Share This Article
“The outcomes of the recent primary election, which will send a wave of younger, progressive candidates to the November ballot, give New Yorkers an unprecedented opportunity for bold change,” the author writes. “These new voices will have real power to shape our health agenda—if New Yorkers organize to push them.”
As the mid-term elections approach, New York City desperately needs a new vision for public health. Fortunately, the outcomes of the recent primary election, which will send a wave of younger, progressive candidates to the November ballot, give New Yorkers an unprecedented opportunity for bold change. Because many of these winners face token opposition in the general election, these new voices will have real power to shape our health agenda—if New Yorkers organize to push them.
The need could not be more urgent. New York City faces a daunting cascade of health challenges: draconian federal cuts to SNAP and Medicaid, climate emergencies like flooding and heat waves, rising chronic illness, especially among younger people, and skyrocketing healthcare costs. Closing the wide gaps in well-being by class, race, and immigration status requires implementing long-recommended changes and bringing fresh ideas to the policy table. Growing attacks on science and evidence and cuts in research funding further jeopardize the city’s and the nation’s capacity to protect health.
New York has long been a leader for public health innovation. To get that work started—and to help voters decide who to back this November—here are five priorities that demand immediate attention.
1. Defend SNAP and Medicaid. City and state legislators need to aggressively shield New Yorkers from the spending cuts and harsh work requirements imposed by the 2025 federal budget. More than 1.7 million city residents rely on SNAP and 3.6 million on Medicaid. By electing candidates who will require city and state agencies to expedite enrollment, waive federal rules where possible, and fund alternative food and health assistance, New Yorkers can reduce hunger and lack of medical care, moving to reverse these cuts nationally by 2028.
2. Build a Path to Universal Health Care. Albany legislators should make 2027 the year New York enacts a state-level universal healthcare system. As public concern for the high cost of health care grows, New York could create a universal state plan that offers a model for the nation. Voters support and experts agree such a plan is more effective at preventing illness and saving costs than our fractured status quo. At the city level, candidates must commit to providing New York City Health + Hospitals, the nation’s largest public hospital system, with the staff and budget needed to fulfill its mandate of providing comprehensive care—including mental health and reproductive services—to all, regardless of income or immigration status.
3. Close Rikers Island. It costs more than $500,000 a year to incarcerate a single person on Rikers Island. This expenditure fails to protect public safety or public health. More people with mental illness pass through Rikers than any psychiatric hospital, yet the city has proven unable to provide adequate care, prevent inmate deaths, or stop the spread of infectious diseases inside. Voters must insist that candidates support fulfilling the city’s promise to close Rikers, shifting resources toward the community health and mental health services that protect public safety by actually helping individuals to rebuild their lives after release.
4. Make Housing Safe and Affordable. Unsafe, unaffordable housing jeopardizes physical and mental health. While the Rent Guidelines Board’s decision to stabilize rents for a million New Yorkers is a step in the right direction, the city needs a comprehensive strategy. We must improve public housing, prevent evictions, protect small homeowners, and curb real estate speculation. Voters should demand that candidates explain their specific plans to tackle the housing crisis and then hold them accountable to those promises.
5. Raise the Minimum Wage and Expand Public Childcare. While union and worker activism successfully pushed New York to a $15 minimum wage, housing, food, and health care inflation has made that number entirely obsolete for supporting a family. In 2026, over 2.1 million workers across the state still make less than $20 per hour, and hundreds of thousands face rampant wage theft. Electing leaders committed to indexing the minimum wage to the true cost of living and expanding public childcare subsidies is a public health imperative.
Many view the upcoming elections as a referendum on federal politics, but we do not have to wait for changes in Washington to create a healthier New York. A cadre of experienced grassroots activists back these five ideas and are ready to move. If voters elect leaders who own this vision and unite them with organizers on the ground, New York can reclaim its place as the nation’s incubator for public health, offering a real alternative to the broken status quo.
Nicholas Freudenberg is the distinguished professor of public health emeritus at the City University of New York and author of “Fighting for New York: Activism for Health and Social Justice Since the 1960s,” published in 2026.