An Open Letter to Mayor-elect Zohran Mamdani

Housing policy is health policy. Evictions, overcrowding, and homelessness are associated with higher rates of emergency department use, chronic disease, poor birth outcomes, and

preventable deaths. Stabilizing housing and lowering household costs are among the most powerful public health interventions a city can make.

Your plans to freeze rents on rent-stabilized units, aggressively expand affordable housing, and rein in abusive landlords provide a critical foundation. We urge you to:

• Pair rent and housing reforms with explicit health goals and metrics—for example, reducing family homelessness through the effective “housing first” model, preventing school displacement for children, and lowering asthma and injury rates in poorly maintained buildings.
•  Expand supportive housing and health-legal partnerships that help tenants fight unlawful evictions and address hazardous (both physical and toxic) living conditions.
• Invest in safe shelters and temporary housing for newly arrived migrants and asylum-seeking families — and co-locate mobile health clinics, legal aid, and educational support on-site to ensure comprehensive, immediate care.

Your proposed Department of Community Safety recognizes what decades of evidence have shown: criminalizing poverty, mental illness, and substance use does not make communities safer—it makes them sicker. A care-first model can save lives, reduce violence, and strengthen trust between communities and government.

We encourage your administration to:

• Build community-rooted pipelines to recruit and retain diverse mental health professionals within non-police crisis response teams — supported by independent evaluation and strong community oversight.
• Expand access to low-barrier mental health services, including school- and community-based counseling, culturally responsive and multilingual care, and peer-led support.
• Fund mental health trainings for staff at community-based organizations, places of worship, barbershops, community centers, and other third spaces to strengthen peer support networks and build community resilience. Address the root causes of trauma and violence by funding youth employment, restorative justice programs, neighborhood-based organizations, and survivor-centered services for gender-based violence.

New York City has long been a haven for reproductive health care, yet profound inequities persist. Black and Brown women and birthing people continue to face unacceptably high rates of maternal morbidity and mortality. Young people struggle to access comprehensive, stigma-free sexual and reproductive health services. Immigrants, LGBTQIA+ communities, and people living in poverty encounter barriers at every turn.

Your commitment to universal childcare and economic justice creates an opportunity to center reproductive justice as a core pillar of your public health agenda. We recommend that you:

• Invest in community-based maternal health models, including midwifery, doula care, home visiting, and respectful maternity care that centers the experiences of Black, Brown, immigrant, and low-income families.
• Ensure universal access to contraception, abortion care, and comprehensive sexuality education in schools, with attention to confidentiality and cultural humility.
• Protect and expand funding for clinics that provide sexual and reproductive health services, and school-based health centers that provide such services in the context of wholistic care for young people, especially in neighborhoods that are currently underserved.

Strengthen postpartum support by extending paid family leave, protecting against pregnancy related workplace discrimination, scaling postpartum wellness checks with mental health support, and expanding family programs such as newborn home visits.

The climate crisis is already reshaping health in New York City—through extreme heat, flooding, air pollution, and infrastructure failures. These harms fall heaviest on low-income neighborhoods, communities of color, and immigrants, many of whom are also facing housing instability and precarious work.

We urge your administration to:

• Integrate health equity into all climate and environmental justice policies — from heat action plans and flood-resilience strategies to air-quality interventions — by engaging residents of climate-affected neighborhoods in shaping the solutions that impact them.
• Protect outdoor and low-wage workers from heat, pollution, and unsafe conditions, including enforcement mechanisms and worker-driven solutions.
• Ensure that emergency planning, shelters, and disaster responses guarantee access to essential medicines, chronic disease care, and sexual and reproductive health services.
• Upgrade New York City’s drainage and stormwater infrastructure, particularly in floodprone and underserved neighborhoods, to prevent basement flooding, sewage backups, and household mold, with the goal of reducing respiratory illness and other health risks linked to poor water management.
• Design migrant and asylum-seeker policies with health, dignity, and long-term integration in mind, not just short-term crisis management.

Your universal childcare agenda and commitments to public education are some of the most powerful health interventions on the table. Conditions in early childhood shape lifelong health, educational attainment, and economic opportunity. For adolescents and young adults, access to safe spaces, supportive adults, and meaningful opportunities can interrupt cycles of trauma, chronic disease, and poverty.

We recommend that you:

• Treat early childhood centers and public schools as health hubs, not just for students but for their families, by investing in  mental health services, vision and dental care, reproductive care and nutrition programs within school-based health centers.
• Embed trauma-informed practices and training for staff across schools and youth-serving systems, particularly for young people affected by foster care, parental incarceration, migration, or community violence.
• Support youth-led initiatives and participatory budgeting that give young people real power in shaping the policies and services that affect their lives.

The COVID-19 pandemic laid bare how essential local public health agencies are—and how fragile their funding and authority can be. A just city requires a strong, independent, and well-resourced public health system that can monitor threats, act early, and partner meaningfully with communities.

We urge you to:

• Fully fund and protect the New York City Department of Health and Mental Hygiene and NYC Health + Hospitals, with particular attention to community-based clinics, community health programs through NYC healthcare institutions, and neighborhood health centers.
• Invest in community health workers and trusted community organizations as core parts of the city’s public health workforce, not as peripheral partners.
• Use data to drive equity: set clear, public goals for reducing racial, socioeconomic, and neighborhood disparities in health outcomes, and report on progress transparently in methods accessible to all NYC community members.
• Use evidence to guide decisions by setting measurable goals, monitoring performance, and evaluating what works. This includes the political will not only to invest in effective programs, but also to reduce or eliminate those that fail to improve outcomes for New Yorkers.
• Create formal mechanisms for community and academic partners—including institutions like Columbia, CUNY, and community-based organizations—to co-design public health initiatives and research with your administration.