New York-Presbyterian is one of the nation’s most comprehensive, integrated academic health care delivery systems. It is partnering with local organizations to establish a Youth Opportunity Hub serving Washington Heights that will provide services including reproductive health services, dental and vision care, violence prevention training, art therapy, parenting support, sports and recreation, education advocacy, and learning disability screening. We spoke with Andy Nieto, Ambulatory Care Network Director of Community Health, as well as Alwyn Cohall, M.D., Janet Garth, MPH, and Erica M. Chin, Ph.D., (Co-Directors of the NYP Youth HUB) about some of the challenges facing youth and how CJII is supporting their work to address those challenges.

This article is part of our series highlighting CJII grantees and the work they’re doing to meet CJII goals of improving public safety and enhancing fairness and efficiency in NYC’s criminal justice system. Programs that support families and that prevent risky behavior in young people can encourage and support positive development and reduce the likelihood of involvement in the justice system. Through its Youth Opportunity Hubs initiative, CJII is focusing on building skills and supports among young people, families, and communities to help prevent crime because investing in efforts that prevent criminality is key to achieving public safety in the long term.

Q: How do you see the role of partnerships and coordinating services in achieving impact? In your experience, and as you develop the Youth Opportunity Hub at New York-Presbyterian, how are you building partnerships to ensure sustainability?

A: As the African proverb states, “It takes a village to raise a child,” we believe that the only way to improve health and social outcomes for youth will be to engage community stakeholders. We have extensive experience in working with traditional and alternative high schools, community colleges, workforce development programs, youth recreational programs, juvenile justices programs, faith-based partners, and community collaborators.

Each of these community collaborators have unique expertise and competencies. The CJII Youth Opportunity Hub investments provide the opportunity to further integrate and create a new and expanded family of care providers. Sharing operational practices and defining as collaborators common screening and engagement strategies will enable them to communicate shared and prioritized goals.

Q: What are some of the potential solutions you aim to provide with the CJII funding to support young people and help them succeed? 

A: Our Youth Opportunity Hub will provide comprehensive, holistic, integrated health and mental health services; academic support; recreational activities; and cultural programming for youth. Additionally, supportive services will be provided for parents and adult care-givers. Our aim will be to provide opportunities for vocational and academic development by offering mentoring, internships, SAT prep, and college preparation outside of the classroom. Our youth will collaborate with other NYP youth centered programs to participate in community service, which prepares them to be ambassadors in their community.

Q: What are some of the opportunities that young people are looking for, and what are some of the obstacles or challenges in trying to access those opportunities?

A: Some of the key factors affecting the trajectory of youth success outcomes can be attributed to social determinants such as poverty; dilapidated housing; crowded and under-resourced schools; and lack of social capital in their neighborhoods. Clearly, racism contributed historically to the initiation of social determinations and may continue to play a role in its continuation. These factors may also contribute to a tsunami of toxic stress, which is often overwhelming.  The results of chronic toxic stress are too often found in the increased rates of depression, anxiety, trauma, substance use, and obesity. The compound effect of these challenges are seen in suicide attempts, chronic illness, sexually transmitted diseases, unintended pregnancies, HIV, and justice involvement.

Here in the Heights, a little over half of our community was born outside of the United States, compared to the 36% average of New York City as a whole and 45% of the households in our community present with limited English proficiency. Navigating and identifying strengths for our bilingual and bi-cultural youth who are often translating the transitions with their families in NYC while defining their own identity needs to be a focus. In many ways, giving voice to our community and youth is a great need that we can all learn and improve on.

Our Hub will help provide the skills our youth need to participate in today’s information-age society with cultural awareness and civic responsibility. We will foster our youth’s self-esteem and help them achieve personal and academic goals. We will try to inspire them to go after their pursuit of career goals, and we will promote meaningful mentoring relationships with staff, faculty, residents, medical students, and hospital administrators. Our programming will assist youth to develop habits of good citizenship and a commitment to their local community.

Q: What are some of the real challenges in trying to remove or overcome those obstacles?

A: Coupled with significant threats to health and well-being are inadequate, fragmented, support and intervention systems in vulnerable communities. Community institutions often exist and operate in silos and are rarely integrated and interdisciplinary. As a result, safety nets have gaping holes which youth slip through and wind up in a free fall spiral that often, and sometimes inevitably, results in involvement with the justice system. When a young person is affected by multiple threats like poverty, trauma, learning differences, mental health needs, and poor health, it is exponentially more challenging for a young person and their family to navigate the multiple systems of care that they deserve and need. Taking a more holistic approach encourages providers to assess the risks, needs, and strengths of a family and young person. Additionally, being youth focused and minded, our interventions for high-risk clients and families can benefit from co-locating varied needed services with youth opportunity and recreational programming.

Q: Taking a step back, when you consider the Youth Opportunity Hub in the long term—the individuals you’re working with, their needs, community needs, long term outcomes, etc.—how would you say that the work of New York-Presbyterian is reaching toward larger system change? What does that system change look like? What else is needed to achieve larger system change?

A: We envision this initiative to be a model by which an academic medical center, in addition to graduate schools of public health, nursing, medicine, dentistry, and social work, designs and collaborates with community and governmental partners to create a system to support young people in their healthy and successful transition to adulthood and self-sufficiency.

Our CEO, Dr. Steven Corwin, often reminds us that we operate for the public good. Our institution is committed to improving community health and well-being. We recognize that social determinants are an important factor in improving the health of our community. Education, poverty, food insecurity, and violence contribute to poor health. The hub will allow us to further collaborate with our community to address these issues. The youth of Washington Heights/Inwood are vibrant, intelligent, talented and hardworking. We look forward to working with them to find ways to bring positive change.