Chair and Members of the Committee:
New York Academy of Medicine (NYAM) is an independent non-profit health organization serving New York since 1847, with deep expertise in health equity, aging, and urban health. We respectfully submit this testimony in strong support of New York City’s Preliminary Racial Equity Plan.
As you know, New Yorkers voted overwhelmingly in 2022 to make racial equity planning a core function of city government. We commend the Commission on Racial Equity for its persistence in ensuring that mandate was honored, and we applaud the current Administration for delivering a plan that now gives the City a foundation to build on. Our testimony is offered in that spirit: to help strengthen the plan’s path from commitment to measurable impact.
The City’s work is especially urgent in health. Some of the most consequential racial equity outcomes are already measurable, and they should remain central to implementation. In 2023, life expectancy in New York City was 82.6 years overall, but only 78.3 years for Black New Yorkers, compared with 83.3 years for white New Yorkers. Healthy NYC appropriately treats life expectancy, premature mortality, and maternal mortality as core measures of progress and estimates that meeting its goals could avert 7,300 deaths by 2030. These are the kinds of indicators that allow the City to assess whether policy is changing outcomes, not simply whether activity is occurring.¹
Maternal mortality is among the starkest expressions of racial inequity in health, and New York City’s data make the stakes clear. Black women in the city die from pregnancy-related causes at rates three to four times higher than white women, a disparity that reflects the cumulative effects of structural racism and differential treatment in clinical settings, not differences in income or education. Black infants die at more than twice the rate of white infants. HealthyNYC has appropriately identified these as core metrics, but measurement must be matched by investment. The City should fund and scale community-based doula programs, require hospitals serving high proportions of patients of color to report maternal outcomes disaggregated by race and insurance status, and treat the postpartum period as a clinical and social services priority. The Final Racial Equity Plan should establish explicit targets for closing the Black-white maternal mortality gap within the planning horizon, not simply track the disparity over time.
Healthy aging should also be treated as a core equity issue. Recent City data reveal troubling gaps: more than half of older New Yorkers did not have, or did not know if they had, a plan for a citywide emergency such as a flood or blackout; more than 40% reported trouble paying at least one regular bill; and nearly 18% showed signs of possible anxiety and/or depression. These are measurable indicators of whether New Yorkers are able to live not only longer lives, but healthier and safer ones. They are also the kinds of indicators that the City should disaggregate by race, income, and neighborhood, and use to guide investment.²
NYAM’s own work in healthy aging reinforces the value of this approach. Through IMAGE:NYC, an open-source map of the city’s current and projected population age 65 and older, NYAM has helped government agencies, advocates, planners, and providers identify service gaps and target resources to support more equitable decision-making. LiveOn NY uses it to identify where affordable senior housing investments may be most needed, and the Brooklyn Public Library uses it to better target services for older adults.³
We are concerned that the Coalition to End Racism in Clinical Algorithms (CERCA) – one of the City’s most innovative programs – will not be funded going forward. That decision should be reconsidered. According to the City’s own reporting, seven of nine participating health systems de-implemented or addressed race-based adjustment in at least one priority clinical algorithm, and more than $3 million was raised to support implementation and evaluation, especially in safety-net settings. CERCA demonstrated that targeted investment can change institutional practice in a way that is concrete, measurable, and directly relevant to racial equity in care. We urge the City to restore funding to CERCA and treat it as a model for what measurable racial equity implementation looks like in practice.⁴
We offer five focused recommendations to drive measurable impact in the City’s Racial Equity Plan:
1. Focus measurement on a small set of unifying health equity indicators to determine the impact of the plan on racial equity outcomes. The Preliminary Plan proposes roughly 600 indicators across 45 agencies. While comprehensive data collection has value, an indicator framework of this scale risks ensuring that nothing is meaningfully tracked. We urge the City to identify a small number of composite, cross-cutting health equity measures that can serve as a unifying scorecard across all agencies and sectors. NYAM would recommend measures such as: racial differentials in maternal and infant mortality; young adult mental health outcomes; non-communicable and cardiometabolic disease burden, including chronic kidney disease; and economic security among older adults, such as poverty rates among New Yorkers age 65 and older. These indicators span the life course, are already measurable with existing City data, and would position health as a universal outcome that every agency, not only the Health Department, has a role in advancing.
2. Tie measurement to real budgetary consequences. Budget allocations are the clearest expression of institutional priority. If agencies are required to report racial disparities but face no fiscal incentive to close them and no consequence for failing to do so, the City will have created a compliance exercise, not an accountability framework. Agencies should be expected to connect their equity indicators directly to resource allocation decisions, and the City should explore performance-based mechanisms: whether incentive funding for agencies demonstrating measurable disparity reduction, or budget review triggers where persistent gaps remain unaddressed. We also note with concern that CORE, the Commission charged with holding the City accountable on racial equity, spent just $314,000 in its first full fiscal year (FY2024) and $1.67 million in FY2025, against a current-year adopted budget of $4.8 million. Appropriation without execution is not investment; it is aspiration.⁵
3. Protect and scale what is already showing measurable results. CERCA is a clear example. In a constrained fiscal environment, the City should preserve and expand efforts that have already demonstrated institutional change and measurable gains, especially where those gains directly improve equity in care and access.
4. Make climate-health indicators part of the equity scorecard. Climate change is not separate from health and racial equity. In fact, it is one of the forces deepening unequal health outcomes across the city. The Health Department estimates that about 525 New Yorkers died annually from heat between 2018 and 2022, and Black New Yorkers experienced heat-stress death rates twice as high as white New Yorkers. Air pollution remains another unequal burden, contributing to more than 2,000 deaths and more than 6,000 emergency visits and hospitalizations each year. Heat-related mortality and illness, flood vulnerability, air-pollution burden, and household access to cooling should be treated as core racial equity indicators.⁶
5. Prioritize investment in the neighborhoods with the greatest combined climate and health burden. The City’s Environmental Justice analysis shows that although Environmental Justice Areas contain 49% of the city’s population, they account for 54% of New Yorkers at risk of stormwater flooding, 57% of those projected to live in the 100-year coastal flood plain by 2100, and 69% of those projected to face tidal flooding by 2100. That means the most effective and equitable use of limited resources is to invest first in the neighborhoods where poor health outcomes, heat, flooding, pollution, and underinvestment overlap most sharply. No single hospital or clinic can cool a neighborhood; this requires coordinated public investment in place-based prevention.⁷
The City has done the harder analytical work: identifying where inequities are greatest, building tools to measure them, and piloting programs that demonstrate what change looks like. What it cannot afford to do now is defund that progress or dilute accountability across so many indicators that none of them drive action. The task ahead is to focus measurement, tie it to funding, and ensure that data shape what gets resourced, what gets sustained, and where intervention happens first.
Respectfully submitted,
Ann Kurth, PhD, CNM, MPH
President & CEO
New York Academy of Medicine
Footnotes
1. New York City Department of Health and Mental Hygiene, Annual Summary of Vital Statistics, 2023; HealthyNYC: Goals for 2030.
2. New York City Department for the Aging, State of Older New Yorkers 2025.
3. New York Academy of Medicine, IMAGE:NYC Interactive Map of Aging, https://imagenyc.nyam.org/.
4. New York City Department of Health and Mental Hygiene, Coalition to End Racism in Clinical Algorithms (CERCA), program evaluation and reports, 2021–2025.
5. New York City Preliminary Racial Equity Plan, 2026; NYC City Council, Report on the Fiscal 2026 Preliminary Plan for the Committee on Civil and Human Rights (Commission on Racial Equity), March 2025; NYC City Council, Fiscal 2027 Preliminary Plan for CORE, March 2026.
6. New York City Department of Health and Mental Hygiene, Heat-Related Mortality Report, 2025; NYC Office of Sustainability, Air Quality data.
7. New York City Mayor’s Office of Climate and Environmental Justice, Environmental Justice NYC Report, 2024.