NYC's new health commissioner and getting to know you
Welcoming Dr. Martin and a reader survey
Can you believe it’s been an entire year since Your Local Epidemiologist in New York launched on Substack?! Wow. Since then, our community has grown to 32,000 subscribers—neighbors, community leaders, clinicians, researchers, parents, and others, from the Bronx to the Finger Lakes—each bringing something unique and important to the conversation.
Now, as we look ahead, I want to get to know you better, and do a pulse check.
I’m launching a reader survey to learn more about who you are, what you care about, and what you’d like to see more of. What questions keep coming up for you? What’s missing from the coverage? Where can this newsletter meet your community better?
The survey is short (~3-4 min), anonymous, and will help me do this work better. Would you mind filling it out? Your thoughts are incredibly valuable.
Alright, back to our regularly scheduled programming. :)
NYC gets a new health commissioner
Who is he?
NYC just appointed its sixth health commissioner in 10 years: Dr. Alister Martin, an ER physician, Harvard faculty member, and founder of Vot-ER, a nonpartisan initiative helping patients register to vote in health care settings (a cool idea, in my opinion). He previously served as a White House Fellow in the Office of Vice President Kamala Harris and helped advise on voting rights. Breaking with tradition, he’s a practicing clinician without a traditional public health background.
Is he a good option?
First off, let’s just recognize that this position is a high-stakes, high-turnover job in a system that’s often underwater. The city’s public health infrastructure faces persistent budget cuts, while trying to address deeply rooted health inequities that can’t be solved overnight. It’s not an easy position to take, no matter who does.
Dr. Martin is also a non-traditional pick—most previous commissioners have had long histories in public health. He is a health care guy. And public health and health care are not the same thing. Some have worried that he doesn’t have the relevant public health experience.
But having a non-traditional pick could be a really good thing right now:
Public health is evolving rapidly. Tackling today’s challenges (like systemic inequities) could benefit from creative approaches beyond traditional public health.
New perspectives can reframe problems. Strong clinical experience could open up new ways to think about health gaps.
Making an impact requires coalition building. Bringing fresh ideas is valuable, but success will depend on collaboration and engagement with community organizations on the ground, as well as a deep understanding of the local context of New York’s neighborhoods.
The challenge will be translating that into meaningful, operational change. That is hard to do as an outsider coming into NYC. It will take coalition-building, humility, and help navigating the day-to-day, deeply local parts of public health.
So, what does a health commissioner even do?
A lot, but there are three big buckets.
1. Lead the NYC Department of Health and Mental Hygiene (DOHMH), AKA the health department. And it’s massive: This the oldest and largest health agency in the U.S., home to ~7,000 staff with an estimated budget of ~$2 billion. The commissioner serves under the deputy mayor for Health and Human Services, and plays a major role in setting the NYC’s health agenda. The health department’s work includes communicable disease control, restaurant inspections, birth and death registration, air quality monitoring, rat control, running sexual health clinics, and much, much more.
2. Chair the NYC Board of Health. This board oversees the city’s Health Code—a set of public health rules that’s separate from laws passed by the City Council. (Though sometimes, a law lets the Health Department write those rules itself, without going through the Board.)* For example, after the City Council passed a law in 2004 requiring home inspections when a child tests with an elevated blood lead level, the health code established the specific procedures for how those inspections and follow-up actions must occur. Other examples include adding requirements to test for Legionella in cooling towers, regulating medical spas (med spas), and requiring chain restaurants to disclose added sugar warnings.
3. Declare and act on public health emergencies. If there’s a threat to public health, like during the pandemic or extreme weather events, he can declare an emergency and establish procedures and orders necessary to protect residents (like school closures during measles outbreaks).
What can’t a commissioner do?
1. Pass laws. Only the New York City Council can do that. Health code regulations (described above) and emergency orders are administrative rules and have different processes and scopes than city laws.
2. Override state authority in key areas. The commissioner does not control state‑regulated areas such as Medicaid policy, hospital licensing, insurance regulation, or the broader structure of health care financing—those are governed by New York State.
3. Direct hospitals or set prices for health care. While DOHMH operates sexual health clinics, tuberculosis clinics, and school-based health centers, it doesn’t operate hospitals or set clinician prices or insurance premiums. Its regulatory authority is public health, not health care delivery. It cannot mandate hospital actions or pricing. This is a key point to remember when assessing the feasibility of the health agenda outlined below.
What NYC’s health agenda may look like
Mayor Mamdani’s agenda focused on affordability, including health care costs. This was echoed in Dr. Martin’s first public remarks as commissioner on Saturday. From his speech, three early priorities are already coming into focus:
Keep people insured, especially as federal cuts loom. With pandemic-era Medicaid protections ending and federal cuts on the horizon, hundreds of thousands—and potentially millions—in New York could lose coverage, especially in NYC which has one of the largest Medicaid-enrolled populations in the country. Dr. Martin emphasized the need to protect New Yorkers from falling through the cracks. That likely means enrollment outreach, renewal assistance, and partnerships with clinics and community groups to help people stay covered, especially in immigrant and low-income communities.
If he can help design and direct these efforts effectively, it could reduce the harms of Medicaid funding losses for the most at-risk New Yorkers.
Keep people housed. Dr. Martin drew a direct line between stable housing and better health. In a city with rising housing costs and growing shelter populations, he’s signaling his support for housing as a health intervention. While DOHMH doesn’t control housing policy, it can strengthen coordination between public health, homeless services, and Medicaid-funded supportive housing and health programs.
Improve access to affordable care. This one is trickier. Both the mayor and the new commissioner have named increasing access to affordable care as a top priority. But the reality is that it’s not actually within their power to do that directly. DOHMH doesn’t set health care prices or insurance premiums—those sit with the state, insurers, and the market. Overpromising on this risks confusion and mistrust if people don’t see progress.
So what can the commissioner actually do to reduce the cost of health care?
Improving health care affordability would require an indirect approach and significant collaboration. One avenue is through supporting Health and Hospitals (H&H), the NYC city-run hospital system, in expanding NYC Care, which offers coverage to the underinsured. However, implementation lies with H&H.
DOHMH could also help reduce practical barriers to care: supporting community-based organizations that offer mental health services, improving language access, and making it easier for people to navigate a fragmented healthcare system.
Finally, the commissioner could advocate for broader reforms, like supporting the NY Health Act, a state bill that would establish a single-payer, universal health care system. But this would require years of collaboration with state government. Overall, any changes to make access to affordable health care will require strong collaboration across agencies and the State of New York, and will not come from the commissioner or mayor alone.
Taken together, I’m looking forward to getting some fresh perspectives from Dr. Martin. New ways of thinking could be exactly what’s needed to meet this changing moment in public health. But creating lasting, positive public health change can’t rely on innovation alone—it requires deep local understanding, strong collaboration, and trust. How he builds that will be key.
Before we look too far into the future, I want to take a moment to say thank you to Dr. Michelle Morse, who served as the acting commissioner for the past 18 months. She has been such a steady voice and strong advocate for health equity during her time at the health department, and New Yorkers are healthier because of her leadership. Thank you for your service!
Infectious disease “weather report”
Flu: This has been a bad flu year in New York, but the worst is behind us. Flu cases and hospitalizations are declining in NYC and the state at large. I would still consider wearing a mask in indoor, crowded places though, especially if at higher risk.
RSV: Cases in New York continue to hold steady, meaning the virus is still circulating at elevated levels. The good news is that emergency department visits continue to decline, and that overall this season has been more mild than the previous two.
Covid: Covid decreased in NYC and statewide. Overall, Covid has been pretty low this season compared to recent winters.
Bottom line
The commissioner has a big job at a really hard time to lead. But we will be cheering on Dr. Martin, and doing our best to communicate what we see. Thank you again to Dr. Morse—we are so grateful!
And please fill out our survey if you have a moment. Thank you :)
Love,
Your NY Epi
*We made a correction on Feb. 5, 2026 to more accurately describe Health Codes and city law.
Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.
Many residents of 3333 Broadway in Harlem, one of New York City's largest apartment buildings, have been avoiding showers for over a month due to Legionella bacteria in their water supply.
This would appear to be an important local epidemiology story that is not getting enough attention.