One Year After Launch, City Initiative Narrows Health Disparities in East Harlem

George Dawson never imagined he’d be back in school when he retired from medicine in the early months of the pandemic. But when COVID-19 took his younger brother, the longtime radiation oncologist found himself at LaGuardia Community College earning a certificate in community health work.

Now Dawson runs vaccine outreach events around Harlem as part of the NYC Public Health Corps, a Health Department initiative to incorporate ordinary New Yorkers into healthcare delivery and help underserved communities keep fighting COVID-19. As the program turned one year old on Sept. 29, Dawson has been putting his certification — and prior medical experience — to good use.

“I probably did 2,000 or 3,000 vaccinations in the first three months alone,” he said during an anniversary event at the East Harlem Neighborhood Health Action Center. “You can achieve so much just by meeting folks where they are.”

The pandemic has exacted a devastating toll on New York City, but the damage has been most pronounced in predominantly Black and Latino neighborhoods. In East Harlem, half the population has been diagnosed with COVID-19, and the death rate is nearly double that of Manhattan as a whole. Vaccination rates also lag behind the rest of the borough.

The Public Health Corps has sought to narrow these disparities by investing in local organizations and medical centers, and by stationing community health workers in hard-hit neighborhoods. Many workers have deep ties to the neighborhoods they serve, allowing them to build on existing relationships and tailor outreach to residents’ specific needs.

“Nobody around here knows people in the Department of Health,” said David Crenshaw, a community health worker and youth sports organizer in Harlem and Washington Heights. “But they do know Coach Dave has been pushing these vaccines. So there’s a big element of trust there.”

Under the Public Health Corps’ watch, vaccination rates in East Harlem have climbed to nearly 80%, up from 61% in September 2021. Meanwhile, community health workers have connected hundreds of residents to affordable housing, food pantries and other essential services.

“Our vision was to create a community-led … fully-resourced initiative to ensure that all New Yorkers can stay protected from COVID-19,” said Olusimbo Ige, assistant commissioner at the New York City Health Department’s Center for Health Equity and Wellness. “One year in, the difference in vaccination coverage between our neighborhoods of focus and the rest of the city has been narrowed and almost eliminated.”

The Public Health Corps has existed under two mayoral administrations, though Ige claims its operations weren’t affected when Mayor Eric Adams succeeded Bill de Blasio in January. She says the program will continue dispensing COVID-19 vaccines moving forward, focusing on getting booster shots in the arms of more seniors and increasing vaccination coverage among children under 12.

Dawson thinks the Public Health Corps should prioritize social services in its second year. He imagines a future where every primary care office in the city has a community health worker screening for social determinants of health.

“Medicine and pills are about 20% of healthcare,” he said. “The other 80% is housing, food security and having a decent job. That’s where our focus needs to be.”

About the author(s)

Illan Ireland is a student at the Columbia Journalism School covering East Harlem and health care around New York City.