NYU Langone Hospitals - Community Health Needs

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NYU Langone HospitalsCommunity Health Needs Assessment and Community Service Plan2019-2021Executive SummaryWho We AreDeveloping our Community Service PlanNYU Langone Health is one of the nation’spremier academic medical centers.Composed of NYU Langone Hospitals(“NYULH”) and NYU School of Medicine(“NYUSoM”), NYU Langone Health has atrifold mission: to serve, teach anddiscover. NYULH currently operates over30 ambulatory care facilities and fiveinpatient facilities: Tisch Hospital Kimmel Pavilion NYU Langone Orthopedic Hospital Hassenfeld Children’s Hospital at NYULangone NYU Langone Hospital–BrooklynEvery three years, all non-profit hospitals are required to create aCommunity Service Plan – a plan to offer programs that meet thecommunity’s top health needs. A Community Service Plan beginswith a community health needs assessment. This is a review ofcommunity data and information from community membersabout their health needs and priorities. This assessment shows uswhat health concerns the communities are experiencing and howwe can help address these concerns.In addition, Sunset Park Health Council,Inc., an affiliate of NYULH, is a FederallyQualified Health Center network, whichincludes nine primary care health centersin Brooklyn and over 40 school- andshelter-based extension clinics, under thename Family Health Centers at NYULangone.Completeassessment ofcommunities’ healthImplement programsfor the mostimportant healthconcernsIdentify mostimportant healthprioritiesReview to decide ifthe programs madea differenceNYULH is the principal teaching hospitalfor NYUSoM, which has trained thousandsof physicians and scientists since itsfounding in 1841. The faculty grouppractice delivers patient care at more than375 practice sites and has affiliations withthe Manhattan campus of the VeteransAffairs Health Care System and with theNYC Health and Hospitals facilitiesBellevue and Gouverneur in Manhattan,and Woodhull in Brooklyn.1DC 12/19/2019

Data ReviewedPublic Participation & PartnersWe reviewed data to understand who is living in ourpartnering communities including age, sex, race andethnicity, education levels, countries of origin andincome levels.We involved community residents and leadersthrough surveys, interviews, focus groups, andcommunity workshops.We looked at data from the New York CityDepartment of Health and Mental Hygiene’s mostrecent Community Health Survey to determine therange of chronic diseases and risk factors in eachcommunity.We also examined hospital admission andemergency department data to understand whouses these services and what are the healthconditions for which they seek care. And, inresponse to community input, we looked at dataabout the housing environment, including issues ofhousing instability and quality.Our Community Service Plan Coordinating Council,which includes leaders from NYULH and from ourcommunity partners, meets every three months tocoordinate programs and to make sure that they areon track. NYU Langone Hospital–Brooklyn’sadvisory structure includes the Sunset Park HealthCouncil as the community governing board; advisorygroups from different cultures; and program-specificadvisory groups, including the Teen Health Council.We also spoke to many public health experts in theCity and State Health and Mental HealthDepartments, the City Department of Education,NYCHA, the Department of Housing Preservationand Development, and other organizations,including community leaders, resident associations,faith- and community-based organizations,advocacy groups, and members of CommunityBoards. A list of people and organizations we spoketo and our partners is included in the full Plan.2DC 12/19/2019

Our Partnering Communities:Lower East Side and Chinatown, Manhattan & Sunset Park and Red Hook, BrooklynNYU Langone Hospitals serves communities of diverse people with a variety of health concerns. As with ourprevious Community Service Plans, the 2019-2021 Plan focuses on the Lower East Side and Chinatown inManhattan, and Sunset Park in Brooklyn. We also completed a needs and assets assessment in Red Hook,Brooklyn and are beginning to implement Community Service Plan programs there as well.These communities were selected based on the need for services and their general proximity to NYU LangoneHospitals. Although these communities are not geographically contiguous, they share important similarities,including the diversity of their populations, an infrastructure of strong community-based organizations, andpockets of poverty amidst gentrification.Community residents in our partnering neighborhoods share similar health concerns. Reducing tobacco use,preventing and addressing obesity and cardiovascular disease, and supporting families through earlychildhood and teen programs continue to be top priorities. In addition, our CHNA revealed a growing concernabout the intersection of health and social and economic needs, particularly housing, across all communitiesand partners. These priorities are described briefly below, followed by a brief description of our evidencebased programs, which respond to these community needs and address health disparities.3DC 12/19/2019

Our PrioritiesPREVENTING CHRONIC DISEASEPROMOTING HEALTHY WOMEN,INFANTS, AND CHILDRENBy Reducing Tobacco UseSmoking rates in New York City have dropped. Only about13% of New Yorkers now smoke. But 16% of low-incomeNew Yorkers smoke. The smoking rate for Asian men in NewYork City is even higher (over 23%) and they are more likelyto be heavy smokers than other racial and ethnic groups.The rates of smoking in the Lower East Side/Chinatown andSunset Park, communities with large low-income Asianpopulations, remain higher than the rest of the City.By Addressing the Intersection of Health andHousingIn recent years, there has been a growing recognition of theintersection of housing and health. Many studies havedocumented the link between housing instability and poorhealth and increased need for health care services.Homelessness increases risk for chronic and infectiousconditions and mental health issues. Severe rent burden,overcrowding and eviction can lead to stress, depression,anxiety and diminished access to care and medications.Structural issues and mold and pests can cause respiratoryproblems and falls and other injuries. Housing instabilityand quality are priority social determinants of health in all ofour partner communities.Mothers and children who are exposed tostress are at risk for many health problems.In New York State, mother and child healthhas not improved over the past decade and,by some measures, has gotten worse.Poverty puts mothers at risk for depressionand problems during pregnancy and putschildren at risk for poor health anddevelopmental problems. Many lowincome families in the Lower East Side/Chinatown, Sunset Park, and Red Hook aresubject to these stresses and at risk for poorhealth outcomes.By Preventing and Addressing ObesityChildhood obesity continues to be epidemic throughoutNew York City. It is more common in low-income urbancommunities where neighborhood resources – like healthyfood and safe places for physical activity – may not beavailable. Although the rates of obesity in the Lower EastSide/Chinatown and Sunset Park are no higher than the NewYork City average (25% as of 2014), low-income children inboth communities are vulnerable, and preventing andaddressing obesity is a high priority for community residentsand leaders. For the large immigrant populations in SunsetPark and the Lower East Side/Chinatown, addressing healthyeating and physical activity in early childhood can preventlater generations from developing obesity and diabetes.4DC 12/19/2019

Implementing Programs That WorkPREVENTING CHRONIC DISEASETobacco Free Community helps smokers get accessto treatments and counseling to help them quit andworks to reduce children’s exposure to secondhandsmoke. It is being offered in the Lower EastSide/Chinatown and in Sunset Park in partnershipwith Asian Americans for Equality and the AsianSmokers’ Quitline. The navigator program isreaching out to NYCHA residents, who may bestruggling to comply with the smoke-free housingrequirements. In addition, the Charles B. WangCommunity Health Center is spearheading a Citywide coalition to raise awareness and to expand thenavigator program across the City, with a focus onimmigrant populations, and their Teen ResourceCenter is developing an education and outreachprogram about tobacco and e-cigarettes.The Health Housing Project is a program inpartnership with Henry Street Settlement, NYCHAand Wavecrest Management in which CommunityHealth Workers helped residents in two buildings onthe Lower East Side by connecting them to neededhealth and social services.Goals: Support healthier eatingIncrease physical activityDecrease smokingImprove access to health care and socialservicesImprove management of health problemsDecrease need for emergency care andhospitalizationsGoals: Increase knowledge about services andmedications to help smokers quitIncrease use of services and resourcesIncrease support for smoke-free housingDecrease rates of smokingThe program is being continued by WavecrestManagement in partnership with Henry StreetSettlement.5DC 12/19/2019

Healthy Habits Program/Programa de hábitossaludables consists of 12 multi-disciplinary sessionsfor 9–11 year olds and their parents. Each sessionincludes customized nutrition education, familymeal preparation, support groups for parents andchildren, and a physical fitness activity. The programis culturally tailored and is conducted in English andSpanish.Goals: Stabilize the participating child’s BMISupport child and family behavior changebased on 5-2-1-0: Fruit and vegetable consumption (5 ormore fruits and vegetables per day) Daily screen time (2 hours or less ofrecreational screen time per day) Physical activity (1 hour or more of dailyphysical activity) Sugar-sweetened beverage consumption(0 sugary drinks).Greenlight works in pediatric offices to improveparents’ understanding of health and healthybehaviors for children starting at age two months.The Greenlight program for Chinese Americanfamilies has been developed in partnership with theCharles B. Wang Community Health Center and isbeing extended to the Seventh Avenue FamilyHealth Center in Sunset Park. The programcomponents include: Easy to read booklets and helpful tools (forexample portion sized snack cups) to supportphysician counseling of patients; Training providers how to communicatehealth messages; Waiting room program where healtheducators promote family engagement andsupport Greenlight messages.Goals: Increase parent knowledge about nutrition,physical activity, and healthy lifestylesIncrease parent engagement and confidenceSupport healthier eatingDecrease TV and computer timeIncrease activity6DC 12/19/2019

REACH FAR Brooklyn (Racial and Ethnic Approachesto Community Health for Asian and Arab Americansin Brooklyn) prevents heart disease by increasingaccess to healthy foods and providing healthcoaching and blood pressure monitoring. Theprogram is located in two mosques in the Lower EastSide in Manhattan and is being extended to twomosques in Sunset Park. A new effort adds aCommunity Health Worker component focused ondiabetes prevention and management.Goals: Promote healthier eating at home andcommunal mealsSupport better blood pressure controlIncrease knowledge about heart diseaseIncrease knowledge about diabetesprevention and management7DC 12/19/2019

PROMOTING HEALTHY WOMEN, INFANTS, AND CHILDRENThe Video Interaction Project (VIP) is an evidencebased parenting program that uses videotaping andtoys, books and resources to help parents utilizepretend play, shared reading, and daily routines asopportunities for strengthening early developmentand literacy in their children. VIP sessions takeplace in pediatric clinics on days of routine wellchild visits, and at each session families meetindividually with an interventionist forapproximately 25 minutes.Goals:ParentChild (formerly called Parent-Child HomeProgram) is a national, evidence-based early literacy,parenting and school-readiness program that serveslow-income immigrant families in Sunset Park.Through intensive home visiting, ParentChild makesa significant difference in the lives of in-need youngchildren and their families. Promote positive parenting activitiesIncrease the availability and use of learningmaterials in the home that support positiveparenting activitiesEnhance parent capacity to cope withstressorsGoals: Build positive parent-child verbal and nonverbal interactionDevelop and promote positive parenting skillsDevelop early literacy skills that are essentialfor school readinessEnhance children’s conceptual and socialemotional development8DC 12/19/2019

ParentCorps works with teachers and parents inearly childhood and pre-kindergarten programs tostrengthen family involvement in children’seducation and help teachers and parents createenvironments that improve child health, behaviorand learning. This program will continue inUniversity Settlement sites and expand to developdigital supports for pre-kindergarten programs inSunset Park.Goals: Project SAFE employs an evidence-based youthdevelopment approach to prevent teenpregnancy, HIV/AIDS, and other sexuallytransmitted diseases. The program includesevidence-based sexual health workshops, peer-ledhealth education groups and community events,sexual health services designed to meet theunique needs of teens, and workshops for youthworkers and parents. Goals: Increase teens’ knowledge about pregnancyprevention, sexually transmitted diseasesand HIV/AIDSIncrease skills and behaviors that reducethese risksIncrease knowledge of HIV status Tailor ParentCorps products and services tomeet the needs of pre-kindergartenprograms and families in Sunset ParkSupport all pre-kindergarten programs inSunset Park with ParentCorps digitalresourcesIncrease parent involvement in learningPromote strong parent-teacher relationshipsFoster positive home and classroomenvironmentsIncrease child social-emotional learningIncrease healthful behaviors9DC 12/19/2019

CROSS-SECTOR CAPACITY BUILDING INITIATIVESThe Brooklyn Health and Housing Consortium todevelop relationships and infrastructure, and buildcapacity to support people with health and housingneeds, with an initial focus on Southwest Brooklyn.The Community Health Worker Research andResource Center (CHW-RRC) to serve as a resourceto community-based organizations, health systems,municipal agencies, and research organizations thatare planning, or seeking to strengthen, CHWinitiatives. The CHW-RRC will help develop, supportand evaluate programs that use lay health workersto enhance care, link services, and improvecommunity health.The Brooklyn Data Station to support partnershipsand foster collaborations that aim to improvepopulation health in Sunset Park, Red Hook andother parts of Brooklyn. The Data Station serves asa shared data and resource repository, supporting aknowledge network and a forum to translatefindings into action to improve health.The Red Hook Community Health Network toaddress residents’ health and social service needsthrough organizational capacity-building and linkageto resources within and beyond Red Hook. Theinitiative is being designed in close partnership withThe Alex House Project, Good Shepherd Services,Red Hook Community Justice Center, and Red HookInitiative following an in-depth Red HookCommunity Health Needs and Assets Assessmentcompleted in fall 2018.An initiative to address social determinants ofhealth, which will pilot a system throughout theFamily Health Center network to provideassessment, referral and follow-up services,engaging a wide array of community agencies,including economic development and legal services.10DC 12/19/2019

Tracking Progress & Evaluating ImpactOur Coordinating Council, composed of community partners and NYULH program leaders, will continue tomeet every three months to track and measure the progress of all of the programs. In addition, each programcollects data about how many people are participating, whether they are satisfied with the services, and whatimpact the program is having on people’s health and well-being. This is done through attendance records,surveys, and other information available about the health of the community. More information is available inthe full Community Service Plan.What’s Next?We will continue to work with the community and our partners to understand community needs and to planand monitor progress on our goals for each of the programs. In addition, we are partnering with organizationsthat represent the Arab American community in Southwest Brooklyn, to conduct a Needs Assessment tounderstand health needs and priorities.Our Core ValuesPerformance – Respect – Integrity – Diversity – ExcellenceCopies of the full Community Health Needs Assessment & Community Service Plan 2019-2021 can be downloaded from theNYU Langone Health website at: th-needs-assessment-service-plan.For questions and comments, please contact Sue A. Kaplan, JD, Research Associate Professor and Director of the CommunityService Plan, Department of Population Health at: sue.kaplan@nyulangone.org or Kathleen Hopkins, Vice President forCommunity Programs, Family Health Centers at NYU Langone Health at: kathleen.hopkins@nyulangone.org.11DC 12/19/2019

NYU Langone Hospitals Community Health Needs Assessment and Community Service Plan Who We Are NYU Langone Health is one of the nation’s premier academic medical centers. Composed of NYU Langone Hospitals (“NYULH”) and NYU School of Medicine (“NYUSoM”), NYU Langone He

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