An article in the March issue of Health Affairs focuses on an emerging phenomenon, that of the pairing of community health and health equity efforts. In the report, entitled “For A Big-City Health Department, A New Focus On Health Equity,” Rebecca Gale focuses in particular on the Brownsville Neighborhood Health Action Center in Brooklyn.
“What makes the Brownsville Neighborhood Health Action Center unique isn’t the types of services offered, but the fact that they are available in a neighborhood that has historically had poorer health outcomes than other parts of the region,” Gale writes. “As part of the push over the past four years for more racial equity in health care across the city, DOHMH [the New York City Department of Health and Mental Hygiene] has sought to redefine what it means to be a big-city health department. The richest example of this experiment so far has been the creation of a small number of Neighborhood Health Action Centers, targeting three key neighborhoods that bear the highest disease burden in New York City: the South Bronx, East and Central Harlem, and North and Central Brooklyn—where the Brownsville Neighborhood Action Center opened its doors in June 2017.”
Indeed, Gale reports, “Bringing these no-cost services to Brownsville is part of a deliberate effort to create more equitable health outcomes throughout New York City. In 2014, with a new health commissioner, Mary Bassett, at the helm, DOHMH decided to make a change. Instead of evaluating programs in the context of public health and what could be done to change behaviors around actions such as smoking or diet, DOHMH added equity as a lens through which it studies public health outcomes. In 2015 it created the Center for Health Equity to advance this work.”
And, she notes, “Leaders at DOHMH now examine racial disparities as an aspect of health and consider relocating services so that they can target and be accessible to populations that have traditionally been underserved. This approach is also about shifting resources and staff away from DOHMH’s headquarters in Long Island City and bringing them closer to the people and organizations they serve. Anecdotes abound on how effective such shifts can be on local health and attitudes, as well as a neighborhood’s willingness to trust government services. But empirical data have been slow to come out, leaving many researchers and advocates to ask whether such a transformational model could work in other parts of the country.”
Gale’s report goes on to examine the nature of the concept of health equity, focusing on the Brownsville Neighborhood Health Action Center as an example of the emerging type of organization that is not only working to improve health status in its community, but also health equity activities—conscious efforts to try to help residents of underprivileged neighborhoods to be able to access decent healthcare in their communities, in the pursuit of enhanced health status.
