Northeast Philly is a health care desert. But its communities are fighting over a new health center.
“There is a real need, and these people are underserved,” said Mingchu Pearl Huynh, founder of the Northeast Philadelphia Chinese Association.
Mingchu Pearl Huynh had nowhere else to go.
After moving to Philadelphia from New York City in 2012, Huynh had no job and no health insurance. She couldn’t afford medical care anywhere, until she found out about the city’s health centers, which provide health care at little to no cost for community members in need.
When Huynh, who is the founder of the Northeast Philadelphia Chinese Association, learned that the city had proposed two new health centers in the lower Northeast, she was elated. Currently, there’s only one city-run health center in the area. To her, these health centers would be a beacon in an area deprived of health care access, and where there has been a growing concentration of immigrants and lower income people.
Many agree that the health centers are needed in the area. Some don’t.
The city health department announced last year that it plans to build two new health centers, one at the current Friends Hospital site on Roosevelt Boulevard and the other near Frankford Transportation Center, in response to a city report that found neighborhoods in the area have fewer primary care providers and higher uninsured rates. Since then, numerous people have voiced their opinions of the center proposals through community meetings, letter-writing campaigns, and petitions (the latest petition in favor of the health centers has gotten nearly 1,200 signatures).
“There is a real need, and these people are underserved,” Huynh said.
The need
Soon after becoming a patient, Huynh became a Chinese interpreter at Health Center, 10 located just off Cottman Avenue.
For four years, she watched immigrants and recently unemployed people have to look elsewhere for health care because the wait lists at the health center were about six months out. And last year, when she became a member of the advisory commission for Health Center 10, she found out those waitlists had grown to at least one year for adults.
“I talked to some of my community members, and some of them could not even get an appointment because there’s no room on the [waitlist],” said Huynh, who has frequently referred new immigrants to their nearest health centers.
The current wait time for Health Center 10 is about 10 months, according to the city, and the average wait time across the remaining eight health centers is four months for new adult patients and 24 days for children.
The first city-run health center, Health Center 5, was established in North Philadelphia in 1969. Since then, the number of health centers has grown and expanded across different neighborhoods in North, South and West Philadelphia. While the health centers generate revenue and are self-sustaining, they receive city, state and federal funding, and operate on a total annual budget of $58.8 million.
Regular physician appointments are critical for treating health conditions and preventing chronic illnesses. But primary care is often unaffordable or inaccessible for people without insurance, and for those who are under-insured and therefore still struggle to afford health care bills. But with their sliding scale structure, city-run health centers accept patients regardless of their insurance status, ability to pay, or immigration status — allowing them to fill health care gaps across the city.
Those gaps are particularly glaring in Northeast Philadelphia, where poverty rates have been growing exponentially over the last few decades.
According to recent census figures, the average household income of zip codes surrounding the proposed sites ranges from $39,000 to $57,000, and portion of those without health care coverage is as high as 15% in some areas. The city report, which was done in collaboration with University of Pennsylvania’s Leonard Davis Institute, found that the lower Northeast is the area in the city with some of the highest numbers of uninsured patients, and with the greatest need for primary health care.
The lower Northeast is also home to one of the highest concentrations of immigrants in Philadelphia — notably important when considering health center locations, because immigrants cannot qualify for government-funded Medicaid health coverage for five years after they obtain a green card. Until then, many are unable to afford private insurance and rely on Health Center 10 for care.
Uninsured health center patients pay on a sliding scale that typically runs about $5 to $20 a visit. Health centers are also offer dental care, pediatric primary care, women’s health care, vaccinations, and testing for sexually transmitted diseases, tuberculosis and other conditions. There is also a pharmacy on-site. The idea is to provide patients with a one-stop shop for primary care needs.
“There are many reasons why the health department came up with this particular site — a lot of analysis went into it,” said Carol Rogers, a retiree from the health department who currently sits on the Philadelphia City Health Center Board of Directors. “If you look at all the city health centers, there’s only one in Northeast Philadelphia. It’s a barren landscape of health centers.”
Filling the gap
In response to the strain on Health Center 10 and need for more health care in the lower Northeast, the Philadelphia Department of Public Health announced last year a proposal to build two new health centers in the neighborhood.
The proposal includes a smaller location, near the Frankford Transportation Center, that will serve about 5,000 people a year. The site has not been challenged by community members.
A much larger site, designed for 30,000 patients a year, is proposed for a site on Roosevelt Boulevard in front of the historic Friends Hospital.
Both sites are within the 19124 zip code, which the health department has identified as the zip code where most Health Center 10 patients live, Councilmember Quetcy Lozada said, and were chosen after a thorough evaluation of more than 40 potential locations for the health centers.
But since the announcement of the new centers, debates have been ensuing among community members, particularly over the Friends Hospital location.
The debates surrounding the proposed health centers became so heated that Lozada, who represents the district in which the centers would be located, launched a series of community meetings in December to provide information about the health centers and hear community members’ opinions. Lozada’s office hosted four listening sessions in different neighborhoods, and one more is being scheduled.
“There is really not much for our own community other than the major hospitals.”
“Community voice has always been important and a priority to me,” Lozada said. “I want people to feel like … we make decisions based on what the broader group of people want.”
Miguel Concepcion, whose “backyard is the tower at the Friends Hospital,” knows firsthand how much of a health care desert the area actually is, and how much of a game-changer a center would be for folks who don’t have insurance.
“There is really not much for our own community other than the major hospitals,” Concepcion said. “Bringing those services to a community that traditionally had to travel miles just to get [health care] — and the fact that it is very well accessible in the community — is very welcome.”
In addition, with the area’s growing non-English-speaking communities, having a health center that provides robust translation services will help eliminate language barriers that immigrants often face when accessing health care, Concepcion said. Up to 43% of surrounding zip codes speak a language other than English at home, according to census data.
The opposition
Despite the demonstrated need for and predicted benefits of having a health center in the neighborhood, however, some oppose the project, largely with concerns about historic preservation.
Debbie Klak, a member of the Historical Society of Frankford, has been living in the same neighborhood as the Friends Hospital since 1987. For Klak, the main concern she has about the proposed project is the preservation of Native American relics that may be on the grounds. Current research, Klak said, found that a Native American encampment, formerly believed to have been located close to the Frankford Creek, was in fact likely to have been located directly behind the Friends Hospital in order to avoid flooding.
“It’s pretty sacred … that there’s a strong possibility of an Indian encampment there,” Klak said. “There should be an archaeological survey and dig before anything on that ground is ever established.”
Many have also pointed to plans to demolish a 170-year-old Lawnside building on the Friends Hospital campus to make way for the health center, which was approved by the Historical Commission last year.
“If [the health center] has to be sited here … the city should see it as their responsibility to not knock down this historic building, but to incorporate it in their design,” said Oscar Beisert, a historic preservationist in Philadelphia.
The architects working with the health department have identified that the condition of the Lawnside building’s structure would make it impossible to be incorporated into the project, Lozada said.
“I appreciate historical sites … that help us tell the story of our city,” Lozada said. “But we also have to remember that there are spaces in our city that we as a city have not taken care of and preserved.”
The opposition has felt like a slap in the face to those who believe that the health center is needed, and many are suspicious that it’s simply a case of “not in my backyard” sentiment.
“There should be an archaeological survey and dig before anything on that ground is ever established.”
“I support the preservation of historical sites,” said Izzy Colón, a community policy analyst who was director of multicultural affairs for former Mayor Michael Nutter. “But I can’t do it at the expense of a health crisis. That, to me, begs a moral judgment.”
Of particular concern to community members in support of the health center is the possibility of finding a new site. While there’s no current timeline for when ground would be broken for the health centers, the process of finding a new location in place of the Friends Hospital site, Lozada said, would take five to eight years — “time we don’t have,” she added.