For Health Care Workers, the Worst Commutes in New York City

NEW YORK — Delrisa Sewell-Henry, a home health aide, was resigned to spending two hours on a bus and three subway trains just to get across Queens to care for a disabled man.

But when one train recently stopped for a sick passenger, her commute expanded to a mind-boggling three hours and 15 minutes. She was late. To make up the lost time, she stayed longer with her patient instead of picking up her granddaughter from school. She had to enlist a neighbor to do that — for $35.

Then last week, another train was delayed. And she was late again.

“It makes me angry,” said Sewell-Henry, 54, who earns $13 an hour. “It’s not like we’re sitting around watching TV and doing nothing. We’re doing something. We have to be there on time.”

By now, the many ways New York City’s failing subway system has upended countless lives has been well documented. But a new report finds that no group has been hurt more than the city’s army of health care workers who fan out across the city every day to take care of older people, the frail and the sick. They ride trains and buses because they do not earn enough to take taxis or Ubers. Every disruption impacts patients and their families who count on them to arrive on time to provide medication and meals. For the workers, it can lead to reprimands, docked pay and being fired.

The report, “An Unhealthy Commute,” by the Center for an Urban Future, a research institute, concluded that health care workers endure some of the worst commutes in the city. Many rely on public transit — yet live and work in neighborhoods with limited and unreliable bus and subway service. The median commuting time for health care workers using public transit stands at 51.2 minutes — the longest for any class of private-sector workers — compared with 47.3 minutes citywide, the report said.

“Although many straphangers face long commutes, those who work in the city’s health care sector experience unique challenges,” wrote Jonathan Bowles, the executive director of the Center for an Urban Future. “Not only is health care a 24/7 business, it is one in which workers are required to be on time, alert and enthusiastic — qualities that are necessary for providing lifesaving services, but that are difficult to sustain when transit shortcomings take a grinding toll multiple times per day.”

The report warns that transit challenges have been especially tough for the health care industry, which is the city’s largest employer with nearly 500,000 jobs, in part because almost two-thirds of those jobs are in the boroughs outside Manhattan. The underlying problem, the report said, is that the city’s transit system is laid out in a “century-old radial design” that was “intended to get workers in and out of Manhattan” and has left transit gaps elsewhere.

Nearly 1 in 3 major health care employers — including hospitals, urgent care centers, nursing homes and doctors’ offices — are more than eight blocks from a subway stop, according to the report, which will be released Wednesday and relied on census and labor data. Others draw much of their workforce from neighborhoods that are at least two or three bus or subway rides away.

At Interfaith Medical Center in Bedford-Stuyvesant, Brooklyn, which is close to the A and C trains, most of its 1,400 employees do not live near those trains, the report said. For instance, 188 of them live in two other Brooklyn neighborhoods, Canarsie and Flatlands, which are served by the L train. So they take two buses — or one bus ride and a long walk — to get to work.

Dupe Ajayi used to start her day with a 1 1/2-hour commute on three subway trains from her home in the Bronx to her job at Maimonides Medical Center in Brooklyn. Then it was another hour and a half at the end of the day. Finally, she had enough and moved to Brooklyn, paying $500 more a month in rent. Her commute is now 45 minutes each way on two subway trains.

“It’s totally worth it. I should have done it sooner,” she said. “I put a dollar value on my time, too, so the time I’m not commuting I’m getting back.”

But other health care workers said moving is not an option, and they simply cannot afford to live in centrally located neighborhoods. More than 11,200 health care workers make their home in Queens Village, Cambria Heights and Rosedale — where there is not a single subway station, the report noted.

Slow buses and limited schedules and routes draw frequent complaints. About 80,700 health care workers commute to work by bus every day, or more than all retail and food service workers combined, the report said. Health care workers have pushed up ridership in neighborhoods in Brooklyn, Queens and the Bronx.

Home health aides often struggle the most. As more New Yorkers age in place at home, aides are being dispatched to every corner of the city. Their ranks have swelled to 151,700 from 61,700 a decade earlier, the report said. Their average salary is less than $25,000 annually, according to census data.

Elizabeth Tavarez, an organizer for home health aides with the 1199 SEIU union, said that in an informal survey of her members, transit problems have become the second biggest cause of stress — after a death in the family. “They feel anxious and then they can feel their blood pressure going up,” she said. “They don’t want to be late. There are patients who depend on them.”

Tavarez said her workers have been cited for lateness — as a result of the transit problems — by their employers in 40 complaints in the past three months alone, or more than double the number from three years ago. She recently intervened to save the job of one health aide, Magna Chimilio, 44, who takes a bus and two trains from the Bronx to Harlem to care for an older woman. A year and a half ago, Chimilio began arriving late almost every day because of signal problems and other issues. Though she gave herself an extra half-hour for the 45-minute commute, it was not enough. And she could not leave any earlier because she had to see her daughter off to school.

“I’ve been working since 1996 as a home health aide and I love my job — and I almost lost my job for something that was not my fault,” said Chimilio, who said she ended up in the emergency room with high blood pressure. “I would have had a blemish on my record and I would not have been able to find a new job.”

Tavarez succeeded in pushing back Chimilio’s start time by a half-hour. Even so, Chimilio is still late sometimes because of the trains, but not as often as before.

Sewell-Henry, the aide from Queens, has crisscrossed the city because she cannot afford to turn down assignments no matter how far away. Once she spent three hours on a bus and three trains going to Coney Island, Brooklyn. Her closest commute is 1 1/2 hours and two bus rides away.

“I would like to have an hour commute, but unfortunately, I can’t get that,” she said. “I have to make adjustments and get up and leave early.”

Besides, what choice does she have, Sewell-Henry added.

“When you make $13 an hour and you have to pay rent and buy groceries, you can’t afford an Uber,” she said. “I can barely afford a seven-day MetroCard.”