Health on the Margins is a limited investigative series from Radio Catskill exploring the Catskills region’s fragile healthcare systems.

Over the last two decades, the availability of healthcare services in the Catskills region has declined. The few community hospitals in the region have consolidated or closed, leaving thousands of patients rerouted to other counties for care. For women, children, and older adults, the options are even slimmer and further.

Meanwhile, opioid overdoses in Sullivan County are down, but the county still leads as one of the highest per capita overdose rates in New York State. Just as progress takes shape, critical community services for people with substance use issues have gradually vanished over time.

Health on the Margins digs into how we got here – and where the region may head next.

EPISODE 1: After Leading New York State in Overdoses, Sullivan County Enters New Phase in Fight Against Opioids 

Opioid overdose deaths are down in New York state. But for many families still grieving or struggling, the fight is far from over. As the state enters a new phase in its fight against substance use, the question remains: what will it take to move people from surviving an overdose to living a dignified life?

EPISODE 2: Advocates Say Opioid Settlement Funds in New York Are Still Too Slow to Arrive – and Hard to Track

New York has secured over $2.5 billion in opioid settlement funds that it says will be distributed over the next 18 years. But how much of those dollars has actually improved rural communities most affected by the opioid overdose crisis? That remains relatively unknown.

EPISODE 3: Women’s Health Services Are Growing Farther Away. So Where Are Patients Turning?

In 2020, Sullivan County lost its only Planned Parenthood clinic. The next nearest Planned Parenthood clinic in Goshen closed four years later, along with three other upstate locations. Now, under President Trump’s changes to Medicaid eligibility, healthcare providers worry that access to women’s health services will grow even farther from home.

EPISODE 4: Aging in Place: Senior Care, Caregivers, and the Rural Safety Net

In Episode 4 of Radio Catskill’s Health on the Margins, Patricio Robayo looks at what “aging in place” really takes—and why winter can turn small warning signs into emergencies.

EPISODE 5: Rural Families Still Without Child Care Assistance 7 Months Later, Despite Hochul’s Child Care Push 

Daycares are a lifeline for families: they provide parents and children structure, help build kids’ social skills, and offer weekly support for working families.

But Sullivan County’s childcare assistance program has been on pause since July 2025. The program currently serves about 650 children. Radio Catskill’s Kimberly Izar reports on the future of rural childcare.