The teachers would ask each white kid, where are you from and they would say, “My name is Parker Whipple, and we come from England and I am an American.” They just passed over us. The class could have 30 students and about five black kids, but we never got asked.
Vincent: And you didn’t say, what about me?
June: Absolutely not, first, you were afraid of the teacher. Second, of all I think it was the reality of how we just accepted racism.
Vincent: That was my next question. Some of the people in your family said to you, “June, you cannot change things,” so was there a conflict within your family?
June: My nanna was hesitant, she would say, “June be careful.” She knew there were bad things in the South, she knew about lynchings. My dad said, “be twice as good as everybody else and you will get it,” even though he was not getting promoted. My mother would work on the interpersonal way — be nice, get your information together and see if you can’t negotiate.
Vincent: Well, that must how we — me, Rachel and Gordon — adopted our activism, we did see you and dad always being involved with The Student Nonviolent Coordinating committee (SNCC). The people coming to the house from Africa and the United Nations … all those students — weren’t they freedom riders? They left all those great 45s and taught us how to dance.
June: Yes, they were freedom riders. When the civil rights struggle began in the 60s, I was a supporter and so was your dad. Among the things that we did is help raise money because we had a big house. We had a big house only because we could not rent a big apartment because we were black. We tried for years, up and down the west side [of Manhattan], but they told us they did not rent to negroes or Puerto Ricans.
We pushed a case that we eventually won that actually changed the law in New York City, but first we bought an old, run down house and converted it. So we had events.
What led to working for civil rights organizations was that when the freedom riders were heading down south, I wanted to go, but I was working at Harlem Hospital. I was a little hesitant too because I knew people were being killed. So what I did do in 64 was go to Atlanta to work with Lou Levine — a good friend of mine — a white, Jewish American, liberal psychologist.
We set up meetings for SNCC workers who had come back with battle fatigue and after that people would come to see me when they came to New York.
A lot of them would get weary from worry about being shot at and hurt and away from home and some of them — if your remember Mathew Jones and Avon Long, the Freedom Singers — they wanted to be away from the battlefield because the civil rights struggle was a battle.
By then, I had left practice and went to Boston University (BU) medical school. There was a lot to fight for there too. There was a national organization, the Association of Interns and Medical Students, we fought for such basic things as national health insurance and the rights of black doctors to have hospital privileges — things black doctors then did not have at all.
So we were pushing for change at BU and there the students thought that we were a bunch of wild-eyed activists. It seems to me that I’ve often been in places where if you wanted to make life better for yourself, you had to work to make life better for everybody.
Vincent: Well, I’m not completely sure how you and dad did it, but the values you instilled have really informed my life and that’s really why I enjoy being a social worker so much.
The memories, for me — the early 60s, when the civil rights movement was going on, the freedom riders really hit home. Chaney and Goodman, I went to school with their younger brothers and we all knew they were going down South and we were all very scared for them, then, as we now know, they did not come back and then there was the assassination of Martin Luther King and Malcom X. I certainly thought back then that those battles were over.
June: No. They are not done…the struggle does continue. And there was a whole period of my life when I tried to be an activist as the commissioner of the NYC Health Department. Having to decide ‘do I support the mayor, who I work for, or do I fight for the rights for the patients and the communities?’ … but that’s another interview.
Excerpted from a piece produced by Eddie Gonzalez from interviews recorded by StoryCorps, a national nonprofit whose mission is to provide Americans of all backgrounds and beliefs with the opportunity to record, share, and preserve the stories of our lives. www.storycorps.org.
Not only is there currently a lack of physicians in underserved neighborhoods across the U.S., but in these neighborhoods, there is also often a disconnect between patients and physicians. This means chronically-ill patients are hesitant to admit their struggles with poverty to their doctors, and patients leave the doctor’s office confused and unable to follow through on instructions. We need to find a way to bridge this gap between patients and doctors.
In New York City, City Health Works is doing just that. The organization was founded in 2012 by Manmeet Kaur, who wanted to help integrate health coaches into our country’s healthcare system. Destini Belton, who is neither a nurse nor a doctor, serves as one of City Healthy Works’ trained and well-trusted health coaches in the Harlem community. As a health coach, Belton seeks to understand the patients’ lives outside of the hospital or clinic setting—where they sleep, what they eat, where they work, how they live, and what they struggle with. She uses that information to help overburdened clinics care for patients with difficult and complicated conditions. Like Belton, the other health coaches at City Health Works are residents and trusted neighbors in the communities where they serve. Many of the health coaches have also experienced the same challenges that their patients face, helping to strengthen the trust and connection between coach and patient. The majority of patients served by City Health Works not only suffer from uncontrolled chronic diseases but also are disabled and struggling with poverty. Therefore, it is very helpful for these patients to have weekly meetings with trusted health coaches on how to follow doctor’s orders and stabilize their physical and mental health amidst the challenges of their daily lives. Testimonies from patients and doctors alike reveal the importance of health coaches in improving the health and wellbeing of patients.
DASH-NY is a strong advocate of policies and interventions that address the social determinants of health. We recognize the significant toll that chronic disease has on our communities, and work to advance prevention by supporting policies that promote healthy food and physical activity for all. We are so excited by the work that City Health Works is doing to bridge the gap between patients and doctors and to advance the prevention of chronic disease throughout our city’s communities.