Kim
Hello everyone. I’m Kim Thibodeaux, and I am delighted to welcome you to this episode of NEBGH Voices. I’m so pleased to welcome today Dr. Michelle Morse, who serves as acting health commissioner and Chief Medical Officer of the NYC Department of Health and Mental Hygiene, where she leads efforts to bridge public health and health care, reduce health inequities, and serve as a key liaison to clinicians and clinical leaders across New York City. Dr. Morse brings a unique perspective shaped by her experience as an internal medicine and public health physician, hospitalist, educator and global health advocate, combining clinical expertise with a passion for advancing health equity, social medicine, and anti racism initiatives. Dr. Morse, we’re so glad to have you with us today. Thanks for joining the conversation.
Dr. Michelle Morse
Thanks for having me.
Kim
So let’s jump right in. Dr. Morse, I want, I want to start. We are so pleased at NEBGH to be part of an initiative called HealthyNYC. Its mission, its key priorities, really align with the work of NEBGH, so for our listeners who don’t know about HealthyNYC, can you talk a little bit about that program and how it builds on the city’s commitment, really, to improving public health?
Dr. Michelle Morse
Absolutely. First, I’ll just start by saying how important I think it is to have partners like you all helping to spread the word and accurate information about public health in this time. And I want to also honor the fact that public health is so much broader than healthcare, and oftentimes people confuse and conflate the two, which is somewhat normal in some ways. But just to be clear, public health is really about shaping the ecosystem and the conditions in which people are born, work, live, and thrive, and making sure that those conditions are conditions that allow for their optimal health. And that looks like policies, programs, and other kinds of interventions, as well as direct services, in order to make sure that those conditions are met. It’s difficult to do, but important, and the health department here in New York City has always really been committed to creating and shaping those optimal conditions. So when we experience the tragedy of the COVID pandemic and the loss associated with it, we knew that we needed to find ways to get our city back on track in terms of health, and so that was the vision behind HealthyNYC when it was launched in the spring of.. Or the fall of 2023 we were kind of coming out of the emergency phase of the pandemic. We had seen significant loss in life expectancy at the height of the pandemic, and that loss was experienced unfairly and unequally, with people of color in the city experiencing more life loss than other groups. And so we said, you know, we need to set a goal. We need to get our city back on track. The goal that we set was to get to a life expectancy of 83 years by 2030, that would be the longest life expectancy ever in New York City history. In 2019 our life expectancy for the city was 82.6 years. And so we wanted to exceed our baseline. We wanted to do even better coming out of the pandemic, and we wanted to reach towards even more fair and equitable goals for our city, and so we’re making progress. And there are seven main areas really that drive those outcomes, in terms of life expectancy. And talk a little bit more about those as well
Kim
Yeah, we want to dive in on a couple of those, specifically with you, Dr. Morse, and I know that that for more than 100 years, public health has been behind so many important advances and really healthy changes that people don’t really think about that. But when you think about the environment, when you think about cleaning up the environment, clean drinking water, when you think about vaccines, reductions in infant mortality, so many of those efforts really have been driven by public health leaders in our community. So I’d love to focus a little bit on the topic of vaccines, which is very timely these days. Vaccines really have been such an important part of the public health conversation in recent years. So what are your current priorities when it comes to vaccine awareness and education in New York City.
Dr. Michelle Morse
Thank you for that. You know, a lot of folks have questions about vaccines right now, and it’s natural to have questions, and at the same time, we’re also seeing deliberate spreading of uninformed, unfortunately and inaccurate information about vaccines. So for the public and for people across New York City, it can be very confusing, so one of my top priorities is to make sure that New Yorkers know that they can trust us at the New York City Health Department, to still share information that is guided by science, by evidence, by research, and by the things that we know have led to the massive improvements in health over the past 220 years that the New York City Health Department has been in existence. It’s our 220 year birthday this year,
Kim
Wow.
Dr. Michelle Morse
And so so that’s a top priority, and and perhaps even more importantly, is not only to share reliable and accurate information, but it’s to share that information in the language that New Yorkers want it, in the locations that they want it, in the style that they want it, and across multiple kinds of platforms. We are a very, very lucky city in that we’re the most global city in the country. We’re the largest city in the country. We have over 20 million international visitors a year. One in three New Yorkers are immigrants, and that means that we get to practice the most kind of complex, beautiful and exciting form of public health. It’s the kind of public health that really stretches the practices, the tools, and does so in a way that really is adaptive. And that’s kind of the best part about it, and that means for Vaccine Information, we need to do the same thing. And then the other priority that I would I would say, is top of mind for me when it comes to vaccination is to make sure that we continue to put out guidance to providers that is also accurate and that providers are not confused. We want the nurses and the doctors and the pharmacists all across the city to also feel confident that what they’re doing is safe and that New Yorkers again know that vaccines are the best way to protect yourself, your family, and your community.
Kim
Yes, that’s terrific, and I think we’re very aligned on that. The Northeast Business Group on Health recently released a vaccine guide for employers to help share accurate information based on science, based on evidence, with employees. Our members at NEBGH cover more than 9 million lives, folks in and around the New York area, and even to other parts of the country. So I’m just curious, from your perspective, how can employer-led organizations like ours be strong partners in supporting vaccine confidence and health education across our communities?
Dr. Michelle Morse
Employers are such a critical foundation for public health, there’s really no if ands or buts about it. And as I’m sure, your your members and you all are very aware, a healthy workforce means a healthy business. There’s there. We saw that during COVID, and we’ve learned that lesson time and time again over the past 220 years of the New York City Health Department. Top of mind for me is just acknowledging the social determinants of health. So employers have to acknowledge that if they are not paying a living wage, that is one of the strongest determinants of the health of their employees. It’s something that we focus quite a bit on here in the New York City Health Department and across New York City government as well. It’s a big challenge. And yet again, economic drivers of health are some of the most important drivers of health. So that’s kind of one piece that I have to start with. Another is paid sick leave. It should not be a privilege. It should be a part of every benefits package for every employee. And the reason that’s so important to us in public health is that we know that we can actually interrupt transmission of viruses, and especially during respiratory viral season, which we’re entering right now, and we can decrease the spread of viruses, decrease the number of people who get sick when people who are sick have what they need to be able to stay home and not work. And that is really fundamental. It sounds basic, and yet it would allow for much less difficult respiratory viral seasons if every employer had a practice, had a, you know, a leave practice that allowed for sick leave. And then the final thing that I’ll say is kind of you already alluded to, but health insurance, you know, health insurance that is also affordable with copies that are reasonable. Because it’s interesting, medical debt is a huge issue. And actually, 60% of the people in the country with medical debt have health insurance. And so we really have to make sure that that health insurance coverage is accessible, and that along with it, things like vaccines are completely free with no barriers. So those are a few of the things that I would say are really meaningful for employers.
Kim
Yeah, and I think that we’re very fortunate that we have employers who are very committed to many of the things that you’ve mentioned. And our employers are so diverse. You know, we have finance firms from New York, we have manufacturing, we have labor unions and pension funds, and I know that our employers and our members are striving to achieve some of those goals that you have outlined, I also think that our employers have realized that workforce health also means Community Health, and that if we can keep our workforce safe, our employees, their children, then that also trickles out into the community, and we’re contributing to a healthier surrounding community beyond the worksite, which I think is is critical. Dr. Morse, I would like to pivot to cancer also a certainly a top cost driver for employers, and I know certainly a priority in your office and within the HealthyNYC initiative, cancer prevention and early detection remain top concerns for both employers and public health leaders, how is New York City working to improve screening rates and also to ensure that residents have access to timely, high quality and equitable cancer care?
Dr. Michelle Morse
Thank you for that question. It’s um, it is also a top concern for us, as you can imagine, in the New York City Health Department, cancer is the second leading cause of death in New York City, unfortunately, and it’s an area where the New York City Health Department’s made significant strides. I want to start actually, with our anti-smoking work. That is probably the most significant contribution we’ve made as a health department to addressing issues of cancer, smoking is one of the most important predictors and risk factors for cancer, and so we have had a significant decrease over the past 20 years in smoking rates in New York City from somewhere around 22% down to less than 10% and that is significant. The other thing that we do is exactly what you said. It’s making sure that New Yorkers have the information they need to know, when to get screened, why to get screened, and how to get screened. So we do extensive education campaigns. We create materials in multiple languages. We do communications campaigns and public media campaigns to get that information out, and we work very closely with providers and healthcare organizations across the city to do that as well. I think it’s really important for me to mention a coalition called the C5 Coalition that we’ve run, that’s been around for about 20 years. It has contributed significantly to much, much, much higher rates of colonoscopy screening in New York City, and actually has also eliminated the racial inequities in colonoscopy screening, which is very exciting because, for cancer, again, it’s early detection for the screenable cancers that makes all the difference. We’re very proud also of our work around breast cancer screening, where we have actually racially equitable rates of mammography screening across groups in New York City, but we do still have a higher rate of black mortality for black women with breast cancer, and we think that that’s actually about getting into care after you’ve been screened. And so there’s plenty more work for us to do in that realm. Employers are critical, not only for having really good health insurance that makes it free for these screenings and making sure that primary care providers, of course, are sharing this information with all of the with all of their patients, of course, but we also see it as a partnership between us and employers, and we’re often asked to come and do briefings for employers and their employee health programs to make sure that this information is really getting out there.
Kim
That’s terrific. That’s terrific and and you know, we certainly agree and acknowledge that there are many cancers and other chronic diseases that do disproportionately affect communities of color. So I really applaud your efforts in addressing health equity and closing those gaps in access to screening, treatment outcomes. We certainly agree with you that people, I worked in cancer for 25 years, people ask me all the time, when are we going to cure cancer? I said, Look, we’re curing a lot of cancers, and the key is early detection, so go get your screenings. It’s critical. And I love the you know, behavior change, smoking cessation, healthy diet, more exercise, all of those things will contribute to reducing the cancer rates and mortality for sure. Dr. Morse, employers are the largest purchasers of healthcare in the US, and play an increasingly important role in shaping health outcomes for millions of working people. From your perspective, what more can employers do to promote and support a healthier workforce? Because they are committed. But I think these public-private partnerships are critical to making the advances that we all hope to achieve.
Dr. Michelle Morse
Absolutely, I think, well, certainly, one opportunity is being a part of our HealthyNYC campaign as a champion or a supporter. It’s a way to signal to your institution or organization or business that you are serious about business when it comes to the health of your employees. And we have extensive resources and references that we share with members of the HealthyNYC. The supporter and champion groups, and we have specific materials, actually, for employers as well. So that’s that’s just making a commitment to prioritizing health issues. I will also go back again to my, you know, prior point about fair pay and fair wages. There is a lot of conversation right now about changing the minimum wage. In fact, we just did an analysis in the New York City Health Department that showed if minimum wage was increased, there would be 1000s more lives saved from preventable illnesses, in fact. And the reason for that, of course, is that you know your economic status drives your health in so many different ways, so paying workers and staff a living wage, making sure that there are opportunities for economic growth, helping your employees create a retirement plan, and helping them to invest in their retirement plans. Ensuring the financial health of your employees is honestly one of the biggest ways to address their health concerns. And then the final thing that I’ll mention is that, you know, employers have such an important stake in health policy, and I think that there are a lot of opportunities actually, for employers to demonstrate that not only are they serious, of course, about committing to making sure that all their employees have health insurance, but that they also want to actually work with those insurers. I think there are tremendous opportunities there and shared benefit when employers and insurers are really working together. And then I’ll just say one last thing, like every employer should know how many of your staff are on Medicaid because of their wages, how many of your staff are using WIC, SNAP, or other programs? That’s a real powerful measure of the level of poverty amongst your staff and employees. And there are certainly powerful things that employers can do within, like the pay category and beyond, to really address some of those issues.
Kim
Absolutely, absolutely. Dr. Morse, as we wrap up here, we’ve looked back a little bit at some of the progress that you’re making in New York, which is great to hear, and happy birthday to your office. It’s great to hear all the great work that you’re doing. Let’s take a little bit of a peek ahead into 2026. Obviously, you have a new mayor coming in in New York, and I’m sure you are in the thick of setting your priorities for 2026 and beyond. Can you pull back the curtain for us a little bit, give us a little glimpse into what we can expect from you and your team in 2026
Dr. Michelle Morse
Great question. Hope is ascendant, and there is a lot of excitement about you know, again, some, some opportunities for new priorities. And so I would say that there is so much in healthy NYC that needs to continue. We’re making progress in some areas and in others we are not. And as as I mentioned earlier, our goal is really to hit these landmarks by 2030, so that means in 2026 we’re going to keep on moving forward with the interventions, policies, and initiatives that we know are going to extend life expectancy fairly and equitably across New York City. That is certainly going to continue. And I would also say that part of what we’re thinking about in the in the new year and the new mayoral administration is community health workers, and part of that also stems from our work in HealthyNYC, where we did modeling and partnership with NYU to really look at various public health interventions to see what their impact would be on life expectancy and community health workers are one of the interventions that’s been proven to improve health and in some cases, extend life expectancy. We are interested in really expanding the community health worker workforce in New York City. It’s a jobs and workforce enhancement initiative, it’s a public health pipeline and healthcare pipeline initiative, it’s a health equity initiative, and we’ve got experience in the New York City Health Department from the pandemic and beyond through our public health core program, showing that community health workers can be exactly the bridge that New Yorkers need to move their health forward. And we’re quite worried, of course, that with the implementation of HR one, that many New Yorkers are going to lose health insurance, they’re going to lose access to benefits. And we’re very worried, of course, that we might lose ground on our healthy NYC goals, and we see community health workers as one of the ways to help address and bridge some of the challenges we may be facing. And then the final thing I’ll mention is that we’re very excited about our office of healthcare accountability, which really looks at prices and costs across healthcare organizations. Patients and insurers. We think it’s a really powerful transparency measure that employers who are listening might be interested in, that really will, hopefully, again, help to create more visibility about some of the variations in costs that end up leading to high premiums and barriers in care to some, for some New Yorkers, particularly New Yorkers who are living in poverty.
Kim
Yeah, those are all great things to point out. I know when we did some surveying with our employers this summer, the number one thing that they were concerned about was the increasing cost of healthcare. They’re looking at double-digit increases for 2026, and that rate of growth is going to be unsustainable, and it ultimately is going to be the employee, slash patient, who’s going to suffer at the end of the day. So we are, we’re keeping an eye on that as well. Dr. Morse, I’m so grateful that you joined us today. I hope you will come back in 2026. We want to continue to follow your path and deepen our partnership at NEBGH, with HealthyNYC, we were so pleased to be invited to join, and are just thrilled about, about the partnership. So I thank you for joining, sharing your experience. I know our listeners will find your insights of thought-provoking, and I think in many ways actionable, and that’s always what our employers are looking for, ways that they can take action. So we appreciate your insights. This has been NEBGH Voices. Thank you, everyone, for listening today, and as always, we wish you wellness.
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