A Look Back at 2020

Reflecting on 2020

NYSHealth typically publishes an annual “Best of…” report to highlight the proudest moments and biggest successes of the prior year. Of course, 2020 was anything but typical, and it was filled with hardships. There were bright spots, to be sure: health care providers and other essential workers who risked their own health and safety to care for others during the COVID-19 pandemic; innovative public-private partnerships to deliver food from struggling restaurants to New Yorkers in need; neighbors checking in on neighbors who were isolated during stay-at-home orders. In some ways, the pandemic has brought out the very best in us.

It’s also laid bare the worst, particularly when it comes to the glaring racial and ethnic disparities that have persisted for centuries. COVID-19 death rates and hospitalization rates are twice as high for Black New Yorkers as for their white counterparts. In 2020, New York and the nation also reckoned with the murders of George Floyd, Breonna Taylor, and so many others; people of color rightly live in fear that they will not receive equal treatment or equal justice. And a contentious presidential election showed us again how divided we are as a nation.

So this year, we’ll simply share our reflections with a Year in Review, exclusively focused on NYSHealth’s and our grantees’ efforts in response to the pandemic. We’ve done other important work this year, including the development of our new Healthy Food, Healthy Lives priority area for 2021, the release of our “Patients as Partners: Advancing Equity” request for proposals, and our analysis of racial and ethnic disparities in severe maternal morbidity in New York State. But in a year dominated by the pandemic, it seems fitting to look back on how it affected New Yorkers and how we were able to respond.

Grantmaking During COVID-19

When the global COVID-19 pandemic hit, it became clear that we should pivot from our usual grantmaking strategy and address the urgent health needs of the hardest-hit New Yorkers. Our staff worked with current grantees to adjust their project scopes, timelines, and deliverables as needed in the wake of the crisis and eased reporting requirements and other hurdles that would be especially challenging during the pandemic. The Foundation also increased our grants budget by 20% and committed $5 million to support COVID-19 response and relief efforts—NYSHealth’s largest-ever authorization of funding. These grants supported projects across a range of areas, such as addressing mental health needs and social isolation among military veterans, older adults, and health care workers; expanding food assistance in communities all across the State, particularly those most food insecure; and providing case management, housing, and other services for formerly incarcerated New Yorkers.

The pandemic also opened up the opportunity for us to leverage our resources with other funders to increase impact. We contributed $1 million of our allocated COVID-19 funding to 11 pooled regional response funds throughout New York State. These regional funds provided coordinated and timely support to meet the emerging needs of local communities and organizations and placed decision-making in local leaders who best know their communities.

The majority of our COVID-19-related grantmaking focused on supporting specific populations across New York State that were most affected by the pandemic, including:

Veterans

Before the COVID-19 pandemic, veterans were already at a high risk of dying from suicide. An NYSHealth issue brief found that New York State veterans die by suicide at a much higher rate than the overall State population, and that veterans ages 18 to 34 years have the highest rates of suicide across the country. We know that suicide risk is associated with an array of factors, including mental health disorders, post-traumatic stress, substance use, and environmental factors such as economic instability, unemployment, unstable housing, and access to firearms. Shelter-in-place orders that were issued throughout 2020 were paramount to containing the spread of the coronavirus, but the resulting social isolation and economic instability from the pandemic posed a great risk to veterans.

To better support veterans during this time, we made a grant to the Headstrong Project to expand its telehealth services to include online peer support groups to facilitate comradery and combat isolation and anxiety. Additionally, while traditional AA meetings are suspended, Headstrong is holding online AA veteran support groups. To address social isolation during pandemic, we made a grant to the Mission Continues to provide “buddy checks,” where volunteer veterans reach out to other veterans across New York City for general wellness checks and to connect them to resources such as free meals, COVID-19 testing sites, and mental health resources. Similarly, Iraq and Afghanistan Veterans of America is providing peer support to veterans across New York State and linking them to vital services such as food or other basic needs, assistance with medical bills, and housing services.

Frontline Health Care Workers

From facing shortages in personal protective equipment to experiencing burnout, frontline health care workers have carried a heavy burden during the pandemic. Many areas of New York State already had a shortage of health care providers, and the barrage of sick patients from COVID-19 has overwhelmed many hospitals and providers throughout the State. We knew that clinicians would be at a higher risk than usual of burning out during COVID-19, but that historically, they are often reluctant to disclose distress, especially to nonclinicians.To combat burnout among clinicians, the Mary Imogene Bassett Hospital expanded a virtual peer support network to connect thousands of physicians, residents, advanced practice clinicians, nurses, and social workers across the State to help reduce the stigma of help-seeking among providers. Similarly, we made grants to Vibrant Emotional Health and The Physician Affiliate Group of New York (PAGNY) to provide virtual emotional and peer support for hospital, health care, and frontline workers to address vicarious trauma in the wake of the pandemic. Vibrant Emotional Health also partnered with other human service organizations and trade associations to train organizations and their employees on the emotional wellbeing and resiliency of their employees, reaching both frontline workers and supervisors. We also hosted a webinar with Vibrant Emotional Health and PAGNY to share tools and strategies to support frontline workers, supervisors, and organizations. Instilling a culture of self-care for this population continues to be a challenge. NYSHealth and our grantees are working to build up an infrastructure of support so that help is available when these workers need it.

New Yorkers Experiencing Food Insecurity

The pandemic has exacerbated food insecurity among many New Yorkers. An NYSHealth analysis of U.S. Census Bureau data found that 1 in 10 New Yorkers reported household food scarcity in the prior week from April through June 2020. Demand for help has been high, and many of our grantees are addressing food insecurity, particularly among the State’s most nutritionally vulnerable residents.

Before the pandemic, Field & Fork Network was using NYSHealth funding to spread Double Up Food Bucks, a nutrition incentive program for recipients of the Supplemental Nutrition Assistance Program (SNAP), to different regions of New York State. The program gives SNAP recipients a dollar-to-dollar match to their benefits at farmers markets and farm stands. For instance, a family that spends $10 in SNAP benefits at a participating farmers market receives an additional $10 in Double Up Food Bucks to purchase locally grown fruits and vegetables.

In fall 2020, the federal government notified Field & Fork that it could qualify for an additional $750,000 in funding—but it would need to find matching funds for any federal amount and with only a 48-hour window to do so. We were the first funder on board, and then worked quickly to connect Field & Fork with other funders across the State. Within the 48-hour deadline, a coalition of funders committed to nearly the full amount—collectively channeling $1.5 million of support to hungry New Yorkers. Over the course of 2020, Field & Fork targeted communities with the greatest needs in urban, suburban, and rural settings across the State to expand and scale up Double Up Food Bucks during the pandemic. It was able to add 12 new sites at grocery stores, farmers markets, and small retail and mobile markets, representing 16,000 new Double Up Food Bucks users.Other grantees have been working to strengthen and transform the food system, particularly for people of color. The Massachusetts Avenue Project is partnering with Black Farmers United to support the capacity of Black-led food and farming groups in New York State to advocate for food policies that are essential to advancing a just and equitable food system. Black and Indigenous farmers and advocates are developing strategies to improve affordable access to high-quality, locally sourced food while also promoting racial equity for financial, land, and other food-related resources. In Brownsville, Brooklyn, Project EATS, deemed an essential service provider, was able to continue to operate its large urban farms. Project EATS also pivoted its programming in response to the increased food and mental health needs of residents. Its food bag program of fresh produce and dry goods available for pick-up was able to feed an additional 3,000 people. It also began a weekly printed and online publication, The Companion, filled with recipes, inspiring stories, and art, designed to “feed the soul” of the community and keep residents socially connected.

Staying Connected While Operating Remotely

NYSHealth has always prioritized our role as a convener; in a typical year, we host dozens of in-person meetings and conferences that bring together grantees and other health leaders from across the State. The introduction of social-distancing guidelines during the pandemic required developing innovative solutions to shift events to online platforms that were accessible and engaging for participants. Flexibility and adaptability were essential for both the Foundation and our grantees as we moved our gatherings online.

Our cohort of health center grantees working to grow OpenNotes—a model that gives patients access to the visit notes written by their doctors, nurses, or other clinicians—in their organizations also pivoted to virtual gatherings. The Foundation brought these grantees together for quarterly online meetings in which they discussed ways to leverage the virtual functionality of OpenNotes with vulnerable populations during the pandemic. One session featured a case study of the “OurNotes” pilot in Boston, an initiative where patients and clinicians work together to co-produce notes. At other sessions, grantees shared best practices and ideas to tackle implementation challenges, as well as participated in a virtual grand rounds to train and answer questions from physicians. Some grantees that had planned to conduct focus groups and solicit in-person feedback from patients have also shifted to a virtual outreach model to assess patients’ perceptions of the OpenNotes rollout.NYSHealth also shifted away from our in-person public events and moved to a webinar format. Our new “Practically Speaking” webinar series shared actionable ideas to better serve New Yorkers during the COVID-19 pandemic. Throughout the year, we held 14 webinars with health care and public health experts on a range of timely topics with nearly 1,600 attendees.

The first webinar in our series featured a discussion with Colonel (Ret.) Jim McDonough, former Director of New York State’s Division of Veterans’ Services, about the State’s efforts to combat the growing pandemic, what veterans service organizations can do to help, and what resources are currently available to the veteran community.

Recognizing the significant racial health disparities the pandemic has exposed, we hosted a discussion with the Institute for Patient- and Family-Centered Care on partnering with people of color and low-income communities on their health care needs during the COVID-19 pandemic. This webinar highlighted best practices for effective partnerships between clinicians and minority patients and their families to ensure that efforts are reflective of patients’ needs and preferences.Another webinar, with the Volunteer Lawyers Project of Onondaga County, examined eviction moratoriums during the pandemic and whether they protect those most in need. People with unstable housing are more likely to have chronic medical conditions that put them at higher risk for contracting COVID-19. The discussion featured actions that public health stakeholders can take to protect the health of their communities.

We also hosted a webinar on how New York City, the largest public school system in the country, planned to feed its 1.1 million public school students and food-insecure residents in the fall. Community Food Advocates spoke about its work with the New York City Department of Education’s Office of Food & Nutrition Services to improve school and City-wide food distribution operations during the ongoing pandemic.Finally, in lieu of our annual veterans’ health conference, we held a two-part webinar series, “Addressing the Perfect Storm: Veteran Suicide & COVID-19.” In April 2020, researchers from the U.S. Department of Veterans Affairs warned that our nation’s response to the COVID-19 pandemic could create a “perfect storm” of conditions that increase the risk of veteran suicide. But had this grim prediction come to fruition? Panelists provided an overview of the risk factors, how they have impacted the veteran community during the pandemic, and community-based solutions that show promise for mitigating veteran suicide rates. Nearly 150 people attended the webinars.

Informing Stakeholders and Policymakers

In 2020, the Foundation and our grantees undertook a wide range of efforts to better understand the effects of COVID-19 on New Yorkers and how communities and policymakers could help keep residents informed and healthy during the pandemic.

Shortly after the State shutdown of nonessential businesses in March, the Foundation created a COVID-19 resource page with national, State, and local information for nonprofits and community-based organizations about topics like food assistance, health insurance, mental health services, employment, housing, and health and safety. We continued to update and share the resource page throughout the pandemic, with many other organizations and agencies drawing from and circulating it as well. This resource page was one of the most-visited pages on NYSHealth’s website this year.

As the pandemic wore on into the fall, NYSHealth conducted an analysis of the potential impact and challenges of the flu season coinciding with the pandemic in New York State. Our report offered policymakers key actions to help make the flu season less severe, such as prioritizing communities at higher risk for the flu; increasing vaccination access; tailoring public health messaging to resonate with New York State’s diverse population; and countering rising vaccine misinformation exacerbated by the development of coronavirus vaccines. Together, these strategies could help prevent additional loss of life and the widening of health disparities, particularly among communities of color.

We also submitted public comments to the National Academies of Sciences, Engineering, and Medicine focused on how to assist policymakers in planning for the equitable allocation of COVID-19 vaccines. Among our recommendations, we advocated that public health officials and other stakeholders support the creation of tools and strategies that prevent, detect, and respond to vaccine misinformation and disinformation and proactively support access to these tools by public health partners.The Public Good Projects operates Project VCTR (Vaccine Communication Tracking and Response), which collects, tracks, and monitors mentions of vaccines across social media platforms and traditional media sources like television. With our support, Public Good Projects has expanded Project VCTR to track misinformation related to COVID-19, ensuring public health departments are able to use this tool to combat misinformation and to make actionable data widely available. And a grant to the New York Academy of Medicine is supporting the pilot of a virtual public deliberation process to learn New Yorkers’ views and community preferences for a COVID-19 vaccine and to help ensure equitable access to and uptake of the vaccine.

The pandemic also has had a severe effect on food security, with many New Yorkers suffering job or income losses and fearful of contracting or spreading COVID-19 while accessing food. To better understand the impact, we released a report analyzing issues related to food scarcity in New York State during the initial months of the coronavirus pandemic, using survey data from the U.S. Census Bureau. We found that 1 in 10 households experienced food scarcity in the prior week. Food scarcity rates by age, household income, and neighboring states were included, as well as data showing stark disparities by race and ethnicity. Between 17% and 25% of Hispanic New Yorkers and 15% and 22% of Black New Yorkers experienced household food scarcity over the survey period—percentages that were three to four times higher than among white New Yorkers. The report also looked at how different groups of New Yorkers were accessing free meals and groceries and from which locations, including school programs and food pantries. Finally, it measured how New Yorkers have used their federal Economic Impact Payments—known as stimulus checks—for food-related expenses.We provided testimony to a New York State Assembly committee, offering our data on the growing and stark food insecurity challenges and recommendations to help the State in its efforts to design programs and target resources to New Yorkers most in need. We followed up with testimony to a New York City Council committee regarding the impact of the COVID-19 pandemic on SNAP administration, food pantries, and soup kitchens in the City. In this instance, we shared our data on how different groups of New Yorkers were accessing free meals and groceries and from which access points, along with recommendations for making it easier and more convenient for New Yorkers to access food.