The Neighborhood as a Unit of Change for Health: Early Findings from the East Harlem Neighborhood Health Action Center

Dannefer, Rachel; Wong, Barbara C.; John, Padmore; Gutiérrez, Jaime Mejía; Brown-Dudley, La'Shawn; Freeman, Kim; Roberts, Carl W.; Martins, Elana; Napier, Ewel; Noyes, Philip; Seoh, Hannah; Bedell, Jane; Toner, Cassiopeia; Easterling, Torian; López, J Romero; Manyindo, Noel; Maybank, Karen Aletha

doi:10.1007/s10900-019-00712-y

Cited by 21 publications

(25 citation statements)

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“…One such approach was the development of Neighborhood Health Action Centers (Action Center) as part of a neighborhood health strategy to invest in historically disinvested neighborhoods which bear disproportionate burdens of premature mortality. This strategy is comprised of three components that address social and institutional issues which affect health: co-location of services and a robust referral system; innovation in programs and policies, which incorporates data and resident feedback to shape programs, systems and policies; and community engagement, action and impact [10]. The first three Action Centers included East Harlem Action Center in Manhattan Community District 11, Tremont Action Center in Bronx Community District 6, and Brownsville Action Center in Brooklyn Community District 16 ( Fig.…”

Section: Introductionmentioning

confidence: 99%

“…An earlier evaluation of the Harlem Action Center focused on the early implementation outcomes of the first Action Center established, and gathered information from visitor surveys, monitoring of referral data, and qualitative interviews with stakeholders [10]. This current study expands on that evaluation with the specific intent to consider how the exchange of information, ideas and the formation of collaborative partnerships supported by the Governance Councils can contribute to a culture of health at the neighborhood level, as laid out in the RWJF's Systems for Action framework, specifically Area 2: Fostering Cross-Sector Collaboration to Improve Well-Being [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Building a Culture of Health at the Neighborhood Level Through Governance Councils

et al. 2020

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To explore facilitators and barriers to developing and sustaining collaboration among New York City Department of Health and Mental Hygiene's Neighborhood Health Action Centers and co-located partners, who share information and decisionmaking through a Governance Council structure of representative members. Semi-structured interviews were conducted in 2018 with 43 Governance Council members across the three Action Centers of East Harlem (13), Tremont (15), and Brownsville (15), New York City. Governance Council members identified collaboration through information-and resourcesharing, consistent meetings and continuous communication as valuable for fostering a culture of health in their communities. Immediate benefits included building relationships, increased access to resources, and increased reach and access to community members. Challenges included difficulty building community trust, insufficient advertisement of services, and navigation of government bureaucracy. The Governance Councils forged collaborative relationships among local government, community-based organizations and clinical providers to improve health and well-being in their neighborhoods. Sharing space, resources and information is feasible with a movement towards shared leadership and decision-making. This may result in community-driven and tailored solutions to historical inequities. In shared leadership models, some internal reform by Government partners may be required.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Building a Culture of Health at the Neighborhood Level Through Governance Councils

et al. 2020

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“…21 The Bureaus employ a place-based approach to advance health equity and address social determinants of health (SDH), recognizing the need to eliminate race-based health disparities to advance the health of all populations. [22][23][24][25] These Bureaus are charged with seeking innovative solutions to the interrelated challenges of poverty, racism, and poor health outcomes, and developing programming that responds to local issues to advance health equity. 23 In East Harlem, the Bureau found high rates of food insecurity among English, Spanish, and Mandarin Chinese (hereafter, Mandarin) speakers who participated in Bureau programs and identified the need to better understand this issue to inform program planning and respond to community needs.…”

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confidence: 99%

“Come with us for a week, for a month, and see how much food lasts for you:” A Qualitative Exploration of Food Insecurity in East Harlem, New York City

Nieves¹,

Dannefer²,

Zamula³

et al. 2022

Journal of the Academy of Nutrition and Dietetics

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Background Food insecurity refers to uncertain access to food on a consistent basis and the stress experienced by families who worry about having sufficient resources to provide balanced meals in their households. Food insecurity has a disproportionate influence on people of color. A robust body of evidence links food insecurity to poor health outcomes.Objective To document experiences of food insecurity among linguistically and ethnically diverse residents of the East Harlem neighborhood of New York City by exploring the ways in which food availability and cost intersect with household budgets, personal preferences, and shopping strategies.Design In-depth qualitative interviews were conducted with adult residents of New York City's East Harlem neighborhood to provide insights about the links between food insecurity, well-being, and quality of life.Participants/setting Thirty-seven adult residents of East Harlem were recruited through purposive sampling. Eligibility requirements included living in an East Harlem zip code (10029 or 10035); being aged 18 years or older; being the main food shopper and food decision-maker in the household; and speaking English, Spanish, or Mandarin Chinese. The study was conducted from February to May 2018. Statistical analyses performedInterviews were analyzed using a grounded theory approach. Codes were organized into broad thematic topics and cross-case analyses were conducted. ResultsParticipants discussed overall perceptions of food insecurity and seven themes related to the challenges of and strategies for coping with food insecurity: intermittent vs chronic food insecurity, shopping and budgeting strategies, pantries as a vital community resource, social support systems, food insecurity and health, frustration with an unjust system, and pride in "making it work."Conclusions To manage food insecurity, many study participants carefully managed food spending, dedicated substantial time to visiting stores and accessing food pantries, and relied on a public benefits cycle that left many without sufficient financial resources at the end of each month.

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“…This was a place-based model designed to cater to the historic inequities in the city. Such models, through information and resource sharing, are found to encourage continuous and organic collaboration within and beyond the councils and include external community organizations such as New York City agencies which aid in health services delivery (Dannefer et al, 2019; Pierre et al, 2020).…”

Section: Ideas For Reimagining Citiesmentioning

confidence: 99%

Cities and COVID-19: navigating the new normal

Khan¹,

Iftikhar

Ali

et al. 2021

Glob. Sustain.

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Non-technical summary Urban density is erroneously regarded as the main factor in the spread of COVID-19 in cities. A review of extant literature and findings from our case study of Karachi, Pakistan indicate that inequalities in income, healthcare, and living conditions play a key role in the spread of contagions along with government responsiveness to the pandemic. Moving forward, urban policies need to address these inequalities through changes in housing policies and decentralized governance systems. Cities must adapt to sustainable modes of travel, reduce digital inequalities, and encourage people friendly urban planning to become resilient in the face of pandemics. Technical summary COVID-19 has changed how urban residents relate to their cities. Urban centers have become epicenters of disease, which has raised questions about the long-term sustainability of high-density settlements and public transport usage. However, the spread of COVID-19 in cities is incorrectly attributed to urban density. Using the case study of Karachi, Pakistan, we find that inequality of income, healthcare, and living conditions is a major contributing factor to the spread of COVID-19. Data on positive COVID-19 cases, density, and socioeconomic status were obtained at the Union Council level from administrative districts of Karachi, Pakistan between March 2020, and July 2020. Despite low population densities, low-to-middle income neighborhoods in Karachi had a higher proportion of positive cases. Further, the experience of dense cities such as Hanoi in Vietnam and New York in the US differs regarding the spread of COVID-19. Hence, the government's response to the pandemic is also a major factor in containing the outbreak. Our findings suggest that a crisis in a city is exacerbated by its inability to take advantage of its density, inequality in the distribution of resources, lack of inclusiveness, and centralized governance mechanisms that make it difficult to respond quickly to situations. Thus, urban planning scholarship and practice should take an interdisciplinary approach to make cities equitable, inclusive, and adaptive. Social media summary Cities in the developing world have an opportunity for more resilient renewal in the post-COVID world.

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The Neighborhood as a Unit of Change for Health: Early Findings from the East Harlem Neighborhood Health Action Center

Abstract: Place-based approaches have been promoted as one way to reduce health inequities by addressing community-level factors that shape health, such as housing quality, healthcare systems, the built environment, and social capital. In 2016-2017, the

Cited by 21 publications

References 10 publications

Building a Culture of Health at the Neighborhood Level Through Governance Councils

Building a Culture of Health at the Neighborhood Level Through Governance Councils

“Come with us for a week, for a month, and see how much food lasts for you:” A Qualitative Exploration of Food Insecurity in East Harlem, New York City

Cities and COVID-19: navigating the new normal

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