HealthierNY, and Ms. Lisa Pivec, the director of Cherokee Nation Health Services, presented information about programs that have been developed and implemented with combined funding from REACH 2010 and Steps.

BRONX HEALTH REACH1

Ms. Ruddick presented information about Bronx Health REACH, a program operating in the south Bronx area of New York City. The Bronx REACH community is predominately made up people of color and the residents are very poor; this area is one of the poorest congressional districts in the nation. By almost every health measure, the Bronx Health REACH community falls short in comparisons to other New York communities and when analyzed against national statistics. The death rate for blacks with diabetes in the southwest Bronx is twice that of those living in the rest of New York City. Black men are more likely to get prostate cancer, and the death rate in the southwest Bronx is 50 percent more than the rest of New York City. These are just a few examples of the health disparities in this area.

The Bronx area has had a troubled past. In the 1970s, it was an area devastated by poverty and crime, and residents were fleeing. There was inadequate or substandard health care, housing, and education, among myriad other societal, social, and economic problems. Many of the organizations that had previously located offices in this part of the city, such as the New York City Department of Health and the American Diabetes Association, closed their offices and relocated to other areas. It was not until the 1980s and 1990s, when the Institute for Urban Family Health established itself by building health centers in the Bronx, that things started to turn around for this community. In 1999, CDC announced their initiative to address racial and ethnic disparities by awarding grants through the REACH program to communities across the country. The new Bronx Health REACH took the next year to plan a program for their community and worked to have the Bronx become a REACH grantee.

A Year of Planning

During the initial planning year, Bronx Health REACH conducted a literature review and held a series of 10 focus groups to help create and mold the coalition action plan. Very early it was determined that the community initiative would focus specifically on diabetes care and prevention, and the project would benefit the entire community, not simply one racial group. Hispanic and black residents were actively recruited to participate in the focus groups to ensure that the results of the discussions would repre-

1

This section is an edited transcript of Ms. Charmaine Ruddock’s remarks at the workshop.



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