To fight racial injustice, save SUNY Downstate Hospital

Assemblyman Brian Cunningham addresses congregation at Fenimore Street United Methodist Church on Feb. 4.
Photo by Nelson A. King

SUNY Downstate is in crisis. Decades of underfunding and insufficient Medicaid reimbursement already strained Downstate when the medical center was designated as a COVID-only hospital for nine months.

Now, our community has been taken by surprise with the news that our beloved hospital is slated for a “transformation” that means reduced services and lost jobs.

I have lived in Flatbush my whole life. Growing up, I was surrounded by folks who worked, studied, and received care at Downstate. As a safety net hospital, it is a lifeline for my underinsured neighbors. It is the largest employer in my district, providing thousands of union jobs for members of my community. It even brings new business to the shops and restaurants in the surrounding neighborhood.

But Downstate is so much more than an economic driver — it is a vital tool in the fight against long-standing injustices plaguing Black communities.

SUNY Downstate is home to the only kidney transplant center in Brooklyn, with an industry-leading kidney care program. African Americans are three times as likely as white patients to face kidney failure, just as we are more commonly impacted by other chronic conditions. It should go without saying that the loss of these resources will devastate our community.

As a new father, and as someone who understands all too well the struggles that Black families experience with maternal health, the maternity ward and neonatal ICU at Downstate hold special meaning to me. Losing these facilities will be nothing short of a tragedy for the families who will lose mothers and infants to a lack of care.

Downstate is also home to an industry-leading orthopedic care facility and rehabilitation center that enable effective injury recovery and reduce the incidence of long-term disability. A 2023 review found that Black patients are more likely to require additional surgery, stay in the hospital longer, and report only minor improvements in their condition after knee replacement.

Are you noticing a trend? Black patients are more likely to see negative health outcomes in both chronic and acute settings.

Experts agree that these outcomes are not caused by genetic differences. Unequal access to healthy food, barriers to preventive care, and the ever-present social stressors of discrimination and poverty put Black patients at significantly higher risk of chronic illness and premature death. Compounding these conditions, our healthcare system is simply not representative of our country’s racial makeup.

A robust workforce of Black healthcare workers is vital if we are to remedy long-standing health disparities in health for Black patients. Cultural competency saves lives and reduces the impact of bias on healthcare outcomes, such as the all-too-common experience of doctors doubting the extent of African American patients’ pain.

Let me be clear: a reduction of services at Downstate will have a deleterious effect on healthcare, not only in Central Brooklyn, but on Black and brown communities across New York. Students of color comprise 68 percent of the student body, and Downstate is in the 93rd percentile nationwide for African American graduates. Drawing down the scope of Downstate Hospital will remove vital opportunities for Black patients to receive care from practitioners who look like them and understand their unique needs, undoubtedly worsening the racial divide in health outcomes.

Yet despite the crucial, lifesaving care that Downstate Hospital provides, my neighbors and I understand fully that the status quo is not sustainable. Chronic underinvestment has left Downstate’s infrastructure crumbling for years. Subpar facilities lead many patients to seek care elsewhere, even leaving the borough entirely to visit healthcare providers. As a result, the hospital is further deprived of necessary revenue, creating a snowball effect that has exacerbated the situation over time.

We need bold solutions to preserve Downstate Hospital and save lives. Last spring, long before anyone was aware of plans to reduce the scope of services at Downstate, I introduced a bill to develop a sustainability plan for the medical center. As concerns mounted over the proposed closure this year, Senator Kevin Parker and I introduced legislation creating a support fund to fuel infrastructure improvements, community health projects, research grants, and more. Furthermore, I have joined my colleagues in supporting Medicaid reimbursement reforms that will provide sustainable revenue for our safety net hospitals.

Brooklyn cannot afford to lose healthcare resources. If the state draws down the hospital’s functions, our most vulnerable community members will face even higher barriers to healthcare access than they already do. Meanwhile, thousands of good-paying, union jobs will disappear, leaving families in dire straits at a time of record-high living costs and accelerating gentrification.

We need all hands on deck to preserve and expand care for communities of color. I urge all my fellow New Yorkers to contact your elected representatives and tell them: from Brooklyn to Buffalo, New York needs SUNY Downstate.

Brian Cunningham represents New York’s 43rd Assembly District, including the SUNY Downstate campus and the surrounding communities of East Flatbush, Prospect Lefferts Gardens, and Crown Heights.