Author: The Opportunity Agenda

    On Tuesday, New York City Mayor Michael Bloomberg signed a ground breaking executive order requiring all city agencies to provide language assistance services for people who speak Spanish, Chinese, Russian, Korean, Italian or French Creole.  According to The New York Times, this is the first time that all New York City agencies will be forced to follow the same standard in providing translation and language interpretation services to people who do not speak English:

Immigrant advocates and city officials say it is the most comprehensive order of its kind in the country. The mayor refused to be specific about how much the services will cost, saying only that it was a “relatively small” amount given the size of the city’s budget. He added: “This executive order will make our city more accessible, while helping us become the most inclusive municipal government in the nation.”

The Opportunity Agenda fact sheet Immigration Reform: Promoting Opportunity for All details the need for immigrants to have access to language assistance services in order to achieve their full potential. In providing immigrant groups with this access, Mayor Bloomberg has taken the entire city forward and empowered communities throughout New York.

    Politicians have also been busy down in Washington, D.C. working to provide language assistance for immigrant families across the United States.  At noon today, Senator Hillary Rodham Clinton and Congressman Mike Honda are introducing the “Strengthening Communities through Education and Integration Act of 2008.” In addition to providing English language literacy and civics education to immigrant families who are in the process of becoming citizens, the bill:

will help immigrant communities become a more integral part of the American fabric and maximize their social and economic contributions.

Legislation like this is crucial to aiding immigrants on their way to becoming U.S. citizens, and is a necessary part of treating immigrants like full and equal members of our community.

*    The aftermath of the ICE raids in Postville, Houston, and most recently Rhode Island, is still being felt in communities across America.  However, a Washington Post article describes how it is not only workers and their families feeling this strife – now, it is employers as well:

The crackdown’s relatively high costs and limited results are also fueling criticism. In an economy with more than 6 million companies and 8 million unauthorized workers, the corporate enforcement effort is still dwarfed by the high-profile raids that have sentenced thousands of illegal immigrants to prison time and deportation.

*    A story in the MetroWest Daily News calls attention to a local organization in Massachusetts, the MetroWest Immigrant Worker Center, that is defending the rights of immigrant workers in the U.S.  Immigrant workers are routinely subject to labor law violations, including the denial of compensation and overtime, as well as unnecessary injuries on job sites.  In addition, the article points out that all immigrants, including undocumented ones, have worker rights:

Contrary to what many people think, illegal workers have rights. Although in the country illegally, those who work are entitled to be paid for their labor and overtime. If they are injured on the job, they are eligible for workers’ compensation coverage, said [Diego] Low, [director of the MetroWest Immigrant Worker Center] who has been advocating for immigrant workers’ rights for the last 25 years.

*    A DMI Blog posting points to an extremely upsetting Associated Press report of a beating in a Pennsylvania town that left a 25 year old Mexican immigrant named Luis Ramirez dead.  

Hate crime or not, the killing has exposed long-simmering tensions in Shenandoah, a blue-collar town of 5,000 about 80 miles northwest of Philadelphia that has a growing number of Hispanic residents drawn by jobs in factories and farm fields.

Last month the Appeals Court of Massachusetts issued two decisions regarding prisoner access to health care, both of which have vast implications for prisoner rights.  Through their rulings, the court affirmed two critical American values: redemption, the belief that humans are evolving beings who warrant the chance for rehabilitation when they falter, and healthcare as a human right.  The cases,  Sullivan v. Correctional Medical Servs. et al. No. 07-P-964 72, 2008 WL 2552982 (Mass. App. Jun. 27, 2008) and Kilburn v. Dept. of Corrections et al., No. 07-P-987, 2008 WL 2566382 (Mass. App. Jun. 30, 2008) concerned claims of negligence due to poor dental care provided to prisoners by private health care contractors hired by the state.  Part of the case for the prisoners’ claims rested on an appeal to third-party beneficiary rights.  Third parties in contracts have the right to sue if they can prove that they are the intended beneficiaries of the contract and are reliant on the contract.  Through their rulings, Massachusetts courts suggest that prisoners have standing as third party beneficiaries and can thus sue private health care providers despite their exclusion from the contract between the state and these private contractors.

In Kilburn v. Dept. of Corrections the Court ruled that the state cannot simultaneously deny responsibility for those healthcare duties delegated to its contractors and claim that those contracts were not meant to benefit the prisoners.  The fact that the state would make this argument to begin with is reflective of the larger shortcomings of the prison-industrial complex.  By contracting out the care of prisoners to private entities, the state claims that it is not liable for inadequate care provided by these groups.  The Appeals Court of Massachusetts took a stand for the right of prisoners to proper healthcare, and more generally to fair treatment, by stressing the state’s responsibility in prisoner care.  It went further to argue that inmates’ lack of standing to sue as a third party beneficiary of the contract does not make the state immune from liability or free from responsibility.  Simply because prisoners do not have the means to raise claims does not absolve the state of its duties.

While the decisions do not explicitly grant prisoners third-party beneficiary rights, they mark an important
step in this direction.  They document the receptiveness of the court third-party claims in government contracts on the part of prisoners.  Moreover the rulings affirm that the state cannot divorce itself from its responsibility to prisoners. Practicing redemption means providing the conditions that allow people to develop, to rebuild, and to take full responsibility for their lives after misfortune or mistakes.  Through its decisions, the court asserted the state’s own responsibility in providing these conditions for prisoners. This particular case concerns dental care, but it opens the door for an invigorated conversation about the fundamental human rights of those people behind bars, and the responsibility of the state in caring for those prisoners such that they may one day reenter society and have the opportunity to achieve their own, full potentials.

A piece in the Sunday New York Times reports that conservative think tanks like the American Enterprise Institute and the Heritage Foundation are engaged in hot internal discussions about self-transformation.  With support for a conservative president and a conservative Republican party at all-time lows, the Times reports, “policy cooks have returned to the kitchen to whip up a menu of new solutions for conservatives disaffected with the party.”  Some, like A.E.I. fellow and Bush alum David Frum, are even taking a fresh look at conservative heresies, like the idea that it’s in all of our interest to offer people in prison education, mentoring, and support for their children.

Those of us in the progressive ideas sector could also benefit from some self reflection.  Few if any transformative progressive ideas emerged from the crowded, marathon primary season, and few are on display in the current debate.  And that’s especially true when it comes to the concerns of the voters who are bringing the most progressive energy to the race: new African-American, Latino, and young voters.  Those voters are struggling with broken systems of education, health care, credit, immigration, housing, and criminal justice, among others.  And they are ready for a reinvented, positive role for the public structures that expand opportunity.

Progressive think tanks and advocacy groups have to step up to that challenge.  For decades, we’ve been seeking incremental change and, more often, fighting off harmful proposals.  As the Bill Clinton years proved, that dynamic won’t magically change just because a more left-leaning Administration or Congress is in office.  It will be up to us, and to the new generation of organizers, activists, bloggers, and thinkers, to bring the big ideas and to push them forward in a form and language that resonates with everyday Americans.

While holding tight to our values, we’ll need to reexamine some core assumptions.  And, perhaps most importantly, we’ll have to really listen to the hopes, dreams and concerns of our nation’s diverse communities–not just through polls and focus groups, but through tough and honest conversations and the interactive power of Web 2.0.  Now is the time to ask ourselves some tough questions, and to change what we do in response.

*    The New York Times is reporting that a recent study of the American health care system, conducted by the Commonwealth Fund, has found that while the U.S. has the most expensive health system in the world, the quality it delivers is grossly inferior to other industrialized nations’ health care.  The report highlighted the fact that many of the improvements made in the U.S. health care system over the years, such as decreasing the number of preventable deaths, dwarfed in comparison to the greater achievements other countries made:

Other countries worked hard to improve, according to the Commonwealth Fund researchers. Britain, for example, focused on steps like improving the performance of individual hospitals that had been the least successful in treating heart disease. The success is related to “really making a government priority to get top-quality care,” [Karen] Davis, [president of the Commonwealth Fund] said.

The report also emphasized the inefficiencies in the U.S. health care system and the role they play in diminishing quality:

The administrative costs of the medical insurance system consume much more of the current health care dollar, about 7.5 percent, than in other countries…
Bringing those administrative costs down to the level of 5 percent or so as in Germany and Switzerland, where private insurers play a significant role, would save an estimated $50 billion a year in the United States, Ms. Davis said.

*    An article in Friday’s Washington Post discusses the potential that community health providers have to save states millions of dollars in health care costs by shifting some of their health programs’ emphasis to preventing illness.  A recent Trust for America’s Health report found that nonprofit community programs could have an enormous role in developing health initiatives such as anti-smoking laws, healthy eating and physical activity programs.  However, despite the fact that many of these programs target at risk groups in impoverished areas, they face a serious lack of funding:

The researchers found that many such programs lack funding, a chronic problem for many preventive health initiatives.

“People think preventive health care pays off 20 or 30 years from now, but this shows you get the money back almost immediately, and then the savings grow bigger and bigger,” [Senator Tom] Harkin [D-Iowa] said.

To learn more about the importance of community health programs, please see the previous posting on The State of Opportunity titled Local Progress in Tackling Health Disparities.

*    An opinion piece in yesterday’s Chicago Tribune calls attention to the health disparities among women with HIV.  Black women have higher rates of HIV, despite the fact that studies have shown that they do not engage in “risky sex” any more than white women do:

A black woman in a poor neighborhood, for example, who engages in the lowest levels of risky behavior is dramatically more likely to acquire a sexually transmitted disease than higher-risk women in communities with low rates of infection, according to public health experts…
In short, who you are, and where you live and, consequently, the sexual partners you choose, matters when it comes to HIV prevention.

*    “The Shame of Postville, Iowa,” an editorial in Sunday’s New York Times, calls attention to an essay written by Erik Camayd-Freixas.  Mr. Camayd-Freixas is a professor and court interpreter who witnessed the aftermath of last month’s ICE raid on the Postville community.  He was disgusted when he saw the injustice in the legal system that the workers were subjected to; instead of being deported immediately, over 260 workers were charged with serious identity fraud crimes and sentenced to 6 months in prison:

What is worse, Dr. Camayd-Freixas wrote, is that the system was clearly rigged for the wholesale imposition of mass guilt. He said the court-appointed lawyers had little time in the raids’ hectic aftermath to meet with the workers, many of whom ended up waiving their rights and seemed not to understand the complicated charges against them.

The editorial also added:

No one is denying that the workers were on the wrong side of the law. But there is a profound difference between stealing people’s identities to rob them of money and property, and using false papers to merely get a job. It is a distinction that the Bush administration, goaded by immigration extremists, has willfully ignored. Deporting unauthorized workers is one thing; sending desperate breadwinners to prison, and their families deeper into poverty, is another.

*    Following the allegations of Guantanamo Bay-like treatment at ICE facilities, the Seattle Times has an article detailing numerous stories of abuse at an ICE facility in Tacoma, Washington.  The stories are part of a 65-page Seattle University Law School report titled “Voices From Detention”.  Detainees claim that they are routinely subjected to physical and verbal abuse, strip searches and manipulation:

The report’s authors said conditions are consistent with those at detention centers across the country. They are calling on Congress to pass laws that protect the rights of detainees…

Detainees in the study say they were pressured to sign documents or asked to sign paperwork they didn’t understand, a practice their attorneys say often leads to their unwitting deportation…

The report said one woman, after an attorney’s visit, was strip-searched and told to open her legs while a female guard peeped into her private parts.

To learn more about detainee treatment at ICE facilities, see this posting on The State of Opportunity.

*    Even after weeks of people discussing the horrific effects of the Postville and Houston raids, ICE has done it again – according to The Providence Journal, ICE agents arrested dozens of maintenance workers in a raid of Rhode Island court houses on Tuesday:

The raid led to a noisy demonstration by at least 100 people outside the Immigration and Customs Enforcement office at 200 Dyer St. last night. Police officers arrived as the crowd grew; at one point the police pushed a line of demonstrators across the parking lot.

For a full summary of the stories on the Rhode Island ICE raid, go to the Citizen Orange Pro-Migrant Sanctuary Sphere posting.

*    The New York Times is also reporting that many immigrants in New York City, most of them Latino, face being disenfranchised in the November election because the federal government is taking so long to fully process their citizenship applications:

At stake are the applications of at least 55,000 people in the New York City area who have been waiting at least six months — and as long as four years — for their documents to be processed, the lawyers said.

On June 18, 49-year-old Esmin Green was admitted to the Kings County Hospital Center psychiatric ward.  After waiting to be seen for 24 hours, she fell to the floor, began to convulse and then passed out.  Two security guards and one doctor walked into the waiting room, looked at her and then walked away.  After one hour, a nurse finally came over, kicked Ms. Green, and then proceeded to get a stretcher.  Shortly afterwards, Ms. Green was pronounced dead.  The entire incident was documented on a security camera, and is now on YouTube, thanks to the Associated Press.

Hospital officials said they fired three of the workers and suspended another three, the New York Times reported on July 7.  However, it is clear that Ms. Greene’s death is far from an isolated incident at Kings County Hospital.  The New York Civil Liberties Union, in conjunction with Mental Hygiene Legal Service and the law firm of Kirkland & Ellis LLP, filed suit against the New York City Health and Hospitals Corporation (the agency that runs Kings County Hospital) in May 2007.  The plaintiffs claimed that patients at the hospital’s psychiatric facilities were subject to conditions of squalor and filth, as well as abuse by hospital employees.  A summary of the case can be found on the NYCLU website.

The evidence displayed in the lawsuit shows that Ms. Green’s death is not solely the fault of the hospital employees who watched her die. The conditions in the hospital, particularly the psychiatric ward, and the treatment of the patients are the responsibility of the city agency that runs the hospital.  It was not until over one year into the litigation, and after Ms. Green’s death, that the city finally agreed to adopt a series of basic stop-gap measures, including:

* That every patient be checked every 15 minutes.

• That there be no more than 25 patients at any time in the psychiatric emergency ward.
• That detailed records on the ward be turned over every week to the advocates involved in the lawsuit.
• And that the advocates be active participants in the search for a new deputy executive director and emergency room director for Kings County Hospital’s Behavioral Health department.

It is shocking that it took a lawsuit and the very public death of a woman to get New York City to agree to such basic levels of care for mental health patients.  Donna Lieberman, executive director of the NYCLU, said:

What’s happening in Kings County Hospital is an affront to human dignity…In 2008 in New York City, nobody should be subjected to this kind of treatment. It should not take the death of a patient to get the city to make changes that everyone knows are long overdue.

What is even more distressing about Ms. Green’s death and the allegations of gross negligence of patients at Kings County Hospital is that many residents in Central Brooklyn do not have access to other hospitals.  This is mainly due to the fact that the predominantly black, low-income areas of Central Brooklyn, particularly the neighborhoods Bedford-Stuyvesant, Brownsville, Canarsie, Crown Heights, East New York, and Flatbush have seen numerous hospital closures in the last few years.

The Opportunity Agenda has documented these hospital closures on its website Health Care That Works.  Since 1985, Central Brooklyn has seen five local hospitals close their doors.  Because of these closures, people in these minority communities have been forced to rely on Kings County Hospital even more.  Local residents also begged the city to keep local clinics open – their requests can be seen in a video on The Opportunity Agenda’s YouTube channel.  At the same time all of these facilities were closing, allegations of mistreatment at Kings County were surfacing.

The fact that people of color have inferior access to health care in New York contributes greatly to the health disparities in the city.  The Opportunity Agenda report Dangerous and Unlawful: Why Our Health Care System Is Failing New Yorkers and How to Fix It documents how areas with high concentrations of African Americans, Hispanics and Asian Americans are more likely to have shortages of primary care physicians than predominantly white communities are.  The distribution of hospitals and other health care services has a significant discriminatory effect on these communities of color – their health care access is simply inadequate.

Ms. Green’s death should do more than signify the need for improvement of existing hospitals like Kings County.  It should also remind us that many people in New York, and across the country, lack basic primary care and access to emergency services.  Changing this reality needs to be a part of health care reform discussions.  If it isn’t, we will continue to see needless deaths like Ms. Green’s occur.

Last Thursday, the American Medical Association issued an official apology for its past racism toward African American patients and physicians.  Along with the apology were the findings of a study conducted by the Commission to End Health Care Disparities, a group that the AMA and the National Medical Association (an organization representing black physicians) co-chair.  The study has found that between 1846 and the 1960s, the AMA’s past transgressions included:

substandard care for black patients or segregated them to black hospitals; a lack of support for black physicians and for the Civil Rights Act; and exclusion of blacks from medical schools, hospital staffs and residency programs.

The apology can be found here, and the study is available in the online version of the Journal of the American Medical Association. To learn more about the work of the Commission to End Health Care Disparities, go to the AMA website.

It is also worth noting that a number of doctors were opposed to the AMA’s discriminatory policies in the 1960s.  A group of physicians picketed the AMA convention in Atlantic City in 1963 in order to call attention to the AMA’s racist acts.  Among these physicians was Dr. Robert Smith, a leader of the Medical Committee for Human Rights in Mississippi (MCHR).  The MCHR grew out of the Medical Committee for Civil Rights, and organized a number of volunteers to come down to Mississippi to provide care to black patients who were not being treated in their communities:

Though MCHR volunteers were not licensed to practice professionally in Mississippi, they could offer emergency first-aid anywhere and anytime to civil rights workers, community activists, and summer volunteers. Working without pay, they cared for wounded protesters and victims of police and Klan violence, assisted the ill, visited jailed demonstrators, and provided a medical presence in Black communities, some of which had never seen a doctor. They established and staffed health information and pre-natal programs in many Black communities. Appalled at the separate and unequal care provided to Blacks by Mississippi’s segregated system, they soon involved themselves in political struggles to open up and improve Mississippi’s health care system for all.

The Health Care Blog has a posting that discusses My Health Direct, the web-based solution to overcrowding in emergency departments.  The idea of My Health Direct is for hospitals to use an online appointment system to re-route their Medicaid and uninsured patients to community and safety-net clinics.  According to the blog posting, the program has been successful in increasing patients’ access to primary care and improving the quality of care and treatment outcomes for those patients:

More than 12,000 health appointments have been made with the vast majority of these appointments for patients who are uninsured or enrolled in a Medicaid managed care plan. These appointments were made for patients who either presented for care with a non-emergent condition, or needed follow-up care in a primary care setting.

A utilization review of My Health Directs impact demonstrated that more than 92% of patients who received an appointment did not present to the ED again. Patients who obtained appointments were more than 4 times more likely to actually attend their appointment compared to previous referral efforts from the ED. Lastly, there was a 25% reduction in repeat non-emergent visits of those patients assisted by My Health Direct.

A recent Health Beat blog posting titled “The Realities of Rural Medicine” discusses the unequal access to health care for people who live in rural areas.  The study on rural health care, conducted by the Center for Studying Health System Change, found that both patients and doctors feel significant strain in living in communities that do not have enough primary care options.

The Washington Post is reporting that Los Angeles City Councilwoman Jan Perry is trying to limit the prevalence of fast food restaurants in South Central Los Angeles by placing a moratorium on new fast food locations in the area.  Perry is a representative for District 9, an overwhelmingly African American and Latino constituency that has significant health disparities in comparison to the wealthier West L.A. area:

Perry quoted research showing that although 16 percent of restaurants in prosperous West L.A. serve fast food, they account for 45 percent in South L.A. Experts see an obvious link to a health department study that found that 29 percent of South-Central children are obese, compared with 23 percent county-wide.

•    Detention Watch Network has created a new interactive map that is now accessible on their website.  The map is a comprehensive tracking system that allows users to view the locations of detention centers, community organizations, ICE offices and immigration courts across the United States.
•    A T Don Hutto Blog posting discusses the recent American Immigration Lawyers Association position paper on alternatives to detention for immigrants.  The paper, which argues that the Department of Homeland Security should shift its focus from raids and electronic monitoring of immigrant populations to community-based, non-restrictive measures, can be accessed here.
•    Some updates on recent ICE raids: a posting on Standing FIRM links to a New York Times report that two Agriprocessor employers have been arrested.  Their arrests were connected to last month’s ICE raid in Postville, Iowa; they were the first non “rank and file” workers to be targeted. Scott Frotman, a spokesman for the United Food and Commercial Workers Union, pointed out that the arrest of these supervisors does not show the full extent of the company’s violations of workers rights:

What about the allegations of worker abuse? Does anyone really believe that these low-level supervisors acted alone without the knowledge, or even the direction, of the Rubashkins and other senior management?

In addition, the same Times story is reporting that last week five senior managers at Action Rags USA were arrested.  Their arrests are connected to the ICE raid on the Houston Plant in late June.

*    In response to these recent government crackdowns on employers of illegal immigrants, business owners have begun to speak out in opposition to tough anti-immigration measures.  A July 6 article that appeared in the New York Times claims that employers have begun fighting the government policies in state and local courts:

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Business groups have resisted measures that would revoke the licenses of employers of illegal immigrants. They are proposing alternatives that would revise federal rules for verifying the identity documents of new hires and would expand programs to bring legal immigrant laborers.

*     A story that appeared in Sunday’s San Francisco Chronicle discusses the positive results of the city’s 1989 immigration sanctuary law.  The law bars local officials, including police officers, from questioning residents about their immigration status.  The Chronicle also points out that San Francisco is not alone in enacting sanctuary measures:

San Francisco is among scores of cities in California and around the country with sanctuary laws, according to the National Immigration Law Center. Several states also have such policies.

A recent posting on The State of Opportunity also called attention to a California superior court decision upholding the Los Angeles Police Department’s of neither arresting people based on their immigration status nor asking about one’s immigration status during interviews.

On Sunday, the New York Times reported on employer opposition to immigration raids and other measures punishing the hiring of undocumented immigrants.  According to the Times, “business groups have resisted measures that would revoke the licenses of employers of illegal immigrants. They are proposing alternatives that would revise federal rules for verifying the identity documents of new hires and would expand programs to bring legal immigrant laborers.”

This is a potentially positive development, as business leaders are well placed to make the argument for real solutions to the immigration challenge that uphold our nation’s ideals and move us forward together.  In particular, they speak to the contribution of undocumented immigrants to our economy and the need for commonsense approaches rather than vindictive, unworkable ones.  And they have the ear of politicians of both parties.

It’s essential, though, that we complement business voices with those of faith leaders, civic leaders, immigrant leaders, and others committed to the protection of human rights in the workplace, communities, and beyond.  Failing to do so could result in an immigration “fix” that serves business interests and provides cheap labor, but fails to protect workers’ rights and depresses wages for all.

We should welcome the voices of business leaders, while making sure that we tell the whole story to the American people.

* A recent study has found that black men are more likely than white men and women to be unaware that they are suffering from high blood pressure, according to an article in Wednesday’s Reuters Health.  The researchers claim that this disparity stems from the fact that men are less likely than women to believe that they need to see a doctor.   Moreover, men, particularly African American men, are less likely to have access to a primary care physician:

What is not good, the researchers say, is that men were less likely than women to have a regular doctor, and they were four to five times more likely to say they had no doctor because they did not need one.

Study participants who did have a regular doctor were nearly four times more likely to know they had high blood pressure, and more than eight times more likely to be taking medication for it.

* The Kaiser Health Disparities Report has linked to a study on the prevalence of asthma that appeared in the Journal of Health and Social Behavior.  By looking at 10 different racial and ethnic groups in New York City, researchers examined how housing and neighborhood conditions might contribute to disparities among asthma patients:

Researchers found that Puerto Rican-Americans, other Hispanics and blacks had the highest levels of asthma, while Mexican-Americans, Chinese-Americans and Asian/Indians had the lowest levels. They also found that reducing minorities’ exposure to deteriorated housing conditions and increasing levels of community unity, as well making improvements in other household factors, reduce asthma rates among blacks and Puerto Rican-Americans.

* An article in Saturday’s New York Times discusses how rising gas prices have led to cuts in various services for the elderly.   Agencies have been forced to cut back on many programs, such as Meals on Wheels, because of the rising costs of transportation.  Elderly people, particularly those who are homebound, are among those most affected by these cuts, since they rely not only on the programs but on at-home volunteers as well:

Val J. Halamandaris, president of the National Association for Home Care and Hospice, said that rising fuel prices had become a significant burden for the 7,000 agencies represented by his group, with some forced to close and others compelled to shrink their service areas or reduce face-to-face visits with patients. A recent survey by the group concluded that home health and hospice workers drove 4.8 billion miles in 2006 to serve 12 million clients. “If we lose these agencies in rural areas, we’ll never get them back,” Mr. Halamandaris said.

* The Washington Post is reporting that New Jersey is one of the states facing the harshest effects of the health care crisis – hospital closures.   New Jersey’s state hospitals are required to treat any person that walks through their doors, and in turn the state is supposed to reimburse the hospitals.   However, the state’s budget crisis has led to cuts in reimbursements, and ultimately to hospital closures:

Six [hospitals] have closed in the past 18 months, and half of those remaining are operating in the red…

The situation has come to a head in this city [Plainfield, NJ] of 48,000 people — majority black, largely poor and with many new immigrants moving in. The city’s hospital of 130 years, Muhlenberg Regional Medical Center, is slated to become the latest casualty of this faltering system, closing its acute-care facility later this year. The obstetrics and pediatrics wards have already shut, and equipment is being packed up and wheeled out.

New Jersey is not the only state that has a problem of hospital closures.  To learn about the extent of the problem of hospital closures in New York, visit The Opportunity Agenda’s GoogleMaps mashup site, Health Care That Works.