This article is co-published with Your Local Epidemiologist in New York, a weekly newsletter that aims to make public health data and science understandable, relevant, and useful for New Yorkers, by a New Yorker. Sign up for it here.

This piece covers the election in New York City, so unfortunately, it may not apply to those of you elsewhere in the state (though feel free to forward it if you know someone there!) Next week, we’ll be back with our usual statewide content—and, if this is helpful, we can do something similar for the statewide elections in 2026.

The NYC Mayoral Primary Election is fast upon us: Election day is June 24, and early voting is from June 14th to June 22. Polls across the city will be open on the 24th from 6 a.m. to 9 p.m.

Here at YLE, we recognize that policymakers impact everything that touches your life, but we thought it would be helpful to take a look at one piece of that pie: policies that impact our health.

This is a guide (not an endorsement) that may be helpful to your research before you hit the polls.

Let’s back up. What does the mayor have to do with health?

In NYC, the mayor impacts health through policy, budgetary control, and agency oversight. The mayor appoints the health commissioner and sets priorities on issues like chronic disease, overdose prevention, mental health, vaccines, and emergency preparedness. The mayor also proposes the city budget, including funding for public hospitals (NYC has the largest public hospital system in the U.S.), community health programs, and things like access to healthy food and housing, which are social determinants of health. The mayor’s priorities have a large impact on what issues get resourced.

I’ve outlined what I see as the most pressing public health issues for New York City, and how current mayoral candidates plan to address those issues. (One note: current mayor Eric Adams is running as an independent and is not part of this primary—we’ll include his information later, before the final election.)

I chose three topics that affect the most New Yorkers, and have the greatest potential to improve overall health across the city. (This is not all-encoming—narrowing these topics down was tough! 😅)

Maintaining Medicaid and public health funding

In NYC, 40% of all people, 60% of children, and 50% of births rely on Medicaid for their healthcare coverage—that’s more than 4 million people.

Congress is actively debating a bill that would cut Medicaid, resulting in an estimated 8.6 million people losing coverage nationally, including 1.8 million in New York state, the majority of whom are children, older adults, and people with disabilities.

Additionally, New York City used to receive significantly more state funding for essential public health services. Currently, the NYC public health budget s for ~2% of the city’s total budget, down from ~3% previously. And, since a law change in 2019, NYC has lost $90 million a year in Article 6 funding (state funding for local health departments to pay for essential public health services).

What will the mayor do to prevent federal Medicaid cuts and advocate for public health funding? If Congress does cut Medicaid, what will the mayor do to ensure that New Yorkers maintain healthcare coverage and access to medical care?

What the candidates

Most candidates acknowledge the importance of Medicaid and public health funding. Adrienne Adams, Michael Blake, and Brad Lander expanding them through strategies like higher reimbursement rates, new funding streams, or wider eligibility criteria. Andrew Cuomo, Zellnor Myrie, and Scott Stringer focus on maintaining current funding levels and preventing federal cuts, but don’t propose expansions. Zohran Mamdani and Jessica Ramos have not taken clear positions in their mayoral platforms, though both have ed relevant legislation previously.

Reducing mental health issues and addiction

Rising mental health issues, especially among teens, and high overdose rates are crises in New York. Both were exacerbated by the Covid-19 pandemic.

In 2022, 13% of adult New Yorkers reported having depression and 1 in 4 reported having anxiety. In 2021, about 1 in 10 (9%) of NYC public high school students reported a suicide attempt, and 41% and 42% of Black and Latino teens, respectively, felt sad and hopeless. Amongst teen girls, 27% reported non-suicidal self-injury.

Overdose deaths in NYC declined in the first half of 2024. (We’re still collecting data on the second half, given a lag in death certificates.) However, the number is still extremely high: every four hours, a New Yorker dies of a drug overdose, primarily due to fentanyl. In the first half of 2024, there were 1,184 overdose deaths in NYC—fewer than the 1,525 deaths during the same period in 2023. They occurred most frequently in the Bronx, Upper Manhattan, and Central Brooklyn.

How will the mayor combat the mental health and overdose crises? How will they ensure that all New Yorkers have access to mental health care and substance use recovery services?

What the candidates

All candidates include policy plans that expanding access to mental health care for at least some individuals. They all recognize the issue and better mental health treatment, though some only focus on those with severe mental illness, while others focus on the general public.

Additionally, Adrienne Adams, Michael Blake, Andrew Cuomo, and Scott Stringer expanding access to substance use disorder treatment and/or harm reduction.

Improving maternal health

Maternal mortality is a huge issue in New York. One woman dies of pregnancy-associated factors each week in New York City, on average. The majority of these deaths are preventable.

And the risk is not uniform. Black women in NYC are three times more likely to die when pregnant (or soon after delivery) compared with white women. Disparities are also seen in infant health. The infant mortality rate for babies born to Black mothers is 2.4 times the average New York state rate. Unfortunately, there has been little improvement in these gaps over the past two decades. Mortality for Black pregnant women in New York has consistently remained higher than the national average for Black pregnant women.

How will the mayor improve the health and outcomes of our New York moms and babies? How will the mayor direct resources toward moms with the greatest need and highest risk?

What the candidates

Several candidates propose expanding maternal health programs, especially to reduce racial disparities. Adrienne Adams, Michael Blake, Brad Lander, and Zellnor Myrie offer detailed plans to expand care, like increasing access to doulas, midwives, or nurse home visits. Andrew Cuomo and Zohran Mamdani maintaining existing programs, while Jessica Ramos and Scott Stringer have not outlined clear approaches in their mayoral plans, though they both have previously ed policies to improve this issue.

Bottom line

The next NYC mayor will help shape the city’s health—not just through emergency response like we saw during the pandemic, but through long-term, structural decisions about who gets care and how. The issues presented here—Medicaid and public health funding, mental health and the overdose crises, and maternal mortality—are not new. But they are urgent. And how we address them now will echo for generations to come.

The good news is that all candidates recognize these problems to some degree. But their plans vary widely—from incremental reforms to systemic overhauls.

When you cast your vote this month, you’re not just voting for a person. You’re helping decide how New York prioritizes health and the systems that shape our well-being. Your voice has a lot of power. If you found this helpful, share it with a friend!

I’ll see you at the polls.

Love,

Your NY Epi

P.S. The research for a piece like this takes a lot of time and . Become a paid subscriber to YLE NY to help make this work possible.

Want to go deeper">Explore the candidates’ plans and policy positions at YLE.