Since February of 2020, New York City has lost over 30,000 residents to COVID-19 and experienced job losses higher than any other city in the United States. Over the course of the pandemic, major inequities across race and ethnicity, age, and class have highlighted immense gaps in access, awareness, and preparedness across the city and around the world.
To provide New York City communities with health solutions and information to prevent, prepare for, respond to, and recover from future health crises, ICAP at Columbia University’s Mailman School of Public Health has launched the Pandemic Response Institute (PRI). The Institute, supported by New York City Economic Development Corporation (NYCEDC), involves key partnership with the City University of New York School of Public Health (CUNY-SPH) as well as a consortium of non-profit, community, and industry collaborators to help reinforce and diversify New York City’s public health infrastructure.
From infectious disease outbreaks to climate-related health emergencies, PRI will develop best practices for responding to crises, including innovating such mechanisms as contact tracing tailored to social determinants of health, simulations on intervention impacts, and forecasts of health, social, and economic impacts of public health emergencies.
Mitch Stripling, MPA, director of the PRI, said New York City is the perfect place to design and build a public health model that not only could be emulated around the world, but incorporates the diverse voices of the city.
“We are one city, but we are also a city of hundreds of unique neighborhoods,” said Stripling. “If we can figure out how to respond in a tailored way for each neighborhood in a true partnership, that will create lessons for large and small cities alike.
Stripling comes from a long history of leadership roles in emergency management and disaster response, most recently at the Planned Parenthood Federation of America (PPFA), and previously at the NYC Department of Health & Mental Hygiene (NYC DOHMH) and the Florida Department of Health.
As he embarks on his new role as PRI director, Stripling reflects on his vision for the Institute and developing a stronger, more inclusive pathway to preparedness.
- What attracted you to the opportunity to lead the Pandemic Response Institute?
For my whole career I’ve tried to focus on how to make public health preparedness and response better and more effective, especially on addressing the disparities that we see in public health response. PRI is a unique pathway to not just learn how to respond to crises better but respond in a way that works directly with community groups, neighborhoods, and populations on the ground that are most impacted. This really requires a revolution in how we think about health response; it’s not just about doing tasks better. We must think differently about these problems and solutions. This doesn’t start in an ivory tower somewhere. It starts at the neighborhood level.
- What is your vision for the Pandemic Response Institute?
At the start, we will do a retrospective analysis of COVID-19 response in New York City. A lot has been done based on that, but we want to go to the public – to the people who are impacted – and develop a retrospective analysis that isn’t solely about an agency or city perspective, but in addition, a broad perspective of the people and about what they need from the city in the future. Secondly, we want to work with our non-profit partners on the ground in the five boroughs. We don’t want to set a vision in isolation, we want to set a vision with the people who are doing such important work in neighborhoods and communities. What we want to do first is listen, listen to the city, work with CUNY SPH and their prioritization of community engagement, and build a joint collaborative vision that really will speak to the needs and the goals of the people who have lived through this pandemic.
- What major challenges will the Pandemic Response Institute address?
Part of what we saw with COVID that the PRI needs to address is there are whole spheres of trauma that public health crises bring that are not featured in any official plans. The general public didn’t expect that suddenly the most important people for their day-to-day lives would be working in their grocery checkout lines, or that there wouldn’t be broad societal support for those who were suddenly unemployed and taking care of their kids all day, while at risk of losing their homes. Those things are clearly part of what a pandemic response needs because they’re part of the social determinants of health. A response that focuses on the social determinants of health needs to focus on the whole life cycle of a person, not just when they’re sick, but all the dominoes that fall based on their actions and who they are. We saw in the emergency management community the great resignation of healthcare workers because we didn’t take care of them during an unimaginable period of crisis and pain, so I think the PRI also needs to figure out how to set an example for taking care of its own to ensure they show up when crises inevitably happen.
- How do you feel New York City could be a model for other cities on how to address emerging health issues?
New York City has a phenomenal amount of capacity to solve problems and it also has an incredible spirit as a city. No one has the capacity that we have, and we can use that capacity to show how to solve problems differently, to make sure we are looking at a problem from a neighborhood-basis. New York City doesn’t really respond as a unified entity. We are one city, but we are also a city of hundreds of unique neighborhoods. If we can figure out how to respond in a tailored way for each neighborhood in a true partnership, that will create lessons for large and small cities alike. A New York City neighborhood is sometimes as big as a small city. We can bring this incredible neighborhood-focus New York City has to figure out lessons that work.
- What valuable tools and knowledge will you bring from Planned Parenthood and other organizations/institutions you’ve worked with to address health needs in NYC?
When I started at Planned Parenthood, working outside of the public health response really let me see the risk of tunnel vision emergency response can have sometimes. I also worked to focus on the disparities underlying health response, specifically the racial inequities that power that. After hurricane Sandy, we had a Legionella outbreak in New York City, followed by a Zika outbreak, and I learned that the tools we use in health response – incident command, emergency management tools, paramilitary systems that get the job done effectively – can also create unintended consequences just because of how they’re structured. When I worked in the health department, for example, we did a study on Zika. When we reviewed our efforts, we learned that most people who were taking us up on testing were those who had substantial resources, who had vacationed to the Caribbean. They weren’t the only people we intended to reach. When we talked to the folks we were aiming to reach, they said they had other problems to focus on, such as the mold in their apartment causing asthma for their children. What this taught me was that you can’t just see the flaws that are there on the surface, you must have the capacity to listen to the voices of the most marginalized and bring those voices into the conversation. If you don’t, sometimes your response can do more harm than good.
- What’s a good pathway to addressing some of those potential negative outcomes?
In the past, I tried to lead a reframing of incident command to make sure that it was supporting those who are most marginalized. One thing that really stuck with me is the interviews we did in every borough where the health department had health centers. We asked people about their experience with emergencies, and many replied they felt they had a great deal of expertise about the people they work with, and that their expertise was not listened to. One important role PRI can have is creating a deliberate way to listen to communities directly and make sure their input is being brought to the seat of power. The PRI can be a place to show clear leadership practices of transparency and accountability, which you need when you’re leading emergency response. If PRI can be the voice of good governance, that’s a way we can make emergency preparedness and response better.
- What value does an institute such as PRI have during this time in history?
The big picture narrative is that as a country, we did not approach COVID in a manner that we all would have desired. Now, more than 800,000 Americans have lost their lives to COVID, and it’s not rocket science as to why this happened – foundational public health has been eroded, powers have been stripped from health officers, and our ability to collaborate as a society has been degraded. The things that you measure in a health security index, like how many hospital beds we have and how much money we spend on research, those can be off the charts. But if people don’t trust that they are going to be taken care of, none of that matters. There are a lot of organizations that are focused on examining the data, but what we lack is an institute that has a broad perspective and a long reach. I think having access to the diversity encompassed in New York City neighborhoods and vibrant civil society organizations as well as academic and corporate depth puts us in a unique position to both make the city an example of public health response and give our country lessons on how to do this better next time.
A major global health organization that has been improving public health in countries around the world for nearly two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 30 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at www.icap.columbia.edu