New Book Explores Lessons From Columbia Community Health Partnerships

Special from The Record

April 20, 2011Bookmark and Share
The co-editors, Hernández-Cordero and Formicola (Image credit: Lynn Saville)
The co-editors, Hernández-Cordero and Formicola
Image credit: Lynn Saville

From 1998 to 2008, the Northern Manhattan Community Voices Collaborative helped 30,000 residents of Washington Heights, Inwood and Harlem get health insurance, immunized 8,000 children, trained 1,500 health workers and raised the area’s vaccination rate from 63 percent to 97 percent. Two leaders of the collaborative have edited a new book on how its lessons can be applied throughout the United States.

The book, Mobilizing the Community for Better Health: What the Rest of America Can Learn from Northern Manhattan, was published last November and details the 10-year collaboration’s failures and successes. Allan Formicola, dean emeritus of the College of Dental Medicine, the organization that led the collaborative, and Lourdes Hernández-Cordero, assistant professor of sociomedical sciences at Mailman School of Public Health, edited the volume.

The program brought together some 30 institutions and community groups led by Columbia University’s College of Dental Medicine, Alianza Dominicana, Inc. and Harlem Hospital Center. Northern Manhattan was one of 13 sites nationwide in the Community Voices program, an effort to improve health care access for the underserved funded by the W.K. Kellogg Foundation.

“The collaboration was based on this respect for our colleagues in the community, that it wasn’t just about Columbia coming and imposing their programming or their research projects,” said Hernández-Cordero.

Community Voices had identified high rates of asthma, high teenage pregnancy rates, drug use and violence as the major problems plaguing Washington Heights and Harlem, as well as low immunization rates among children and some 48,000 people without health insurance. In addition to its success in raising the number of insured residents and the vaccination rate, the program provided 4,000 families with improved asthma management.

“We spent a fair amount of time on the structure,” Formicola said of the program. “We also didn’t just go to the community and say, ‘We know everything and you need this.’ We did a survey with the community and wanted to find out what they thought were their main health problems, what bothered them most, and then set our priorities around their needs.”

As an undergraduate, Hernández-Cordero was studying chemical engineering at University of Puerto Rico when she realized she was spending more time organizing health promotion activities than working in the chemistry lab.

“I was in and out of the lab and really missed human interaction,” says Hernández-Cordero, describing her fifth year in engineering school. “At the same time, I was working at Student Health Services, mobilizing student organizations to take on community projects. I would always complete my monthly hours and then some. I loved it so much.”

Her fervor for community-based health led her to Columbia’s Mailman School, where she completed her doctorate in sociomedical science in 2004. She joined Community Voices as a student when the program began in 1998.

Community work has played a significant role in Formicola’s career from the beginning. He became dean of the dental college in 1978 and would see patients from the community with no access to preventive care, who suffered from dental disease and could not afford treatment. The experience led Formicola, who specializes in gum disease, to start Columbia’s Community DentCare Network, which provides dental care to underserved and uninsured residents in Northern Manhattan. He has developed several other community-based health programs.

When Formicola began community work as a dean at Columbia, the University’s ties to the surrounding neighborhoods were rocky. Columbia’s relationship with the community “has since come a long, long way,” Formicola said. “I’m a big believer in building solid community relations for universities. That’s what universities should be doing. We should be taking on some of these real and practical problems that people suffer with.”

Formicola’s hope is that more academic medical centers in the United States consider this community-based approach. “We would certainly make a big dent into the health problems we have in the United States,” he said.

—by Melanie A. Farmer