On the Road to Uber in Upstate New York

DASHNY Advocacy & Policy, Economic and Community Development, Environment, HOMEPAGE LATEST NEWS 0 Comments

By Amanda Li, B.A., Junior Policy Associate

The idea of Uber was born on a snowy night in 2008, when Travis Kalanick and Garrett Camp struggled to get a cab. Wouldn’t it be nice if we had reliable transportation available at the push of a button?

Uber has since spread to over 530 cities across the globe, transforming the way that urban transportation works. As Uber has grown in popularity, other ride-hailing apps like Lyft, Gett, Juno, and Curb have joined the rapidly expanding industry.

By providing affordable, reliable transportation, ride-hailing apps make the cities that they operate in more accessible. They help make trips to the airport, park, grocery store, doctor’s office and any other location you need to go, quick, easy, safe, and cheap. Not only do ride-hailing apps help connect people to where they need to be, but they also help boost local economies, creating jobs and increasing business for the ride-hailing industry overall.

Despite their rapid growth in cities worldwide over the last few years, the benefits of ride-hailing apps have not yet reached less urban communities, like those in upstate New York. In areas of New York with limited public transit, accessibility to places not within walking distance can be a major issue with significant health implications for those who cannot drive. For instance, a person without reliable means of getting to the doctor’s office may be more hesitant to schedule needed appointments or regular check-ups. Also, a lack of affordable transportation to grocery stores or farmers markets can contribute to poor diets lacking in healthy produce. Ride-hailing apps can potentially provide a solution.

Unfortunately, New York’s insurance laws have made it difficult for ride-hailing apps to expand beyond New York City. For over a year, Uber and Lyft have been in gridlock with insurance companies and taxi companies over a law to allow ride-hailing app companies to expand beyond NYC. During the last half of 2016, Uber and Lyft spent $1.8 million on lobbying expenses to unsuccessfully persuade the Legislature to pass the bill for ride-hailing apps in upstate New York.

But we may finally be seeing a long-awaited breakthrough in the gridlock. On Monday February 6, 2017, New York’s Senate voted to allow ride-hailing apps like Uber to operate across the entire state of New York. Though this is major step towards expanding ride-hailing apps across the state, there is still a hurdle to overcome. The bill does not yet have an Assembly sponsor, and there are important differences between the Senate’s bill and Cuomo’s proposal: an agreement must be reached before March 31st, the deadline for the state budget to be finalized.

Having access to ride-hailing apps like Uber helps people access places that are important for a happy, healthy life. Whether city, suburban, or rural, affordable and reliable transportation plays an important role in connecting communities and promoting well-being. DASH-NY hopes that the state will move towards bringing more transportation options to all communities across New York.

 

The American Antibiotics Resistance Crisis: Experts in Agriculture and Health Talk Solutions

DASHNY Clinical and Community Linkages, DASH-NY Partner Highlights, Food Policy, HOMEPAGE LATEST NEWS 0 Comments

FROM THE URBAN HEALTH MATTERS BLOG BY AMANDA LI

Academy hosts forum on taming a growing, national health threat

With resistance to antibiotics prevalent in every country across the globe and more than 2 million people infected annually with antibiotic-resistant bacteria in the United States alone, antibiotic resistance is posing significant risks to human health. In fact, the World Health Organization classifies it as “one of the biggest threats to global health, food security and development today.

 What is causing this major health challenge?

Most people assume that antibiotic resistance develops because of the misuse of antibiotics in the treatment of infections. That’s correct, but it’s just a small part of the story. Approximately 80 percent of the antibiotics used in the U.S. are deployed in food production. 

Antibiotics are regularly used by industrial farms in the raising of livestock, fish and poultry. By feeding antibiotics to animals, farms can stimulate quicker growth as well as compensate for exposing animals to unclean environments. Although economically beneficial for the farms, this practice contributes greatly to the antibiotic resistance in humans who consume poultry, meat and fish.

The dangers of antibiotic resistance are real and all around us, but so are the increasing efforts to fight it. In recognition of the health risks that come with using antibiotics in agriculture, the Food and Drug Administration (FDA) has implemented a new policy that tightens the rules for antibiotic use in livestock. This policy prohibits the use of medically important antibiotics to speed the growth of healthy animals.

The FDA now requires antibiotic prescriptions given to animals that will be used for food to be administered only with a veterinarian’s approval and supervision. Additionally, the New York State Department of Health has created the NYS Antimicrobial Resistance Prevention and Control Task Force, a collaboration across local, state and federal agencies. The aim of this task force is to develop recommendations and statewide strategies to fight antimicrobial resistance within New York State. The Academy works to inform policy makers about the need and benefits of policy changes related to this issue through its work with organizations such as Health Care Without Harm and its Designing a Strong and Healthy New York (DASH-NY) initiative.

Stopping increasing antibiotic resistance means working with communities, physicians, farmers, the food industry and policy makers to find new ways to address this growing health threat. That’s why leading activists and experts came together at the Academy, on February 7, 2017, to explain the potential scope of the epidemic and make recommendations about how to contain it.

Panel moderator Kimberly Libman, PhD, MPH, the Director for Prevention and Community Development at the New York Academy of Medicine’s Center for Health Policy and Programs, started off the panel by stunning the audience with a video that demonstrates bacteria’s ability to become resistant to antibiotics at extremely high doses in a mere 11 days. After following the video with the shocking idea that antibiotic resistance is currently projected to become a top killer worldwide—causing even more deaths than cancer—by 2050, Libman and her co-panelists talked solutions.

Jennifer Obadia, PhD, the Eastern U.S. Regional Director for Health Care Without Harm; Ken Jaffe, MD, a former family physician who raises grass-fed beef in the Catskill region of New York; and Saul Hymes, MD, who is a physician at Stony Brook Children’s Hospital and serves on the New York State Task Force on Antimicrobial Resistance, suggested a three-point approach. First, they reminded us that as patients, each of us can play a role by questioning our doctors about antibiotic prescriptions for ourselves and our children to make sure they are absolutely necessary. Antibiotics do not kill viruses, for example, though they are often prescribed for the common cold.

Addressing other farmers, Jaffe pointed out that farmers should never use antibiotics to make animals grow larger. They should only be given when an animal is sick. Lastly, the panelists made a public call to action for all institutions that buy and serve food to the public—hospitals, schools, cultural organizations and others—to only purchase meat, poultry and fish that has been raised without antibiotic growth therapy. Advocating for this approach to food procurement is also a key part DASH-NY’s work. If followed, the panelist’s recommendations would have a tremendous impact on protecting the public’s health in urban and rural communities. 

Originally posted on 1/25/2017 and updated on 2/15/2017 to reflect the panel’s recommendations. 

New York’s Journey to Safe and Complete Streets

DASHNY Active Communities, FEATURED ARTICLES 2 Comments

By Amanda Li, B.A., Junior Policy Associate

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.

Placemaking Our Way to Healthier Communities and Better Lives

DASHNY Active Communities, Clinical and Community Linkages, Economic and Community Development, Environment, Food Policy, Healthy Schools and Childcare, HOMEPAGE LATEST NEWS, Prevent Chronic Disease, Promote Mental Health 0 Comments

By Amanda Li, B.A., Junior Policy Associate

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.

With increasing awareness of the truth around Goodman’s statement and the potential impact that placemaking can have on health, the Project for Public Spaces has recently released The Case for Healthy Places: Improving Health through Placemaking report. The report provides research, recommendations, case-studies, and evidence-based guidance for creating positive programs and infrastructure that promote the following placemaking initiatives:

  • 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.

Placemaking is an integral part to achieving DASH-NY’s policy priorities around Active Communities, Clinical & Community Linkages, Economic & Community Development, Food Policy, and Healthy Schools & Childcare. Additionally, APP will host a learning collaborative in the spring for local health departments looking to identify placemaking activities that can reduce health disparities in their communities. We are very excited by Project for Public Spaces’ release of The Case for Healthy Places report, and will continue to support placemaking initiatives throughout our communities.

To Prohibit or to Incentivize? Promoting Healthy Eating among SNAP Beneficiaries

DASHNY Food Policy, HOMEPAGE LATEST NEWS, Prevent Chronic Disease 0 Comments

By Amanda Li, B.A., Junior Policy Associate

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.