When Jose Sanchez took over as executive director at Lincoln Medical and Mental Health Center in 1998, officials weren’t paying enough attention to Mott Haven. It was a neglected neighborhood with typical inner city health problems, he recalls.
In 2009, Sanchez was named one of the “Most Influential Latinos” in the country by Hispanic Business Magazine, a New York Times affiliate, for his leadership at Lincoln, two Hospital Centers in Harlem, and smaller walk-in care centers in the South Bronx and Northern Manhattan. The magazine cited his oversight of expanded primary care service and the introduction of new technologies to improve patient care.
Sanchez left Lincoln in October to take a new position running a hospital in a low-income neighborhood in Chicago, confident the changes he helped bring about over the last 12 years have helped set an example for the provision of health care in the South Bronx.
He leaves the city’s most profitable public hospital with a $37 million surplus, after managing a combined workforce of 7,000 employees and a budget of $800 million.
The Herald asked Sanchez about his 12 years at Lincoln.
Q: What were the most serious health issues in the South Bronx when you began in 1998, and what has been done to address them?
A: Twelve years ago the community was going through an economic downturn. There was no investment or new housing. Then it began to transform itself.
There is a connection between poverty and health disparities. Some diseases have been controlled in other communities that haven’t been controlled in the South Bronx. The South Bronx is often referred to as an epicenter of asthma in the nation. We created an asthma case management program, sending letters, picking up the phone to remind people—and found that with education, some patients would come to the emergency room. As a result, between 1998 and 2010, there was an 80% drop in asthma recidivists.
Diabetes was the other big condition. The rate of type-2 diabetes is 8% in the city, but 11% in the Bronx. It’s 25% in the Mexican community. There’s more mortality and amputations among Puerto Ricans than any other group in the city.
We did a diabetes registry, where we tracked every diabetic in the system. We really have made some significant headway getting patients into treatment that will make a difference.
(Lincoln’s public information campaigns have also lowered cervical cancer rates among Hispanic women and prostate cancer rates among Hispanic men, Sanchez said.)
Q: What are some of the hidden health problems in the area?
Something no one ever talks about is infant mortality. We were able to reduce the rate from 8 out of 1,000 in 1998 to about half that.
Children, in general: One of our sources of great pride was working with the Yankees. We created incentives for kids, with tickets, hats. We moved the clinics from the hospitals into Yankee Stadium. The kids would then get all their shots before returning to school so they weren’t turned away.
There is the debate over whether to provide health care to the undocumented, and yet they live here, they are parents of children who were born here. Yet we have created a two-tier system. You parents won’t get health care but your five kids are okay? How can [the government] do that? They have contagious conditions that can be passed along to the general population without treatment.
Q: Do you have any regrets now as you leave?
I failed in something I pushed for. The highest incidence of HIV/AIDS in the whole country is in the Bronx. The highest concentration is right in our backyard. But because consent is needed in order for treatment to be administered, most turned down treatment. . . . I wrote to every elected official to change the policy, and no one took it on because some groups were against it. I spent several years fighting that battle, but special interests blocked it.
Q: How has the recession affected the provision of health care?
The recession really hasn’t affected health care in New York. We never turn away any patient, even if we have less dollars to provide the services we needed. Nationwide, yes, the recession has affected health care. New York City is probably the most liberal state, and we spend more money per capita on health care than anywhere else.
I’m very proud to say New York City all along has had universal health care. There IS a model for universal health care.