CENTRAL HARLEM: A WOMEN'S HEALTH CARE DESERT
By Li Yakira Cohen, Samantha Springer, Alex Myers
The north end of Central Park marks the beginning of a different world in Manhattan. In the 1.4 square-mile space between 110th and 155th Streets lies Central Harlem, an area best known for the Apollo Theater and for being a former home to various music legends, such as Duke Ellington and Billie Holiday, during the Harlem Renaissance, but despite its storied past, the community is in need of primary health care for women.
Gynecologist Candice Fraser works at Trinity Medical Care in Central Harlem. As the sole gynecologist at this practice, she works with dozens of female patients who are experiencing a range of women’s health issues, including painful menstrual cycles, polycystic ovarian syndrome, infections and sexual health problems.
“I’m very big on education and sort of closing that gap because I feel for women there really isn’t that emphasis on just making things just plain,” she said. She added that women tend to not see a women’s health care provider regularly enough, primarily because of a lack of financial and physical access.
“I feel like, a lot of times as women and as a society, we focus a lot on that small portion of our lives in terms of fertility and childbearing. And I think women, we have another 40 years of our lives that sometimes get neglected,” she said. “I have women who are in their 60s that haven’t had a pap smear since they had their last child. That needs to be emphasized and [people] need to realize that as a woman you have helped means or you know, your entire life.”
Harlem is Manhattan’s third most populated neighborhood, and according to the American Community Service Census, there are approximately 78,693 primarily black or Latina women living in Central Harlem specifically. Within that same area, there are just eight women’s health care providers that offer comprehensive services, such as illness and cancer testing, annual exams, birth control and menstrual cycle issues.
Two of the facilities, run by Ryan Health, have five women’s health care providers between them both; the only gynecologist within them is a male. A representative for Ryan Health said over the phone that patients should make an appointment at least a month in advance because the schedule fills quickly. Community Health Network’s Helen B. Atkinson Health Center does not list any women’s health care doctors on their website; the single women’s health care specialist is a board-certified women’s health nurse practitioner.
There are no databases or websites that provide a list of women’s health care providers in New York City. By searching Google Maps, Zoc Doc and Yelp, we were able to locate roughly 130 comprehensive women’s health care providers in Manhattan, excluding Central Harlem, mostly located south and east of Central Park. Most gynecologists in the city are men, and many locations, particularly those in Central Harlem, only have a handful of doctors on staff.
For women living in Central Harlem, a lack of health care can be debilitating and potentially fatal.
When searching for centers that provide comprehensive women’s health care services, including pap smears, cancer screenings, ovarian cysts and menstrual cycle concerns, few resources were found to be available. After calling 311 three different times, they could only provide information for one resource for women’s health services in Central Harlem, located at 506 Lenox Avenue. The service 411 said they were not able to find any listings for women’s health care centers.
Central Harlem’s Community Board 10 provided a list of health care resources they have on file. The majority of the providers they listed are located outside of Central Harlem, do not provide comprehensive women’s health care options or their numbers are no longer in service, with no other contact information available.
Dominique Berthier works with the non-profit organization SHARE to provide health care education and support to women throughout New York City. She believes there is a problem not only with a lack of access to health care centers but also with a lack of access to information and education regarding women’s health. With SHARE, she is working to combat these problems, particularly breast cancer, a leading cause of cancer-related premature death in Central Harlem.
The lack of comprehensive health care providers impacts a demographic that is also suffering from socioeconomic barriers. According to research conducted by the Furman Center, the median household income in Central Harlem is just under $50,000, about 19% less than citywide median household income. Nearly a quarter of the Central Harlem population also lives in poverty, a rate nearly 18% higher than New York City as a whole.
Organizations are doing what they can to help alleviate this combined socioeconomic and health burden. But many say they should not have to be the ones to carry the burden of solving this issue.
Michelle Hope, a women’s health advocate and sexologist, said that there is a historical “rift” when it comes to how people of color are treated in health care. Aside from cultural barriers, she said, doctors and medical groups often don’t understand how their patients are able to understand information, creating an education and communication barrier between medical care and patients.
“We have to understand that oftentimes, pamphlets, brochures, any kind of medical information you get at the doctor’s office is written beyond the reading level of the average person … it should be at about a third-grade reading level. But oftentimes people forget that,” she said. “We have people who are first-generation, we have people who are immigrants, and we have people that English is not their first language. So if we’re trying to spew at them, all these medical terms in English, it’s a high likelihood they’re not necessarily going to understand exactly what we’re saying.”
Hope said that the city needs to “stop assuming” that HIV/AIDS is the only prevalent health issue worth addressing in Central Harlem. While the area does a good job of providing information on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to help prevent and alleviate HIV symptoms, she said, HIV is not the only leading health issue in the community. Women, Hope explained, have little to no public information available about breast cancer, gynecological issues, uterine fibroids or regular women’s health screenings.
Until access to comprehensive services and education tools are made available in Central Harlem, its residents will have to continue to actively seek out the existing resources that are few and far between – like oases in the desert.