PCDC Report: Many NYC Areas Most Affected by COVID-19 Have Low Primary Care Access

NEW YORK, NY – People in lower-income and communities of color in New York City will have a tougher road back to health after the COVID-19 pandemic subsides, according to a new report issued by the Primary Care Development Corporation (PCDC). Points on Care: The Intersection of COVID-19 and Chronic Disease in New York City compares the geographic patterns of COVID-19 cases to those of socioeconomic, health status, and primary care access. Without rapid and targeted community-level investment and intervention in primary care, the report states, health disparities will continue to widen.

“COVID-19 has laid bare stark health disparities in communities of color,” said Louise Cohen, CEO of PCDC. “People living in these neighborhoods aren’t genetically predisposed to getting sicker or dying from COVID-19 compared to other New Yorkers. Rather, their life circumstances have all but guaranteed it. By identifying associations between infection and community characteristics, we can better inform the critical role primary care will play in the months ahead.”

“Zip code level data show us which communities are being hardest hit, who is being impacted the most, and to what extent,” said Mary Ford, PCDC’s Director of Evaluation and Analytics, and the report’s primary author. “The highest COVID-19 rates are found in low-income, racially and ethnically diverse neighborhoods in Bronx, Brooklyn, and Queens. Residents of these same neighborhoods have more chronic diseases such as hypertension and diabetes, are more likely to be un- or underinsured, and have much less access to primary care.”

For the past several months, people with chronic diseases have gone without critical screenings, vaccinations, and medications because of reduced primary care capacity, social distancing guidelines, and the associated public fear. While demand for primary care will increase dramatically and soon, the pandemic has devastated the healthcare sector, reducing jobs by 1.4M in April, and dropping primary care visit rates by 58%. Since primary care providers (PCPs) are paid on a fee-for-service basis, they have had to scale back or close their doors.

“Communities most affected by COVID-19 and chronic disease will become sicker without a quick response from the primary care system,” Ford continued. “The temporary reduction of primary care will have long-lasting effects on health outcomes and increase the need for primary care, particularly in sicker neighborhoods. We anticipate the consequences of unmanaged chronic conditions will persist long after the COVID-19 pandemic has subsided.”

Recommendations

A robust, high-performing primary care system will shrink health disparities and help achieve health and economic equity.

In the short term, PCDC recommends:

• Increase funding to help primary care practices provide COVID-19 testing.
• Provide primary care practices with immediate relief funds to meet the increase in demand for primary care.

In the long term, PCDC recommends:

• Increase primary care investment in New York State.
• Deploy capital to address COVID-19 safety concerns and increase primary care access in underserved communities.
• Provide global prospective payments to primary care practices with uninsured and publicly insured patient populations.