Neighborhood Health Action Centers

New York City, United States

The Action

The Neighborhood Health Action Centers (NHACs) aim to promote health equity by revitalizing underutilized city health buildings in key neighborhoods, grouping together health and social services, catalyzing community responses to health disparities, and confronting the legacy of institutionalized racism in the city. At any Action Center, co-located services provide access to primary care, mental health care, and, in some cases, dental care. Residents can also get referrals to a network of social services, join health and wellness classes, and use shared meeting spaces. By taking a holistic approach to health care and social services, providing spaces for community organizing and planning, and partnering with community-based organizations, the model seeks to link up and better leverage community and government assets to address health disparities. 

Democracy Challenge

The best policy comes from listening to and working with communities to identify, measure, and solve problems. But too often, policymaking is an insular, expert-driven process that takes place inside professional offices. It is not out in the streets, connecting with residents as they access core services.

How It Works & How They Did It

New York created its first neighborhood public-health centers nearly 100 years ago to cope with rapid urbanization and it has revived the model in the 21st century to address persistent social inequity. In 2003, district public health offices (DPHOs) were established in neighborhoods that had been deprived of resources: the South Bronx, East and Central Harlem, and North and Central Brooklyn. Those offices created a strong and trusted model for working with community members to understand and address health issues.

In 2014 the NYC Department of Health created a dedicated Center for Health Equity to better address the health impacts of injustice and discrimination. Building on the DPHO model, the Center launched Neighborhood Health Action Centers (NHACs) in 2017 in East Harlem, Brownsville (Brooklyn), and Tremont (Bronx.) The Action Centers are designed to do three things:

• Provide an array of health and social services under one roof,
• Create a space for diverse groups to take action to address systemic and institutionalized injustice, and
• Use data, evidence-based practices, and community expertise to support policy innovation around the root causes of illnesses and disease.

Partnerships and participation are core to the model. Community organizations and city agencies partnering with the Center are obligated to participate in a governance council. Marketing for the Centers pitches them as a place to be seen, heard, and understood, emphasizing trust and inclusion as much as transactional health services.

How’s It Going?

The Brownsville Health Action Center offers special services for new parents. It partners with the Brooklyn Perinatal Network and Healthy Start Brooklyn, and it houses the Brooklyn Breastfeeding Empowerment Zone (BBEZ), another initiative of the city’s Center for Health Equity. Events include a Baby Cafe where breastfeeding mothers can access free lactation services and a support group. BBEZ plans to advocate for breastfeeding-friendly policies in all three communities where HACs are located.

The East Harlem Health Action Center serves as a home base for community non-profits, including Concrete Safaris, which empowers youth to change their communities and lead healthy lives, SMART, which educates women about living with HIV; Public Health Solutions, which provides health insurance and access to nutrition; and Association to Benefit Children, which provides mental health support to children and families. There are also organizations that are temporarily housed in the Action Center that provide other services including legal housing assistance and workforce development.

Point of Contact

John Padmore

Neighborhood Health Action Center Manager

Who Else Is Trying This?

• Alexandria, Virginia, US: The long-running Neighborhood Health program provides physical, psychological, pediatric, dental, and HIV/AIDS treatment programs to city residents regardless of ability to pay. Services are grouped together in several clinics throughout the city and in neighboring counties.
• Lake County, Colorado, US: Lake County Build a Generation works with residents and policymakers to understand and address the full range of issues affecting young people’s health, using a Collective Impact model as well as grassroots community organizing. In particular communities, such as ski-resort workers from Latin America, this might include addressing low wages, poor food access, limited recreation opportunities, segregation and substandard housing. Build a Generation began as a community board tasked with preventing substance abuse among young people, using the Communities that Care model. But they came to recognize that youth and their families are facing a much broader array of challenges, so the group led a two-year collaborative process to develop a Youth Master Plan. When the plan was published, the organization merged with the Lake County Public Health Agency to lead implementation. Read more
• Levanger and Verdal, Norway: In 2012 these twin cities formally acknowledged public health and social inequality as priority challenges. This aligned with a national push for Health in All Policies, but the cities still did a lot of work to justify the commitment and build a local approach to a sustainable public health economy. They analyzed local survey data to show the steep disparities in health and well-being, and they put faces on the numbers by interviewing vulnerable residents and then recording dramatized versions of their lives with local actors and music. They developed a conceptual framework for building health that emphasized empowerment, co-creation, and co-design. They restructured a planning process which had previously produced 110 fragmented, unrealized plans. The new process was participatory and integrated, resulting in seven ‘partial plans’ which all considered health and could share data and insights across sectors. Read more

This action was originally developed for Big Bold Cities, an initiative of Living Cities and the National Democratic Institute (NDI); republished here with the permission of Living Cities.