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 NYC Health Department’s Center for Health Equity launched three Neighborhood Health Action Centers (Action Centers), which use a place-based approach to improve health in neighborhoods with disproportionate burdens of premature mortality. We describe this approach and the genesis of the Action Centers. We then describe the East Harlem Action Center, which was the first to open, and share findings from qualitative interviews with the East Harlem Action Center’s Governance Council, a group comprised of Action Center staff and co-located partners and programs which supports Action Center coordination. Interviewees felt that collaboration, being responsive to community needs, and being community based were essential elements of the Action Center. Interviewees recognized the complex dynamic of a large city agency serving as the host for the Action Center while simultaneously aiming to establish more equitable relationships with partners. Governance Council members’ expectations and hopes for the East Harlem Action Center were consistent with the overall vision and model for the Action Centers, which may facilitate implementation.
Highlights
Though New York City (NYC) is one of the wealthiest cities in the United States, it is one of the most economically unequal and racially segregated
Governance Council members consistently spoke about collaboration as an essential element and important benefit of the Action Center model and shared ways that partners could collaborate: As we all get to know each other in the building and... we’re working together and with referrals, working on maybe even health fairs in the building, just different initiatives so people know we’re in tune with each other. -Co-located partner
We describe a health department-led placebased intervention which uses a health equity approach and we share early experiences from the East Harlem Action Center
Summary
Though New York City (NYC) is one of the wealthiest cities in the United States, it is one of the most economically unequal and racially segregated. The Action Centers build on the legacy of NYC’s District Health Center movement, which began in 1921 with a pilot project in East Harlem to co-locate health services, welfare agencies and community-based organizations to coordinate health and social services for the neighborhood [6]. In 2014, Dr Bassett was appointed Health Commissioner for NYC, and under her leadership advancing health equity became a clearly stated agency goal As part of this commitment to health equity, vacant or underutilized Health Department buildings in the District Public Health Office neighborhoods were selected to become Action Centers, serving as a way to reinvest in marginalized neighborhoods. The Action Center “neighborhood” is the community district in which the Action Center building is located, while the “catchment area” includes additional community districts that defined the District Public Health Office areas (Fig. 1)
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