Ramon Mosquea, a 58-year-old heavy set Dominican, looked away nervously and winced as a small needle pricked his finger to draw blood for a glucose reading.
A couple of drops of his blood were inserted in a glucose-monitoring machine. The reading revealed that Mosquea, a cabbie for 20 years, had a blood glucose level of 206 milligrams per deciliter – a level high enough to diagnose him as diabetic.
“Wow!” Mosquea exclaimed when he saw his reading. “It’s never been that high before!” he said in Spanish, promising he’d make an appointment with his doctor as soon as possible.
Taxi drivers like Mosquea are highly susceptible to a number of health problems because of their sedentary lives spent sitting behind the wheel, studies have found. Drivers are often forced to eat on the go, making fast food their easiest option. Few of them get any exercise whatsoever, and often suffer from back, hip and leg pain from sitting in a car all day. This lack of exercise combined with a bad diet has led to high rates of diabetes and high blood pressure among cabbies, according to health experts. Many of them even have kidney problems because they frequently can’t find a place to park when they need to use a bathroom.
Vulnerable Population
A 2001 survey by the New York Taxi Worker’s Alliance found that more than 20 percent of drivers had cardiovascular disease or cancer.
And it is often difficult for taxi drivers to get the health care they need. Another study conducted by the city council in 2009 found that 52 percent of the city’s cabbies are uninsured, twice the rate of the average American.
Drivers often face language and cultural barriers to health care access as well. A 2006 study by a taxi industry consultant found that 91 percent of the city’s taxi drivers were born in another country.
But fortunately for drivers like Mosquea, hospitals and healthcare initiatives across the city are offering an increasing number of free health screening and information programs aimed specifically at taxi drivers.
Making Health Services Available
Mosquea’s glucose test was provided by Lincoln Hospital’s taxi driver outreach program. Maria Ramos, who founded the program, is the daughter of a cab driver who died of a heart attack.
“He never took care of himself,” she said of her father. “Every day he would say his chest hurts, his back hurts.”
Ramos said that demand for the taxi drivers health program has been steadily growing. The program visits taxi bases in the Bronx providing screenings, health information and flu shots. Lately Ramos has been getting requests from taxi bases in Queens and Harlem for the program to provide services there as well.
Part of the reason the program is in such high demand, Ramos said, is because most drivers work 60 to 70 hours per week, and they rarely have the time to go see a doctor. She remembers sometimes her father would come home for only a half an hour of sleep before heading out for another shift. Many taxi drivers also have stress-related problems from the long work hours spent navigating New York City’s hectic traffic.
“Many of them need to see a psychiatrist,” Ramos said.
Rafael Arias, a 62-year-old cabbie who has been driving taxis for 17 years, also received a glucose and blood pressure screening from Lincoln Hospital’s program. He said that a year and a half ago he had to have surgery because of a buildup of blood in his brain. The doctor told Arias that without the surgery he could have had a stroke. Arias said that he felt a great deal of stress from work at the time, and that his stress was partially to blame for his condition.
“If the blood went over here, I’d be dead,” Arias said, pointing to his right temple. “The doctor told me I’m a very lucky guy to be alive.”
Providing Services
Marcelo Villagran, an outreach coordinator at Lincoln Hospital, administered glucose tests for Mosquea, Arias and other drivers at the Prestige Car Service on Webster Avenue in the Bronx on a recent Tuesday. Villagran has been partnering with Maria Ramos to screen drivers for high blood pressure and glucose at taxi bases across the Bronx for four years now as part of the hospital’s taxi driver health outreach program.
That Tuesday Villagran turned the entry hallway of the Prestige Car Service taxi base into a small medical clinic. The drivers lined up to receive their free screenings from Villagran, who also gave out doctor referral forms and information pamphlets in both English and Spanish on diabetes and heart disease. He also gave the drivers $25 gift cards to supermarkets to discourage them from eating fast food, as well as cases of water bottles, telling them to drink water instead of soda.
One of the drivers said that he hadn’t seen a doctor in three years. Many of them said they don’t regularly see a physician, and rely on programs like Lincoln Hospital’s for their health care.
Even Rafael Arias said that he hadn’t seen a doctor since his brain surgery a year and a half ago. But after his blood pressure reading from Villagran was much higher than normal, Arias said he would try to set up an appointment soon to see one.
Hazards of the Job
Villagran said that more than 60 percent of the drivers at any given base have high blood pressure, more than twice the rate of average Americans.
“All of the drivers, they drink all soda and beer, they don’t eat healthy, they don’t exercise,” said Jose Hernandez, who manages the Prestige Car Service taxi base.
Hernandez was a driver himself for 17 years, and is diabetic. He said that more than half of the drivers at the base were also diabetic.
“They always sit. I should start an exercise program for these guys,” he joked.
One taxi driver health initiative found an unusual but effective way to get drivers out of their cars and start to exercise. The STEP program conducted by Memorial Sloan-Kettering Center and the South Asian Council for Social Services gave pedometers to taxi drivers like Pritpal Singh, an Indian immigrant who has been driving a cab for four years, and encouraged them to walk more by counting their steps each week.
“Our work is very hard, taxi driving,” Singh, who works 11 hours a day, Monday through Saturday, said. “But if we don’t exercise, then in the future we will have to take lots of medicine.”
Singh said that when he started using the pedometer at the beginning of last year he typically took 2-3,000 steps per day. After a few weeks with the pedometer he was taking more than double that number, and his weekly blood pressure readings showed a significant improvement. Singh said that he and other drivers in the program used to sit and play cards while waiting to pick up customers at the airport, but now they take walks together with their pedometers.
Dr. Francesca Gany, the lead researcher for the STEP program, said that about half of the participants increased their step count significantly. Some even requested pedometers for their friends and family.
For his part, Singh has become a serious ambassador for exercise. After he started using the pedometer, he began doing yoga for a half hour with his family each day after work. He said he always takes the stairs up to his sixth floor apartment, and jokingly chides his children for taking the elevator.
He also said that he tries to convert other drivers to exercising whenever he gets a chance.
“I ask other drivers if they exercise. They always say, â€No.’ I say, â€Why? It is good for your future. Come, let’s go for a walk.’”
