Health Equity

Health Equity

As we work to make New York City more equitable, the de Blasio administration is focused on addressing health and wellness disparities in neighborhoods that have often been overlooked, underinvested in and disconnected from the resources and possibilities New York City has to offer, and public-private partnerships play a critical role in this effort.

Connections to Care

Mother and her baby at a doctor's office
Ensuring the positive mental health of New Yorkers is critical to creating a healthy City. Yet one in five New Yorkers experiences a mental health disorder in a given year and there are significant disparities in access to care across the City. Among New Yorkers who experience psychological distress—which disproportionately affects low-income individuals, the uninsured and those receiving public assistance—40% reported a time in the prior year when they needed treatment but did not receive it. Left untreated, mental health issues negatively impact other facets of life, including physical health, education, housing, and employment. In addition to this human toll, it is estimated that mental illness and related substance abuse issues cost New York City approximately $14 billion annually in productivity loss.


In 2015, as part of the ThriveNYC, the City's $850 million historic and holistic approach to address mental health needs, the Mayor's Fund, the Mayor's Office for Economic Opportunity (NYC Opportunity) and the Department of Health and Mental Hygiene (DOHMH) developed and launched Connections to Care (C2C), a $30 million public-private partnership that integrates mental health support at community-based organizations serving low-income New Yorkers. This innovative modelsupports collaborations between community-based organizations and licensed mental health providers, with the goal of increasing on-site care for program participants with lower-level mental health conditions and improving referral relationships with clinicians for participants in need of treatment.

C2C funds 15 high performing community-based organizations focused on workforce development, youth development and early childhood services to access the support and services of licensed mental health providers who conduct ongoing training and coaching in mental health practices for their staff. The C2C partnership with mental health providers also establishes robust referral relationships for clients in need of more in-depth clinical care. C2C targets three groups particularly at risk for unaddressed mental health needs: expectant parents and/or parents of children up to the age of four; out-of-school, out-of-work young adults ages 16 to 24; and unemployed or underemployed adults ages 18 and over.

Connections to Care builds the evidence base for "task-shifting," which maximizes the ability of program staff to support the mental health of their clients and better assess when clinical expertise is required. While task-shifting is still a relatively new practice in the United States, there is evidence that non-mental health professionals, with training and supervision, are able to detect, screen for, and provide initial support and care for individuals living with mental illness. Such practices have also been shown to be cost-effective in low resource settings. This approach serves to expand capacity in an overburdened mental health system by better allocating the attention of clinical professionals to cases that truly require it.

As of March 2018, the 15 participating community-based organizations had trained over 1,200 staff in at least one C2C modality and 15,000 clients had received services. Connections to Care is anticipated to provide mental health services to 40,000 New Yorkers over five years.

Building Healthy Communities

Building Healthy Communities

When it comes to health, ZIP code is sometimes more important than genetic code. Our health is affected by the environment in which we live and work and whether our neighborhoods have safe, clean, outdoor spaces where we can go to exercise, relax, play and learn. While access to hospitals and other health care services are crucial to well-being, these other "social determinants" are the bedrock of health.

We know that longstanding and rising income inequality, combined with a history of racial residential segregation and public disinvestment, has led to startling health inequities among neighborhoods. As a result, neighborhoods with the most neglected parks and open space, unsafe public space, and the lowest access to healthy food bear the heaviest burden of chronic disease and poor health. For example, life expectancy in Brooklyn's Brownsville is 10 years lower than life expectancy on the more affluent Upper East Side of Manhattan.

To create vibrant neighborhoods that nurture health, the de Blasio Administration has reinvested in areas that have been deprived of resources for too long and has aimed to foster a "culture of health" that is designed to prevent disease and promote healthy living. As part of this effort, Building Healthy Communities (BHC) was launched in 2016 as a public-private partnership to improve health outcomes in 12 chronically-underserved neighborhoods across NYC's five boroughs: East Harlem, Brownsville, Canarsie, Mott Haven, Hunts Point, Morrisania, Bedford-Stuyvesant, Central Harlem, Corona, Flushing, Mariners Harbor, and Stapleton.

BHC takes a system approach to social impact that focuses on connecting City resources to community-based partners and facilitating cross-agency collaboration to maximize collective impact. Philanthropy, small business and corporations have all played a role, working in tandem with a range of City agencies— from the Department of Health and Mental Hygiene, to the Department of Transportation and the Department of Parks and Recreation, among others—to leverage $318 million in public investment and unlock opportunities for private support to take this work further.

The initiative focuses on three key goals:

  • Increasing opportunities for physical activity
  • Expanding access to healthy and affordable food
  • Promoting public safety

BHC is founded on principles of giving residents the tools and resources to make empowered, collective decisions to shape their communities. The initiative includes a network of more than 150 community organizations and has awarded grants to 30 CBOs to increase access to physical activity, affordable foods and promoting public safety.

At the heart of the BHC initiative are the urban farms on New York City Housing Authority (NYCHA) properties, which provide NYCHA residents with the opportunity to plant and harvest fresh vegetables, trade food scraps used for compost for fresh food and enjoy beautiful, vibrant, fertile land on historically underutilized space. The Farms at NYCHA provide over 25,000 pounds of fresh produce per year to community residents. The farms have environmental benefits, including diverting 4,500 pounds of food scraps from landfills through composting and 1.8 million gallons of added storm water absorption annually. They also activate underutilized NYCHA space—over 70 farm stands and cooking demonstrations have occurred on the farms and in 2016, over 800 NYCHA residents volunteered on the farms and 3,000 people visited the farms.

In 2016, the City and its partners launched the New York City Soccer Initiative, a public-private partnership that will invest $3 million dollars from private funders to build and maintain 50 soccer fields and afterschool programming for 10,000 students in underserved neighborhoods over the next five years.

In addition, the partnership has resulted in 150 new instructors trained to lead language specific and culturally relevant fitness classes; four Youth Markets, farm stands run by young people and supplied by regional farmers; four Fresh Food Boxes—clubs that offer fresh produce for up to 50 percent less than retail; 11 community gardens growing and distributing fresh food locally; active design improvements in 14 schools to promote healthy play; support for nutrition education through school gardens and healthy cooking programs; small grants to 30 community organizations to lead walking tours, fitness programs, street closings and park programs; and 20,000 maps printed to promote healthy opportunities in multiple neighborhoods.