Reducing Anxiety in the South Jamaica Houses

PUBLISHED June 10, 2025

In New York City, approximately 18 percent of all adults have been diagnosed by a health care professional with anxiety, city records show.¹ Anxiety can impair a person’s ability to carry out daily tasks, especially when they are perceived as threats—such as situations encountered at work or school. Anxiety disorders affect women more than men, and in some cases, show no symptoms.²

This report focuses exclusively on the South Jamaica Houses, a large public housing complex about a 15 minute walk from the Jamaica Center Parsons/Archer subway stop. It begins with a broad overview of the surrounding environment, and then based on first-hand observations, looks at how the social determinants of health can increase risk factors leading to anxiety. It then documents what mental health providers are available in the area and concludes with a set of mostly practical interventions that city and state officials can act on to help reduce anxiety.

Overview

The South Jamaica Houses are bounded by the York College athletic field to the north, the Long Island Railroad tracks to the west, and middle class housing to the east and south. There is an elementary school one block to the east with a supermarket, a pharmacy, and a health clinic two blocks to the east on Guy Brewer Boulevard. There are no banks or mental health providers in the area.

In general, residents of the South Jamaica Houses are similar to other New Yorkers when it comes to having health insurance and having seen a doctor within the past year.^3,4 The major difference is avoidable hospitalizations—a metric depicting how many hospitalizations could have been prevented if adults had access to quality primary care. For Jamaica, there were 1,619 avoidable hospitalizations per 100,000 adults, exceeding the city average of 1,213.⁵ This reflects, in part, limited access to primary care physicians for people living in the South Jamaica Houses.

The Social Determinants of Health

Income—The average public housing family’s income is $25,047 a year, which is below the federal poverty level of $25,820 for a family of three.^{6, 7}  Research suggests that poverty is a key contributor to anxiety.⁸ Commuting can add on to that anxiety. Local commuters living in South Jamaica taking a bus and train to work have an average commute time of 45.5 minutes.⁹ One Korean study found that commutes of this length increase the risk of anxiety by 17 percent.¹⁰ In addition, data by Klumpentown Consulting shows that a person living in New York City with good transit connections can reach almost one-half million more jobs in 45 minutes than someone living in a low income neighborhood.¹¹ This increases that person’s chances of earning a higher pay, and subsequently, boosting their mental well-being.

Crime—The built environment and the social behavior that accompanies it may induce a fear of crime, which is often associated with anxiety.¹² The South Jamaica Houses are old, with rusted iron fences and the occasional garbage bags lying about. The business district on Guy Brewer Boulevard two blocks away has shuttered storefronts among a handful of bodegas, beauty salons, and empty sidewalks. At times, the men at the South Jamaica Houses shout, curse and make threats to one another. Studies show that a fear of crime can cause area residents to exercise less and partake in fewer social activities, thereby increasing their risk of cardiovascular disease. People with a strong fear of crime have 75 percent higher odds of experiencing anxiety than those with a low fear.¹³

Access to Care—As mentioned previously, the closest primary care facility to the South Jamaica Houses is two blocks away. It is only open Monday through Friday and does not see patients in the evening.  For emergencies, local residents need to visit either Jamaica Hospital, which is closer, or Queens Hospital, a part of Health and Hospitals, which is farther away. In either case, patients will need to hail a taxicab. Studies show that poor transportation alternatives can lead to inadequate medical care and exacerbate chronic disease.^{14, 15} Diagnosing a chronic disease can then contribute to anxiety because patients tend to worry about their future and may cut-off social relationships.¹⁶

Mental Health Providers

The closest mental health specialists who accept Medicaid and Medicare work at a  Federally Qualified Health Center on 115^th Street and Sutphin Boulevard, about a 20 minute walk from the South Jamaica Houses for a person in good shape. In addition, the Psychology Today directory lists another three private mental health providers serving the South Jamaica Houses—one psychologist and two social workers.¹⁷ The social workers charge $75 and $150 per session, respectively; the psychologist charges $200 per session. All provider consultations are online and use cognitive behavioral therapy, an evidenced-based talk therapy. None of the three providers take Medicaid or Medicare. Residents from the South Jamaica Houses can also access mental health services at Jamaica Hospital and Queens Hospital. Of the two, Queens Hospital offers more privacy when inquiring about mental health treatment, is easier to find one’s way around, and has friendlier staff. Significantly, it takes HealthFirst, MetroPlusHealth, and Fidelis Insurance Medicaid plans while Jamaica Hospital only accepts Healthfirst.

Recommendations

This paper makes four recommendations to help reduce anxiety for people living in the South Jamaica Houses. First, NYCHA needs to paint its fences, mow its lawns, plant more flowers and trees, and pick up the garbage to make an aesthetically pleasing environment for people, especially women, to walkabout and socialize. The MTA, for its part, should put up bus shelters for commuters.

Second, New York City needs to make better use of its assets. Schools sit idle after 5:00 PM and on the weekends. Instead, turn them into community centers during this time period. Classrooms could be used to conduct health education classes, hold support sessions for anxiety, and offer vocational courses to improve job skills. Gymnasiums could be used by local residents to play basketball or to run yoga and dance classes. Using the kitchen to show people how to cook healthy foods and then pass out free samples to all attendees could simultaneously improve life skills and reduce hunger. The sum total of opening a community center would be to reduce isolation and to promote exercise and healthy foods alternatives, all of which foster better mental health.^{18, 19, 20}

Third, New York City could use intergovernmental transfers to raise the capitation rates that that Medicaid managed care plans pay mental health providers, bringing them more in line with commercial insurance carriers.²¹ But even with higher reimbursement rates, many mental health providers still do not want to accept Medicaid because of the administrative burden. New York State is responsible for much of that burden and could pass legislation simplifying the entire claims process.²²  

Ultimately, New York City needs to invest in its people. At a minimum, there should be an expanded, full-service medical clinic on Guy Brewer Boulevard, open seven days a week and equipped with an urgent care unit for after-hours emergencies. Establishing a community mental health center where the “mentally ill…need no longer be alien to our affections,” as first articulated by President Kennedy in 1963, would be a second step in the right direction.²³ Ideally, these clinics would serve as anchor institutions within the South Jamaica community, spurring private investment and promoting entrepreneurship. Guy Brewer Boulevard could attract a bank, a competing grocery store, a dress shop and more.

All of this activity would go a long way to reducing anxiety.

References

1. Hamwey M, Norman C, Suss R, et al. The state of mental health of New Yorkers. New York City Department of Health and Mental Hygiene; 2024 May. Available from: https://www.nyc.gov/assets/doh/downloads/pdf/mh/state-of-mental-health-new-yorkers.pdf

2. Penninx BWJH, Pine DS, Holmes EA, Reif A. Anxiety disorders. Lancet. 2021 Feb 11;397(10277):914–927. doi:10.1016/S0140-6736(21)00359-7.

3. U.S. Census Bureau. DP04: Selected housing characteristics, ZIP Code Tabulation Area 11433, 2023 American Community Survey 5-Year Estimates. Washington (DC): U.S. Census Bureau; [cited 2025 May 19]. Available from: https://data.census.gov

4. New York City Department of Health and Mental Hygiene. EpiQuery: Community Health Survey – Health Care Access and Use. New York (NY): NYC Health; [cited 2025 May 19]. Available from: https://a816-health.nyc.gov/hdi/epiquery/

5. New York City Department of Health and Mental Hygiene. Community Health Profiles. New York (NY): NYC Health; [cited 2025 May 19]. Available from: https://www.nyc.gov/site/doh/data/data-publications/profiles.page

6. New York City Housing Authority. 2024 Fact Sheet. New York (NY): NYCHA; 2024 Mar. Available from: https://www.nyc.gov/assets/nycha/downloads/pdf/nycha-fact-sheet.pdf

7. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Prior HHS Poverty Guidelines and Federal Register References. Washington (DC): HHS; [cited 2025 May 19]. Available from: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines/prior-hhs-poverty-guidelines-federal-register-references

8. Ridley M, Rao G, Schilbach F, Patel V. Poverty, depression, and anxiety: Causal evidence and mechanisms. Science. 2020 Dec 11;370(6522):eaay0214. doi:10.1126/science.aay0214.

9. U.S. Census Bureau. S1810: Disability characteristics, ZIP Code Tabulation Area 11433, 2023 American Community Survey 5-Year Estimates. Washington (DC): U.S. Census Bureau; [cited 2025 May 19]. Available from: https://data.census.gov

10. Lee HC, Yang EH, Shin S, Moon SH, Song N, Ryoo JH. Correlation of commute time with the risk of subjective mental health problems: 6th Korean Working Conditions Survey (KWCS). Ann Occup Environ Med. 2023 May 11;35:e9. doi:10.35371/aoem.2023.35.e9. PMID: 37342827; PMCID: PMC10277206.

11. TransitCenter; Klumpentown Consulting. Average access to employment in New York City: 45-minute transit trips by demographic group, March 3, 2024. New York (NY): TransitCenter Equity Dashboard; 2024 Mar 3 [cited 2025 May 19]. Available from: https://dashboard.transitcenter.org

12. Lorenc T, Clayton S, Neary D, Whitehead M, Petticrew M, Thomson H, et al. Crime, fear of crime, environment, and mental health and wellbeing: Mapping review of theories and causal pathways. Health Place. 2012 Jul;18(4):757–65. doi:10.1016/j.healthplace.2012.04.001.

13. Stafford M, Chandola T, Marmot M. Association between fear of crime and mental health and physical functioning. Am J Public Health. 2007 Nov;97(11):2076–81. doi:10.2105/AJPH.2006.097154.

14. Rask KJ, Williams MV, Parker RM, McNagny SE. Obstacles predicting lack of a regular provider and delays in seeking care for patients at an urban public hospital. JAMA. 1994 Jun 22;271(24):1931–3. doi:10.1001/jama.1994.03510480055034.

15. Syed ST, Gerber BS, Sharp LK. Traveling towards disease: transportation barriers to health care access. J Community Health. 2013 Oct;38(5):976–93. doi:10.1007/s10900-013-9681-1.

16. Knaak S, Mantler E, Szeto A. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser. 2013 Sep 1;13(16):1–33.

17. Psychology Today. Therapists in ZIP code 11433 (Jamaica, NY). New York (NY): Psychology Today; [cited 2025 May 19]. Available from: https://www.psychologytoday.com/us/therapists/11433

18. Koskinen MK, Hovatta I. Genetic insights into the neurobiology of anxiety. Trends Neurosci. 2023 Apr;46(4):318–31. doi:10.1016/j.tins.2023.01.007.

19. Noetel M, Sanders T, Gallardo-Gómez D, Taylor P, del Pozo Cruz B, van den Hoek D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024 Feb 14;384:e075847. doi:10.1136/bmj-2023-075847.

20. Marx W, Moseley G, Berk M, Jacka F. Diet and anxiety: a scoping review. Nutrients. 2021 Dec 10;13(12):4418. doi:10.3390/nu13124418.

21. Karl AO, Herring A, Polk EC. Key takeaways for states, providers and plans on state directed payments and separate payment terms. Manatt Health. 2024 Jun 19 [cited 2025 May 19]. Available from: https://www.manatt.com/insights/key-takeaways-for-states-providers-and-plans-on-state-directed-payments

22. New York State Department of Financial Services. Report of the Administrative Simplification Workgroup. Albany (NY): NYS DFS; 2021 Oct 3 [cited 2025 May 19]. Available from: https://www.dfs.ny.gov/system/files/documents/2021/10/admin_simplification_rpt_20211003.pdf

23. Kennedy JF. Remarks upon signing bill for the construction of mental retardation facilities and community mental health centers [Internet]. Washington (DC): The American Presidency Project; 1963 Oct 31 [cited 2025 May 19]. Available from: https://www.presidency.ucsb.edu/documents/remarks-upon-signing-bill-for-the-construction-mental-retardation-facilities-and.