The Academy in the City

A LEGACY OF HEALTH, HISTORY AND PROGRESS

WHY URBAN HEALTH?

ON THE FRONTLINES FOR HEALTH

LOOKING BACK TO INFORM THE FUTURE

INTEGRITY EQUITY HERITAGE COMMUNITY EVIDENCE-BASED COLLABORATION

4

DIVERSITY

Dear Friends and Colleagues: If there is one thing we can rely on, it is the inevitability of change. From one day to the next, one city to the next, and one administration to the next, our world is in a constant state of flux. Any healthy organization must be able to adapt to change and be willing to test the relevance of its traditional mission against the needs of society.

Since its founding, the Academy has been committed to promoting the health of people in the City of New York and, in the modern era, in cities across the nation and worldwide. As nearly 80 percent of the United States population lives in urban areas, along with the majority of the global population, our mission couldn’t be more relevant and important.

Though specific health problems have changed over time, the Academy has proved to be a resilient and effective agent for tackling them as they arise, and for identifying future threats that others may not yet be addressing. In the face of great shifts in our political climate, our work to promote prevention, reduce chronic disease, and prepare the city to be age-friendly remains critically important.

Committed to our core values—integrity, equity, heritage, community, evidencebased policy and research, collaboration, and diversity—we work to influence and inform health decisions every day with our many partners, both public and private.

In the next few pages, we will share some of the most exciting parts of the Academy’s story—past and present—including stories about many of the lives we have touched.

We hope you will enjoy this look back on the Academy’s achievements over the last ten years. The stories you are about to read were written by award-winning journalists, including a prominent Fellow and winners of the Academy’s prize for Urban Health Journalism.

8 A Legacy of Health, History and Progress Susan Dominus Highlights of the Academy’s 170-year legacy of advancing urban health.

28

62

Gotham: NYC At-A-Glance

Icon: Culture Happens Here

Leadership Lessons

Health and well-being by the numbers in the world’s greatest city.

Action! Film and TV happens at the Academy. Were we in your favorite show?

for 2017 and Beyond

INSTITUTE FOR URBAN HEALTH

6

A Q & A with Jo Ivey Boufford, MD.

14 Why Urban Health?

Alana Semuels Cities are tough places for some to live long, healthy lives, while others thrive.

22

30

38

Following the Evidence: Making the Case for Change

The Power of Partnership

Community Comes First

Brie Zeltner

Brie Zeltner

Katherine Hobson

Breaking through barriers to bring people together moves policy and makes change.

Listening to New Yorkers—the real experts on urban health.

How science and great ideas combine to create healthier cities.

FELLOWS

TABLE OF CONTENTS

48 On the Front Lines for Health Kiri Oliver Learning, collaboration, fellowship and friendship, while advancing health in the city.

52

Healthy Aging: A New Interdisciplinary Approach

Nurses: Critical Partners in Improving Health

LIBRARY

50

54 Looking Back to Inform the Future Randi Epstein The treasures of a world-class library and a one-of-a-kind collection.

56

60

Festivals & Series

Preserving Heritage and Health

Programming from the Library that spans from 2013 to 2017.

Arlene Shaner A unique collection of treasures from the past.

“ Cities have the capability of providing something for everybody, only because, and only when, they are created by everybody.” ― JANE JACOBS, THE DEATH AND LIFE OF GREAT AMERICAN CITIES

RAPIDLY AGING POPULATION

FROM 2010

IN OLDER ADULT POPULATION IN THE

NEXT 25 YEARS

IN 2017 MORE THAN

1 MILLION RESIDENTS WILL BE OVER

6

IN NYC

“I believe that health does not occur in the doctor’s office or the hospital only—it also occurs where we live, where we learn, where we work, where we play and where we pray—so health is in everything that we do.” ― FORMER SURGEON GENERAL, REGINA BENJAMIN, MD

“ Prevention is better than cure.” ― DESIDERIUS ERASMUS

{

HAD ACCESS TO HEALTHIER FOOD MOVED MORE

OF NEW YORKERS COULD LIVE

YEARS LONGER

IF, AMONG OTHER THINGS, THEY:

SMOKED AND DRANK LESS HAD MORE SOCIAL SUPPORT

“ Our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the

― ATUL GAWANDE, MD, MPH, BETTER: A SURGEON’S NOTES ON PERFORMANCE

7

last chapters of everyone’s lives.”

8

The New York Academy of Medicine establishes a home at 1216 Fifth Avenue, NYC, illustration 1926.

1847

A LEGACY OF HEALTH, HISTORY AND PROGRESS

Supports laws requiring the registration of births, deaths, and marriages Beginning of the Library

The Academy held its first Stated Meetings at the Lyceum

much of the Academy, reflected an

unusual meeting took

organization that was once devoted to

place in an unusual room

establishment medicine.

of Medicine, on upper Fifth Avenue.

The room, formal and high-ceilinged, was decorated with fine historical etchings that, upon inspection, depicted anonymous skulls and skeletons, images that were nods to the rigors of medicine.

The images also served as a reminder of legislation the organization sponsored back in the early 20th century that allowed for the legal obtaining of autopsies, attempting to overcome cultural reservations about the practice, with a new emphasis on modernity and research. Both are values the Academy has championed since its inception, in 1847, when it was first established as an institution devoted to advancing the medical profession, bringing physicians together in a collegial environment

The meeting, however, represented

Critical in passing state law to prevent the adulteration of milk

perfectly another legacy of the institution, that of a champion of urban and community health, both of which were an especially important emphases for Jo Ivey Boufford, MD, who became president of the Academy in 2007 with the intention of fostering policy in those spheres.

The guests visiting, a group of around 75 older residents of East Harlem, speaking Chinese, Spanish or English, or other languages, were, in a way, experts on urban health, in so much as they had opinions about what they thought would enhance their well-being. That the opinions of these seniors, specifically, were being solicited reflected another signature policy of the organization: an effort to make New York an age-friendly city.

in which to exchange ideas. The

One woman, when it was her turn to

formality of the room, like that of

address the group, fondly recalled

1866

Leads campaign to establish the Metropolitan Board of Health (NYC Department of Health and Mental Hygiene)

1878

Library opens to the public

1898

Society of the New York Hospital sends the Library over 25,000 books

1918

Promotes legislation converting the coroner from an elected office to today’s Office of the Chief Medical Examiner

9

at The New York Academy

1862

I

In the spring of 2013, an

1847

SUSAN DOMINUS

From some of those same focal points came many of the other accomplishments of the Academy over the past decade: more clearly marked crosswalks, for example, and other safety design innovations for streets in neighborhoods where there had been a pedestrian fatality (the elderly are particularly at risk for pedestrian injuries). It was the Department of Transportation (DOT) that implemented the changes; but the continuing focus was largely the result of policy inroads that the Academy had made in establishing healthy aging as a priority of the Bloomberg administration.

Working closely with the community, the Academy also learned that The Board of Health in session. Frank Leslie’s Illustrated Newspaper, April 14, 1866, the Academy’s Healy Collection.

older adults wanted to be more active, to shop, for example, in their neighborhood, but lacked benches on

In December, 1846, a group of fourteen New York City-based physicians gathered to discuss spurring progress in medicine.

population—based

which they could rest (many of which

on an idea that came

had been eliminated because they

directly from the

were thought to attract the homeless

community itself.

population). In another collaboration

The initiative to

with DOT, the Academy helped bring,

dedicate pool hours her memories swimming, as a young person, in East Harlem’s Thomas Jefferson public pool, which she now feared was too crowded for someone of her advanced age to brave. City leadership, invited by the Academy, took note, and eventually, along with the Academy, worked out a plan to set aside hours at the pool specifically for older adults. This small, logistical shift yielded great results—more community, more exercise, and

10

relief from the heat for a vulnerable

for older adults was just one of many that grew directly out of approaches that the Academy has emphasized in the past decade: an active voice for members of the urban community; an interest, with the award-winning Age-friendly NYC initiative, in improving the quality of life and health of older New Yorkers; an active role in the community in which it is housed, in East Harlem; and the catalytic power of public and private partnerships.

throughout the city, attractive, sturdy benches that would give older adults a natural resting spot, the better to further their vitality.

Protecting Public Health Through Policy Caring for the city’s aging residents is part of an Academy tradition of safeguarding New Yorkers’ health that began more than a century ago.

On a Saturday afternoon in December 1846, a group of fourteen New York City-based physicians gathered to

discuss spurring progress in medicine.

By January 6, they had written the constitution for the Academy.

Soon after that meeting, the founding Fellows made protecting the city’s

1931

The founding Fellows made protecting the city’s most vulnerable inhabitants a chief priority.

Endorses the right of the public to receive physician counseling on contraception

1932

The Academy publishes “Maternal Mortality in New York City: A Study of all Puerperal Deaths”

most vulnerable inhabitants a chief priority: managing the cholera

The Academy also used its

outbreak of 1848, for example,

compassionate brand of

or ensuring the purity of the milk

pragmatism and ability to use

supply in 1862. But, they also had

research to shape policy to

the vision to ensure that the ability

introduce, early in the 20th

to regulate the city’s health would be

century, the idea that addiction

legally codified: Only nine years after

and other forms of substance

the Academy’s founding, it started

use should be addressed as a

petitioning the state legislature

public health issue, as opposed to

for certain changes in health law,

solely a criminal justice concern.

eventually lobbying for an act that,

That open-minded approach

in 1866, created the Metropolitan

continued in its recommendation,

Sanitary District and Board of

in 1969, of the establishment of

Health—with at least four physicians

methadone maintenance clinics

on its board, by law—that could both

for heroin users and its early, 1990,

Testimony on safety of fluoride leads to mayor’s endorsement of

make and enact legislation for its

championing of needle exchange.

NYC’s water supply fluoridation

In its approach to drug policy, as

1965

citizens’ well-being. The department would go on to become a model for others nationwide.

1944

The Academy publishes the LaGuardia Report on marijuana in NYC

1959

Recommends government assures equal opportunity for high-quality, comprehensive

with many other health issues,

health care

1969

Recommends the development of methadone management for heroine addiction

Library Reading Room, 1978

11

1979

Implements a comprehensive health education program in NYC public schools

Above: The Academy’s original 1847 meeting place Right: The Academy building today, rimmed with Citi Bikes

the Academy was often far ahead

but mental health concerns such as

a story about a continuing history of

of its time, delivering findings that

PTSD.

providing vision in the area of urban

the public may not have been ready to hear: In 1944, the “LaGuardia Report”—a study of marijuana use in New York City—established findings that the drug was not, in fact, addictive or being used as a gateway to more addictive, crime-inducing drugs, evidence that was contrary to the policy aims of the mayor who commissioned the report.

influence policy played out following the opening of pool hours for older adults at Thomas Jefferson, which succeeded beyond expectations: The Academy conducted research that found that older adults who used the pool reported both weight

yielded such far-reaching results that the International Federation on Ageing awarded it as “the best existing agefriendly initiative in the world.” It has gone on to serve as a template used in cities ranging from Manchester to Melbourne.

information that was used to convince the

undergirded the Academy’s policy

Parks Department

proposals, whether in the arena of

to advocate for an

maternal health or sanitation. Willard

expansion of the

Parker, one of the founders, was

program elsewhere. It

crucial to a door-to-door initiative

was quickly recognized

that yielded a comprehensive survey

as an appealing, low-cost solution

of New York’s sanitary conditions

that got results: Now fourteen public

in 1865. The Academy was one of

pools in New York City have senior

the first organizations to study the

hours, and the program has become a

impacts of the 9/11 terrorist attacks,

model for other cities.

physical effects—respiratory issues—

health. The Age-friendly NYC initiative

loss and better overall well-being,

Rigorous research has always

turning its attention to not just

12

Its tradition of using research to

The Academy … one of the first organizations to study the impacts of the 9/11 terrorist attacks and PTSD.

But, the story of the pool is as much

In 2017, the Academy’s work is—in many ways—a continuation of what the organization did in its earliest days, serving as an even-handed convener to solve problems and using influence and reputation to

1993

Establishes research focus on HIV/AIDS-related health problems

1999

Creates coalition of 400,000 doctors to address handgun injury as a public health issue

2001

First to assess the mental health impact of the 9/11 attacks

2002

Founds the International Society for Urban Health

make change and promote health.

By bearing down on policy, the organization aims to maximize its

Willard Parker, one of the

reach, by shifting thinking towards

Academy’s founders, was crucial

all the ways the world around a city’s

to a door-to-door initiative that

residents can touch their health. “We

yielded a comprehensive survey

are in it for the long haul,” Boufford says, “trying to make fundamental change so that it sticks.”

2007

Establishes the Office of Trustee and Fellowship Affairs

2008

Establishes Age-friendly NYC

(map above) of New York’s sanitary conditions in 1865.

Susan Dominus is a writer for the New York Times Magazine. She was

2010

Launches DASH-NY

a finalist for the Academy’s 2016 Urban Health Journalism Prize.

2013

Publishes a “Blueprint for a Public Health and Safety Approach to Drug Policy,” to advance a harm reduction approach to substance use

2017

13

Above: Society of New York Hospital bookplate, 1898 Right: The first book given to the Academy Library, Medical and Physiological Commentaries.

New York, London: Collins, Keese, & Co., John Churchill, 1840, by Martyn Paine.

Governor Cuomo launches Health Across All Policies initiative and calls for an age-friendly New York State

WHY URBAN HEALTH?

14

ALANA SEMUELS

15

WHY URBAN HEALTH?

D

1. Bronx housing rising just above highways exposes residents to pollution and contributes to asthma corridors.

2. Paying tribute to Bronx hometown girl, Supreme Court Justice Sonia Sotomayor.

3. Fresh fruit and produce stand rises under a gritty train track.

4. Fast food dominates Bronx streets.

Doctors have long speculated that health is

In some Bronx neighborhoods, for example, more than 13

about more than just ailments that affect the

percent of all adults have diabetes, with the largest part

human body. Back in 460 B.C., Hippocrates

of that burden falling on Hispanics and African Americans.

talked of the impact of “airs, waters, and

That’s compared to nearby areas of Manhattan where

places,” on people. More recently, in the 19th century,

diabetes prevalence is much lower, affecting around 2 to 3

as America industrialized on the eve of the Civil War,

percent of adults.

reformers advocated for better housing in cities so that workers wouldn’t get sick and cost companies money, according to Jason Coburn, PhD, a professor in the School

Bronx resident Angela Ewing’s struggle with type 2 diabetes, at age 41, offers clues to the origin of such disproportionate differences in

of Public Health at UC Berkeley.

health. Ewing admits she didn’t think

Even though the earliest

about what she ate. She would drink

understanding of the link between

soda and eat fried foods and candy,

environment and health dates back

grabbing dinner or snacks as she

hundreds of years, the idea has not

hurried around the city, taking care of

completely taken hold. Often, when

her six children.

doctors talk about health, they don’t

“Once I got older and had my kids,

talk about these outside factors.

I just stopped eating healthy,” says

They focus on health care delivery

Ewing. The pressures of raising a large

systems. That’s a mistake, says Jo Ivey

family no doubt contributed, but

Boufford, MD, who first realized the

Ewing also lives in a neighborhood

importance of places on public health when she did her residency in the South Bronx in the 1970s.

“If you have a patient in your clinic and you send them back out into the same conditions they came in with, they’re not going to get better,” she says. “It’s just the fact of it.”

options for healthy foods like fruits and vegetables.

Disparities like these are everyday occurrences in dense urban areas. Cities are increasingly engines of economic prosperity throughout the country. But in New York and in many other places, large populations can be left out of that

Increasingly, though, practitioners are starting to look at

prosperity because of where they live. Their neighborhoods

how cities and geography impact people’s health. This idea

are often cut off from transit or safe places to walk, devoid

is central to the field of urban health, which focuses not

of supermarkets or places to buy fruits and vegetables,

just on diseases, but also on how factors such as housing,

and near highways or power plants that create air quality

poverty, transportation, violence, and segregation can lead

issues.

to health problems. The core of the work of urban health is addressing those challenges, especially in cities like New York where dramatic health inequities exist in communities that are just a few blocks apart.

16

with many types of fast food, but few

The factors that define these neighborhoods’ geographies can also cause poor health outcomes. In East Harlem, for instance, life expectancy is just 76 years (it’s 75 in the Bronx), while a few blocks south, in the Upper East Side,

1.

2.

4.

17

3.

Outdoor track at Yankee Stadium in the Bronx, 2017

people can expect to live almost a decade longer. The Bronx

REACH sponsored, community-based meetings in which

is also the least healthy county in the state, with high

teachers guide Ewing, and others with diabetes, in how

levels of cardiovascular disease, respiratory disease, and

to maintain healthy blood sugar levels, lose weight, and

high rates of obesity.

eat healthy. She no longer drinks soda, and steams her

Yet, just as cities can contribute to urban health problems, they also provide unique resources to address them.

Because cities are compact, they can become platforms for programs that can make big changes by operating in a small area. Ewing, for example, learned through a neighbor about a program run by a not-for-profit, Bronx Health REACH, that sought to make locals more aware of how to

diabetes was serious, but I wasn’t listening,” she says.

“Once I joined the program, I started to take it seriously.”

Cities as Incubators of Health Innovation Throughout its history, the Academy has pioneered the movement to recognize that solutions to some of the most glaring problems caused by the built environment are best

manage their diabetes.

addressed at the city level. What’s more, cities like New

REACH partners with the Academy’s Designing a Strong

than federal or state governments are, and city leaders who

and Healthy New York City (DASH-NYC) Workgroup—a coalition of 21 organizations attempting to bring balance to the dramatic health inequities that exist throughout the city.

On the ground, that work translates into the availability of 18

food now instead of frying it. “My doctor told me that my

York have strong governments that are more accessible are often invested in improving outcomes for constituents.

“Operating with mayors and with local elected officials, you have a lot more potential for accountability and visibility of what you’re doing,” Boufford says.

In 2002, with the founding of the International Society for

improve.” Research by Diez Roux, who is also the deputy editor-in-chief of the Academy’s Journal of Urban Health and director of the Drexel Urban Health Collaborative, for example, found that connecting low-income neighborhoods to the rest of the city, by installing public transit in Medellin, Colombia, led to a dramatic decrease in crime in connected neighborhoods.

Harnessing Urban Resources In 2016, José Pagán, PhD, director of the Academy’s Center for Health Innovation and Academy Research Scientist Yan Li, PhD, investigated the impact of high sodium consumption on New Yorkers’ health. More than 80 percent of New Yorkers consumed more than the recommended 2300 mg a day.

Just months before, the city’s health department had adopted a regulation requiring restaurants to add sodium Bronx residents working out on outdoor gym, Yankee Stadium

labels to menu items. The simple question: would it make a difference?

Urban Health (ISUH), the Academy signaled an awareness of the need to address urban health in cities worldwide.

With 70 percent of the world’s population moving to urban areas by 2050, cities like Mumbai, Sao Paulo and Lagos are experiencing rapid increases in chronic diseases, unsafe housing, and populations with limited access to decent health care. As the only organization looking at how to tame growing urban health inequities on a global scale, the ISUH brings together academics, practitioners and policy makers from around the world to find ways to apply a Health Across All Policies approach to these issues.

“There’s been increasing interest within the medical world in thinking about how factors that are external to

Using computer modeling of big data, Pagán discovered that convincing city dwellers to take a hands-off approach to the salt shaker would lower hypertension rates in the city so much that certain groups would potentially live as much as five years longer. The research also showed that the policy could improve health across all boroughs, encouraging a 5 to 6 percent reduction in sodium use in every borough. In the Bronx alone, the policy might prevent more than 100,000 cases of hypertension, but nearly 88,000 in Manhattan as well.

Looking at health behaviors across the city, Pagán has also captured data that shows what’s going on in communities at the neighborhood level. Using the New York State

the patient are affecting their outcomes,” says Ana Diez Roux, MD, PhD, MPH, dean and professor of Epidemiology at Drexel University’s Dornsife School of Public Health and a speaker at the 2016 ISUH conference. “Many health providers understand that if they don’t start thinking about environmental

A 5 to 6 percent reduction in sodium use might prevent more than 100,000 cases of hypertension in the Bronx alone, and nearly 88,000 in Manhattan as well.

19

factors, low-income patient outcomes are hard to

20

East Harlem vendor brings fresh produce to the community.

Behavioral Risk Factor Surveillance System that measures, among other things, the New York neighborhoods where smokers live and the areas

The International Society for Urban Health

where people seldom exercise, he can help community health experts decide what interventions can be most useful or where an anti-obesity program might have the greatest impact. “The size of cities allows you to access information and collect information in ways you cannot in a less dense area,” he says.

Transforming cities into sustainable, health-supporting urban environments requires more than conducting research and sharing it with policy makers—that can take place anywhere. It’s knowing what essential city service, such as public transportation, can be leveraged to make a community safer. It’s understanding which industry among thousands— such as restaurants—touches people’s lives in a way that can substantially improve personal health. It’s listening to people and learning where, in a heavily populated, underserved, low-income community, to open a program that can help an overwhelmed mom, like Ewing, get a second chance at living healthy and watching her kids grow up.

Academy’s Urban Health Journalism Prize.

The Journal of Urban Health As a leader in urban health, it is only natural that the Academy would publish the premier and authoritative source for rigorous analyses to advance the health and well-being of people

observations and research at the Academy. In

in cities. The Journal of Urban Health, a one-

1925 it became The Bulletin of the New York

of-a-kind, peer-reviewed journal, provides

Academy of Medicine until 1998, at which

evidence to inform policies, programs and

point it became known as The Journal of Urban

governance for urban health.

Health: Bulletin of The New York Academy of

Over the years, the Journal has undergone

Medicine.

several transformations. Initially launched in

In 2017, the Journal underwent a visual

1851 as Transactions of the New York Academy

transformation to reflect new Academy

of Medicine, it published papers of preeminent

branding and to better represent the global

physicians who presented their clinical

nature of its content and readership.

Very few organizations can claim to be unique in the world, yet the International Society for Urban Health (ISUH) can.

Focusing exclusively on the broader determinants of urban health, and comprised of a global membership that crosses disciplines, bringing together researchers, educators, policy makers, practitioners, community leaders and urban health advocates—the organization is uniquely positioned to address the complex issues that impact health in cities around the world.

As the founder and secretariat for ISUH, the Academy has successfully built a force for international leadership, education and advocacy for implementation of evidence-based policies and programs that improve health in cities. Since its founding in 2002, the Academy has organized 14 international conferences around the world and attendance has expanded to include urban planners, architects, geographers, climate change scientists, transportation and housing experts, as well as others who recognize the value of collaboration on issues relating to health in cities.

21

Alana Semuels is a staff writer at The Atlantic and the 2016 winner of the

Every day when he leaves and enters his home, he looks at a cross that belonged to his mother.

22

“I thank God for giving me the day, I thank Him for blessing my home and my family.�

Ray Tirado

Tirado is a living example of something health experts began

FOLLOWING THE EVIDENCE: Making the Case for Change

to understand decades ago. Often, it’s the conditions and policies that seem unrelated to health that affect people’s health the most.

And housing, in particular, is absolutely crucial to physical and mental health. “Stabilizing someone’s home base lets them stabilize everything else in their lives,” says Prabhjot Singh, MD, PhD,

KATHERINE HOBSON

director of the Arnhold Institute for Global Health at the Icahn School rent eats up too much of a paycheck

Ray Tirado has lived in

on electric heaters for warmth and is

East Harlem for almost

bringing in prepared food. The stress

his entire 57 years.

has been intense, as he experiences

And until recently, he

insecurity about a future that he

thought he’d live there forever, in the

thought he had settled. “I’ve been

same rent-controlled apartment.

looking, but my rent is very modest,”

In anticipation of retirement from

and apartments in the neighborhood

his construction job, he made

now go for many multiples of what he

improvements—new floors, a fresh

pays. Rent increases in East Harlem

coat of paint, new appliances. “I’d

last year were among the steepest

already envisioned it,” he says. “I could

in Manhattan, at an average of 8

live here comfortably with my pension

percent, according to Zumper.com.

and my annuity.”

came close to a mental breakdown,

building’s owners told him that

his composure cracking at work. “At

they wanted him to move out. They

first I didn’t know why, and then I

planned to buy him out of his lease

started to think—it’s the situation

and to tear down his building, part of

I’m in,” he says. He took a break from

the East Harlem construction boom.

his job to cope. His physical health,

building’s last resident—and is negotiating to see how long he can stay and on what terms he will depart.

But he’s less than comfortable. He says the boiler is broken, and he relies

dislocation, for example, people may skimp on nutritious food and medical care as well as experience significant, health-damaging stress. Conversely, when someone knows they don’t have to worry about finding a new or cheaper housing situation, they can prioritize the other needs in their life.

About six months ago, Tirado says he

Then, two or so years ago, the

Tirado held on—he’s now the

or is unsustainable and leads to

too, has suffered, with a diagnoses of diabetes and high cholesterol. “I wake up at all times of the night,” he says. “I can’t make plans for the future.” And, he adds, he knows the same thing is happening to a lot of his neighbors.

Tirado’s building is the last one standing on his East Harlem block.

23

R

of Medicine at Mount Sinai. When

Proving the Housing and Health Connection Knowing that affordable housing was key to resident health in East Harlem, The New York Academy of Medicine saw an opportunity to potentially inform what might happen next in the neighborhood when the East Harlem Neighborhood Plan was announced. The plan aims to inform the city’s rezoning process to assure that, as the area becomes a hotbed of commercial and luxury housing development, the needs and health of long-term residents of the neighborhood are considered. Like

Abandoned apartment buildings in East Harlem

Tirado, they don’t want to be pushed out: “they want affordable housing in the neighborhood,” says Kimberly Libman, PhD, MPH, director of prevention and

sectors other than health

The East Harlem HIA is the first ever conducted about the neighborhood, and only the second HIA conducted in New York City.

and outside government.”

To provide that evidence, the Academy conducted the “East Harlem Neighborhood Plan Health

community development at the Academy’s Center for Health Policy and Programs.

Impact Assessment (HIA): Connecting

research for making a case for the value of holding onto affordable

Housing Affordability and Health”

Yet, convincing a powerful entity,

housing: evidence that also supports

in September 2016, to inform the

like a government agency, to act

what the World Health Organization

planned rezoning of the community,

in ways that will help people like

says is essential for governance

which is also the Academy’s home.

Tirado requires a great deal more

for health and well-being, the

The East Harlem HIA was the first ever

than the will of people—there must

development of a “synergistic set

conducted about the neighborhood,

be evidence, a solid foundation of

of policies, many of which reside in

and only the second HIA conducted in

The Prevention Agenda: Improving Health for all New Yorkers The Academy strengthens policies that protect

2008 to help develop this initiative, along with

health through a range of activities. One

hundreds of organizations, including local public

of the most effective is Designing a Strong

health departments, hospitals and health care

and Healthy New York State (DASH-NY),

systems, universities, businesses, faith and

which works to advance the New York State

other community-based organizations across

Prevention Agenda.

the state. The current phase of the Prevention

The Academy has worked with the New

Agenda (2013-2018) increasingly aligns the

24

York State Department of Health since

actions of local coalitions, led by hospitals and

stock. The HIA is now part of the decision-making process as the zoning proposal takes shape.

Reshaping Language Laws Advocating for evidence as a key element of policy decisions has been a hallmark of the Academy’s efforts in the past decade. Research published in 2007 by Linda Weiss, PhD, director of the Academy’s Center for Evaluation and Applied Research, for example, found that while the majority of New York City pharmacies surveyed reported they

Pharmacy sign in Spanish, South Bronx

regularly served patients who weren’t proficient in English, only a minority

New York City. The Academy’s team

Rebecca Morley, director of the

analyzed how factors like mixed-

Health Impact Project, a collaboration

income neighborhoods and residential

between the Robert Wood Johnson

density impact health conditions that

Foundation and The Pew Charitable

That research was cited in legal

contribute to the significant health

Trusts.

actions that led to an agreement

disparities that exist in East Harlem, including diabetes, infant mortality, and mental health problems, says Libman, the lead author of the assessment.

The East Harlem HIA presented concrete recommendations for how Mayor Bill de Blasio’s rezoning proposals could prioritize health, including how much of new housing

“The advantage of an HIA, a

should be affordable and what income

relatively new tool, is that it covers

levels should be targeted. It also

consequences that environmental

recommended mitigation measures

impact assessments may omit,

to reduce the negative impact of

and puts a greater emphasis on

construction in the neighborhood,

community input,” according to

and improvements to current housing

of them translated prescription labels and instructions.

with major chain pharmacies, says Weiss. And ultimately, local and state legislation mandated prescription instructions be translated into the major languages spoken in the area, both orally and in crucial written materials. A 2015 follow-up survey found pharmacies overwhelmingly had the ability to translate, but that patients weren’t always availing themselves of that service.

health systems and local health departments, with other key stakeholders, to address priority health problems. We are extremely proud of the successes we have seen thus far.

The Prevention Agenda coalition continues to pursue 96 evidence-based objectives aimed at dramatically improving health across the city and

25

the state.

Cuomo announced that each state agency will now use the ‘Health Across All Policies’ approach.

The Academy also built on its long-

And since 2010, the

term involvement in drug policy with

Academy has been

a 2013 report done in conjunction

part of the Designing a

with the Drug Policy Alliance, the

Strong and Healthy New

“Blueprint for a Public Health and

York State (DASH-NY)

Safety Approach to Drug Policy,” which

coalition, which works to

urged a public health approach to

prevent chronic disease

Address, when he announced that

illicit substance use.

and increase well-being throughout

each state agency will now use the

the state by advocating for policies,

“Health Across All Policies” approach

including expanded access to parks

to incorporate health into policy

and trails and improving the supply of

decisions in all sectors, including

fresh produce to local schools.

transportation, agriculture, markets

“If our goal is to reduce the harm, the policy approaches look very different than if we look to punish drug users or only reduce total drug use,” says Anthony Shih, MD, MPH, executive vice president at the Academy.

More recently, the Academy joined a coalition of groups urging the city to create supervised injection facilities—a controversial idea, but one that is backed by evidence—in an effort to lower overdose deaths, cut down on infectious disease and increase access to drug treatment, among other goals.

Those efforts to connect the dots

and economic development.

between government policy and

“We want to make decisions that

health got a significant, formal boost

make promoting health relatively easy

from Governor Andrew Cuomo in

and part of the normal way of doing

his January 2017 State of the State

business,” says Boufford.

“ If our goal is to reduce the harm, the policy approaches look very different than if we look to punish drug users or only reduce total drug use.”

Tirado, meantime, is hoping that East Harlem housing policy and plans will include options that will be good for him and for his health.

These days, he’s feeling a bit better.

He is active with his union and

― ANTHONY SHIH, MD, MPH

organizing for affordable housing

The Drug Policy Blueprint: Moving Beyond Criminalization In 2009, New York was facing a crisis.

Mandatory incarceration for nonviolent offenses—largely a result of the Rockefeller Drug Laws—was driving the corrections

Imprisonment = $44,000

system into bankruptcy. Communities and individuals were questioning the validity of laws that criminalized substance use, tore families apart, and drove racial and health disparities, while failing to reduce rates of drug use or drug-related crime. Research also showed state dollars were being wasted.

Imprisoning a person for one year was $44,000, while the cost for drug treatment

3-43% COST SAVINGS

Research also showed state dollars were being wasted.

Imprisoning a person for one year was $44,000, while the cost for drug treatment averaged $1,200 to $19,000 a year. Treatment also proved 15 times more effective at reducing crime and recidivism.

averaged $1,200 to $19,000 a year. Treatment also proved 15 times more effective at reducing crime and recidivism.

26

Experts in the harm reduction approach to substance use, the Academy’s leadership

Drug Treatment = $1,200-19,000

Researching Safer Care: Reducing Medical Errors Technology promises an increasingly bright future in health care. Complex information systems offer physicians, nurses and other care providers great opportunities to do more for their patients. Yet, while technology has reduced many of the medical errors that harm hundreds of thousands of people each year, it has increased others—especially those associated with Electronic Health Records and related systems.

Understanding and solving the problem of technology-based mistakes that can potentially hurt patients and cost hospitals millions is the work of

through Community Voices Heard—an

God for giving me the day,” he says. “I

Vimla L. Patel, PhD, director of the

Academy community partner—that

thank Him for blessing my home and

Academy’s Center for Cognitive Studies

advocates for affordable housing and

my family.”

career-track jobs in the neighborhood.

And he’s trying to think positively and figure out what comes next. “I play chess, so I try to think two moves ahead.” He’s also reconnected with his faith. Every day when he leaves and

Katherine Hobson is a Brooklyn-based journalist whose work has appeared in the Wall Street Journal, U.S. News & World Report, National Geographic. com and other publications.

in Medicine and Public Health.

“We found that technology could sometimes overwhelm clinical teams, occasionally exacerbating errors, causing mistakes in diagnosis or the dosing of medication. Yet, it also became clear that technology could play a major role in error mitigation, if human cognition and its interaction

enters his home, he looks at a cross

with socio-cultural environments

that belonged to his mother. “I thank

were taken seriously in the context of health information technology design,” Patel says. Through her research, and with the publication of her threevolume series Cognitive Informatics for

decided the city, and the state, needed

move to reform the Rockefeller Drug Laws, a

a new way to address these issues. That

new chapter in the Academy’s long history of

January, the Academy held a conference

advancing harm reduction.

called New Directions New York: A Public

In March 2013, nearly 100 years after the

the challenges posed each day by new

Academy’s first 1917 harm reduction campaign,

health-related technologies.

bringing together people from government, city neighborhoods, public health, drug treatment, the court system, policy makers and other stakeholders to find ways to replace New York’s existing, criminal justice-based methodology for dealing with substance use with a public health and safety approach. The goal, conference attendees agreed, was to work toward a world in which all drug policies would begin with the question: “What impact will our policies have on the public’s health and safety?” The conference was one of several powerful forces contributing to the state’s

continually breaking new ground in the comprehension and management of

the organization, along with its partner, the Drug Policy Alliance, published the “Blueprint for a Public Health and Safety Approach to Drug Policy.” It called on Gov. Cuomo to create a multiagency task force modeled on the “four pillars approach” drug policy—prevention, treatment, harm reduction and public safety.

The Academy harm reduction team continues to work to advance a harm reduction approach to substance use in New York State health care reforms and in the work of the many municipal agencies that shape the laws and regulations that address substance use.

Research studying the impact of health information technology on clinical workflow shows physician time spent at different emergency department locations.

27

Health and Safety Approach to Drug Policy,

Biomedicine, Patel and her team are

The Academy’s graceful, Romanesque structure is a draw for many of film and television’s most popular, contemporary storytellers. Built in 1926, the building is not only legendary in the history of medicine and health, it’s a timeless work of art.

TV

Here are some of the Academy’s greatest hits:

FILM

SATURDAY NIGHT LIVE Host Benedict Cumberbatch ends a sketch under one of the Academy’s cathedral ceilings, 2017 (NBC).

KILL YOUR DARLINGS Allen Ginsberg (Daniel Radcliffe) and Lucien Carr (Dane DeHann) try to solve a murder in the Academy Library in 2013 (Sony Pictures).

THE ROYAL TENENBAUMS

28

Owen Wilson, the Royal Tenenbaums’ favorite neighbor,

MOZART IN THE JUNGLE Bernadette Peters works out her next scene in the Hartwell Room, 2015 (Amazon).

MADAM SECRETARY

holds court in the Academy Library in 2001 (American

Tea Leoni (Secretary of State) and her team solve an

Empirical Pictures).

international crisis in the Academy Library, 2017 (CBS).

ICON: CULTURE HAPPENS HERE BLUE BLOODS Tom Selleck faces an angry crowd in Hosack Hall 2016 (CBS).

RADIO LIVING WITH CANCER Details of the series’ extensive exploration of people struggling with cancer were researched with help of the Academy’s expert library team (WNYC radio).

The Academy also appeared in...

THE KNICK The series celebrates its premiere in the President’s Gallery. The Knick’s production team learned everything from how to recreate an early 20th century operating room to what medical instruments were in vogue at the time in the Academy’s Library (Cinemax).

DOCUMENTARY CANCER: THE EMPEROR OF ALL MALADIES The Ken Burns documentary film features the Edwin Smith Papyrus from the Academy Library’s collection, and parts of the script were researched in the

29

organization’s stacks.

“The kids used to get sick inside the apartment more than they did outside.�

Patricia Gorritz

30

Gorritz and her kids had been breathing unhealthy quantities of mold spores, likely for years.

THE POWER OF PARTNERSHIP

BRIE ZELTNER

F

For 11 years, Patricia Gorritz watched her two

to help families eliminate asthma triggers, preventing

youngest children, Neftali and Rebecca Rivera,

relapses.

struggle to breathe as they were diagnosed with repeated chest colds, bronchial infections

and, eventually, asthma.

Gorritz had been ill a lot too since moving into a ninthfloor apartment in the Taft Houses (New York City public housing) in East Harlem in 2001. “The kids used to get sick inside the apartment more than they did outside,” Gorritz says. “It was always freezing; we used to double up on pajamas and could never get warm in the winter.”

Ray López, now director of Little Sisters’ Environmental Health Services, headed up the Controlling Asthma through Home Remediation (CAHR) program and visited Gorritz and her family.

“Ray came over and he interviewed me, and the kids, and they took samples of absolutely everything,” says Gorritz.

Their environmental testing proved that Gorritz and her kids had been breathing unhealthy quantities of mold spores, likely for years. López and his team were able to

In 2003, Gorritz discovered black mold steadily creeping up

search for other environmental triggers for their breathing

a bedroom wall, but she didn’t connect it to her children’s

problems such as dust, cockroach and mouse infestations,

asthma until much later. Soon there would be mold in both

provide help alleviating some of the kids’ symptoms, and

bedrooms.

advocate for the family with the housing authority.

Gorritz did try, unsuccessfully and for years, to get it

It’s an approach Little Sisters has used for almost two

cleaned up. At one point, the mold was so bad she had to

decades, and one the staff there knew made a difference.

move two of her three kids into the living room to sleep.

But to help more families like Gorritz’s, to increase funding

The New York City Housing Authority painted over the mold

and test their methods, Little Sisters needed to prove

five times but never fixed the leak that was causing it.

CAHR’s effectiveness.

Finally in 2012, when Neftali and Rebecca were 12 and 9 years old, they found help. A unique local partnership

Finding Out What Works

between two East Harlem organizations, The New York

Partnering with the Academy made it possible for Little

Academy of Medicine and Little Sisters of the Assumption

Sisters to both expand and strengthen its home visiting

Family Health Service (Little Sisters), used a grant from

program, López says, and to see that it indeed was helping

the U.S. Department of Housing and Urban Development

East Harlem’s children.

31

(HUD) to send community health workers into homes

BEFORE

AFTER

Gorritz home in Taft Houses

“We at Little Sisters knew it worked because people would

able to get by with only their inhalers, and don’t need the

recommend us to their neighbors and friends,” says López.

frequent nebulizer treatments and emergency room visits

“In today’s world you need more than that; you need to be

they did before.

able to demonstrate that it works both qualitatively and quantitatively.”

Only when López began working in partnership with Linda Weiss, PhD, director of the Academy’s Center for Evaluation and Applied Research (CEAR), and her team did Little Sisters acquire the research, evaluation and data analysis that would lead to the organization’s first-ever federal award.

“I couldn’t be happier with how they helped us,” Gorritz says. “I still recommend people to them, and I live across town.”

Partnering with the Academy on the project has also allowed López and his team to learn new skills to apply to new projects. But the partnership also freed Little Sisters to focus its energy where it was most needed, on home-based interventions and outreach with families like

“Little Sisters is a great example of how to do public

Gorritz’s. López couldn’t be more grateful to the Academy

housing work in a community-based way,” Weiss says.

and to Weiss, who he says he frequently embarrasses with

“We were excited for the opportunity to work with them to

his praise.

evaluate the results on the research side of it.” As Weiss, López and their staffs worked together to secure the Housing and Urban Development grant, they also published the results of the asthma home visit interventions to inform others.

Those results were impressive—the children who received home interventions had statistically significant reductions in nighttime awakenings, emergency department visits, rescue medication use, and hospitalizations.

The partnership didn’t end there, though. Now in the

“I’ve learned so much from her,” he says. “The Academy helped me take that step back and to think about the program and all its moving parts. It helped us to make sure that the program aligned with the outcomes we wanted to see, and to be able to measure if it was in fact doing what we were seeking to do.”

Building and maintaining partnerships like the one with Little Sisters in the Academy’s own neighborhood of East Harlem are key to the organization’s past and future success, says Academy President Jo Ivey Boufford, MD.

second year of its second round of funding from HUD, the team is returning to families like Patricia Gorritz’s to see how they’re faring today. Since moving to a lower Manhattan apartment three years ago, Neftali and Rebecca

32

Rivera have been doing much better, Gorritz says. They’re

Combining Strengths, Changing Lives As a relatively small nonprofit in a vast sea of New York City health, service and academic organizations, the Academy

has long understood that much of its power lies in knowing how to bring people together to accomplish change. “We try to identify gaps in knowledge or policy, or in areas that present a looming crisis and unnoticed opportunity,” Boufford says.

Boufford drew attention to one of these neglected areas when she arrived at the Academy ten years ago, bringing with her a passion for aging-related issues born of her work as Principal Deputy Assistant Secretary for Health in the Clinton administration and U.S. representative on the executive board of the World Health Organization.

Jo Ivey Boufford, MD, NYC Mayor Michael Bloomberg, Doris Robinson (seated), Mamie Robinson, Linda Gibbs, announcing Age-friendly New York City survey, 2008.

That led to the creation of Age-friendly NYC, one of the most enduring, successful and

separate part of communities, but instead are recognized

celebrated examples of the Academy’s ability to create

as integral to community vitality. Ten years in, the initiative

and sustain partnerships. The Academy-led collaboration

has become a part of the fabric of the city’s strategic plan

with the Office of the Mayor (first Bloomberg, now Bill de

for growth, sustainability and equity, OneNYC, a fact which

Blasio) and the New York City Council, is now in its tenth

“speaks to the continuity the Academy has brought to the

year. The program identifies and then knocks down barriers

work,” Goldman says.

contributing to city life.

In 2017, Governor Cuomo expanded New York’s emphasis

“The Academy has really taken a lead in promoting healthy

friendly policies statewide.

on supporting healthy aging by deciding to institute age

urban living for the growing aged population in New York

It’s miles from where the

City,” said City Health Commissioner Mary Bassett, MD. “They’ve brought a needed balance to population health priorities in the city.”

Most importantly though, says Academy Healthy Aging Director Lindsay Goldman, LMSW, Age-friendly NYC has helped many partnering city officials, business owners, and organizations change the way they think about older adults. “Aging is usually this sort of afterthought or addendum,” Goldman says. “That’s changing. There’s a recognition that there’s a lot more to a satisfying life than just going to doctor’s appointments or getting your home-delivered meals.”

“ The Academy has really taken a lead on promoting healthy urban living for the growing older adult population in New York

work began, but exactly where it should be.

“The Academy has been successful in forming partnerships at the not-for-profit and governmental level—

City.”

NGO and government ― MARY BASSETT, MD

relationships are exceedingly important to make progress on almost

any societal issue,” says George Thibault, MD, chairman

Perhaps the best measure of Age-friendly NYC’s success is

of the Academy’s Board of Trustees and president of the

that the inclusion of aging is now taken for granted in many

Josiah Macy, Jr., Foundation. “I think the Academy has been

discussions, Goldman says. Older adults aren’t seen as a

(continued on page 36)

33

that prevent older adults from fully accessing, enjoying and

Academy Signature Partnership Programs Age-friendly NYC: Making New York a Great Place to Grow Up and Grow Older

In 2008, the Academy made the decision to build on international research and trends reported by the World Health Organization (WHO).

The result was a dramatic change in America’s cities for older adults, starting with the Academy’s home— New York. Jo Ivey Boufford, MD, explains it as wanting to make New York City one of the healthiest places to age, based on what she had just learned about the international agefriendly movement.

Within months, the Academy took on the WHO challenge to use the best practices from 35 cities, across 22 countries, to make New York an agefriendly city for the nearly one million New Yorkers over 65 at the time.

By 2010, the number was projected to grow to 40 percent of the city’s

34

Age-friendly Partners:

population in roughly 25 years. The result was the Academy’s Age-friendly NYC initiative, a unique partnership created with the office of then Mayor Michael Bloomberg and the New York City Council. Fast forward 10 years, in 2017, it’s a growing and successful program with an impressive track record.

Like so many of the Academy’s efforts, Age-friendly NYC began by listening to the community. Team members held conversations with thousands of New Yorkers age 60 and older, from all over the city, then reached out to service providers, health experts and others. That knowledge informed more than 20 city agencies—including transportation, parks, and city planning—which came together to decide how to make New York better

for people as they age.

With that information, Age-friendly NYC created 59 initiatives to build an infrastructure for aging healthy in NYC, but that was just the beginning.

The initiative’s NYC Commission and working groups are leading projects and creating resources focused on housing, public safety, media, arts and culture, primary care and financial wellness.

With activities and aging improvement districts in nearly 50 percent of NYC neighborhoods, 3,000 newly designed bus shelters, a 16 percent reduction in senior pedestrian fatalities and—most important, thousands of hours spent listening to older New Yorkers—Age-friendly NYC is bringing an age-friendly initiative to every council district by 2018.

16%

DECREASE IN SENIOR PEDESTRIAN FATALITIES

3,000

NEWLY DESIGNED BUS SHELTERS

The DASH Toward a Healthier New York

The idea behind the city and state-based Designing a Strong and Healthy New York program is simple, yet powerful—bring the best knowledge we have on how to stop a host of chronic illnesses before they begin to communities. To that end, the Academy works in every borough of the city and throughout New York State to help residents stay healthy.

As a leader for both the DASH-NY initiative (2010) and the DASH-NYC Workgroup of 18 organizations, part of the Population Health Improvement Plan, the Academy

partners to advocate, organize, instruct and plan activities that support health. The work takes many forms—teaching community groups how to advocate, advancing policy at the state level to inform budget priorities, and supporting government partners in preventing and lowering New Yorkers’ health risks. The DASH-NYC Workgroup complements this work through efforts to investigate and disseminate proven community-based approaches to chronic disease prevention.

35

Multi-sectoral Approach to Urban Health

The Academy’s DASH-NY program partners with organizations to improve opportunities for better health, such as safer streets for more active living.

(continued from page 33)

says John Damonti, president of the Bristol-Myers Squibb

an excellent model for that … . It’s been involved in the committee work of the city and the state, and it has been able to influence policy by being a very effective partner.”

Foundation and a member of the Academy’s Board of Trustees. “All too often this work is done in a fragmented way,” Damonti says. “You have city government, state

As home for one of the state’s most successful

government, academic institutions, boards of health,

partnerships, Designing a Strong and Healthy New

community-based organizations, all these individual

York, known as DASH-NY, the Academy brings together

players. To make sure that the small community-based

and collaborates with dozens of

organization working in East Harlem has

organizations in its coalition from

the input to the health department where

sectors as diverse as transportation, agriculture, economic development, city planning, and academia. DASH-NY aims to develop strategies for reducing the burden of obesity and chronic disease across New York State. The

“ We need a different range of organizations to really help address the health challenges that we’re facing.”

work is complemented by the DASHNYC Workgroup.

them, that’s critical. I think the Academy has been that level playing field.”

To the New York State Health Department, one of DASH-NY’s key supporters, the partnership has been essential to helping

― SYLVIA PIRANI, MPH

the department look more deeply at health issues, policies and programs, says

Bringing together so many disparate

Sylvia Pirani, MPH, director of the Office

groups around a single issue is often an eye-opening

of Public Health Practice. “We need a different range of

experience. “Usually this is the first time they’re meeting

organizations to really help address the health challenges

each other, because they don’t have occasion to,” Boufford

that we’re facing,” she says. “I think the Academy with their

says. “Bringing them together allows them to see what

commitment to urban health and prevention has really

they have in common.”

exemplified that, that you need partners in many walks of

It also makes the work they do together, and the outcome for New York City and state residents, far more cohesive, 36

sometimes that forum doesn’t exist for

life.”

Kyle Restina, manager of the New York State Department

of Health’s obesity

“ When I hear state budget proposals announced, I can see a correlation between them and the agenda that I know DASH-NY has advanced.” ― KYLE RESTINA

prevention program, in the division of chronic disease prevention, has worked with the Academy since it began bringing statewide stakeholders to the table to form DASH-NY in 2010.

In the early days of

organizing around the state’s obesity crisis, the Academy’s ability to identify who needed to be part of the discussion— including non-traditional partners like federal housing agencies and the American Farmland Trust—was critical.

“Right from the get-go, they had a health in all policies approach in who they were looking to engage and we were on board with that,” Restina says. That approach has paid off in many ways, she says, from mandatory daily active recess policy guides to ensuring New York State’s Complete Streets law is applied uniformly statewide.

Restina says she also sees a subtler yet wider impact of the Academy’s prevention-related policy work. “When I hear state budget proposals announced, I can see a correlation between them and the agenda that I know DASH-NY has advanced,” she says. “I can’t help but think that it’s certainly supported by their good work in this area.”

At the core of any of the Academy’s accomplishments on this scale, says Boufford, is its credibility and reputation as a neutral forum for health policy discussion. “Part of our challenge in the contemporary world is maintaining that reputation so that people want to work with you,” she says.

“When you do it right, people want to be a part of it. They know it’s going to be interesting and substantive, and that

Brie Zeltner is a health care reporter for the Cleveland Plain Dealer and the 2015 winner of the Academy’s Urban Health Journalism Prize.

Corner stores with unhealthy snacks outnumber healthy food stores in many Brooklyn neighborhoods.

37

it will have impact.”

38

Mural in Brownsville, Brooklyn, celebrates the community’s spirit

COMMUNITY COMES FIRST

39

BRIE ZELTNER

COMMUNITY COMES FIRST

E

1. Faith-based institutions play a central role in bringing the community together.

2. A Park Slope Food Coop member does his volunteer shift.

3. Brooklyn residents enjoy Prospect Park.

Ernest Estimé was already passionate about

One of Estimé’s suggestions during the deliberations—

the topic of mental health when he joined a

offering mental health training for local clergy members—

group of 20 other Bushwick residents last year

has already been put into action. The health department

to talk about how the topic, and the stigma

launched four mental health first-aid trainings in

surrounding it, affect his neighborhood.

March and followed up with more in the spring, aimed

He volunteers weekends with young people at Rikers Island Correctional Center and is a member of Brooklyn’s 67th

at churches, schools, hospitals and community-based organizations.

Precinct Clergy Council, a group that seeks to reduce gun

“Look at that,” Estimé says. “That’s incredible, to have that

violence. He knows that depression and anxiety underlie

response.”

a lot of his neighborhood’s more visible problems, like violence and homelessness. And that a lot of people are affected, invisibly.

“If you have an initiative that’s really shaped and driven by the voices of people who are affected by it, it’s hard to make a mistake when you translate those voices into

“It can look like an everyday citizen, or your neighbor,” he

action,” says Academy President Jo Ivey Boufford, MD.

says. “It’s definitely something that I see every day.”

It’s a formula that’s proved true many times in the

So Estimé was eager to join the first of a series of public

Academy’s work over the past decade, from the formation

deliberations on mental health stigma held throughout

of Age-friendly NYC, to the unprecedented scope of the

Brooklyn this year, a partnership between The New York

2016 City Voices publication series, to public deliberations

Academy of Medicine and the New York City Department of

and the first health impact assessment of East Harlem.

Health and Mental Hygiene (DOHMH).

At the heart of the project, and much of the Academy’s work, lies the notion that it’s community members themselves who should shape health policy for their own neighborhoods.

Depression and anxiety underlie a lot of his neighborhood’s more visible problems, like violence and homelessness.

“As long as we’re doing neighborhood changes, if it’s rooted in the culture, the values and the voices of the people, I think it’s going to have a lasting impact,” says Torian Easterling, PhD, assistant commissioner for the Brooklyn Neighborhood Action Center at DOHMH and the Academy’s partner in the project. “The Academy got that from the beginning.”

With the help of funding from the New York City Population

40

Health Improvement Program, residents of three Brooklyn

Age-friendly NYC, an academy-led collaboration with the Office of the Mayor and the New York City Council, began in 2007 by asking older adults a very simple question: What makes it harder or easier for you to live in your community?

“The beauty of it is: you ask, and they tell you!” says Boufford. The initiative’s many successes all stem from answers to that question, she says.

neighborhoods—Brownsville, Bedford–Stuyvesant and

Joyce Jed, co-founder of Good Neighbors of Park Slope

Bushwick—took part in the conversations, and gave their

(GNPS), a volunteer-run, non-profit designed to help older

feedback.

adults age in place in her Brooklyn neighborhood, is one of

2.

1.

the people the Academy works with to find some of these

“ It’s community members themselves who

answers. Jed, 74, has lived in Park Slope for 45 years and

should shape health policy for their own

retired about 15 years ago from a career as a psychologist and a psychiatric hospital administrator. She, like many of

neighborhoods.”

her friends, wants to stay in the neighborhood she loves as she ages.

In forming GNPS, Jed discovered that many of her

housing and access to public transportation.

neighbors felt socially disconnected, and needed less help

“Affordable housing is a major problem in terms of how

with services like getting to doctor’s appointments and

things have changed since the time that I moved in here,”

more help with finding friends to enjoy activities with.

Jed says. “We have members who are afraid they’re going to

GNPS members, who now number nearly 600, have formed

be priced out.”

a pretty tightly-knit social network that increases that

The group is also listening to and advocating for older residents in two areas that concern many New Yorkers and are high on Age-friendly NYC’s list of priorities: affordable

None of the four subway stops in her neighborhood has elevator or escalator access, Jed adds, limiting transportation options for older residents.

GNPS has been advocating for its members on both fronts, 41

feeling of connection, she says.

reaching out to Park Slope residents who may be eligible

don’t often reach,” mostly due to the wide scope of the

for Senior Citizen Rent Increase Exemption (SCRIE) sign up

assessment.

and partnering with a council member to demonstrate in support of better subway access.

The most significant conversations from the community needs assessment results were published in the series

Resident directives like these are much harder for city

“City Voices: New Yorkers on Health” which included

officials, business owners, and community leaders to

six deep dives into topics of particular concern to the

ignore.

community, including mental health, aging, food and nutrition, and the health needs and perspectives of the

Raising City Voices In 2014, the Academy’s Center for Evaluation and Applied Research (CEAR), the Center for Health Innovation and the Center for Health Policy and Programs conducted an unprecedented community needs assessment on behalf of 14 large hospital systems and their partners in the Bronx,

Weiss, who trained as an anthropologist, says talking to people about their lives and what’s important to them is the best place to start true community work. “How could you know what’s going to work and what people need without talking to them?” she says.

Brooklyn, Queens and Manhattan. Through focus groups,

Those conversations are inevitably eye-opening.

individual interviews and surveys of thousands of low-

“Sometimes you come away thinking ‘O.K., of course we

income and uninsured residents in these communities,

knew that.’ But then there’s some surprising, or novel

the center and its partners learned what mattered most to

detail,” Weiss says.

those who live there.

42

immigrant and transgender populations.

In the City Voices Overview report, for example, a focus

“We asked about their health concerns and priorities, and

group of people with disabilities revealed a surprising lack

also for recommendations for changes that might improve

of sensitivity to the basic needs of this community in the

health and the delivery of health care services in their area,”

health care setting, including adjustable heights on exam

says Linda Weiss, PhD, director of CEAR, “and we got great

tables and allowing extra time for exams when limited

information from a lot of different people and groups we

dexterity makes undressing difficult.

43

Noise pollution can damage hearing and contribute to poor health.

The City Voices Publication Series

“The geriatric population cannot afford, on their Social Security checks sometimes and pensions, to get the proper foods ... that is very much prominent in our communities.” ― FOCUS GROUP PARTICIPANT, MANHATTAN

“ When you say “I’m trans” at the doctor they give you this look of death, like “trans?” and then I hate to explain …” ― TRANSMAN

Understanding the health needs of historically disadvantaged groups is a key aspect of addressing the tremendous health inequities that occur in cities like New York. But it’s also at the heart of the Academy’s approach to understanding the needs

“ I think that one of the things that we’ve identified for sure is that a lot of seniors are alone in the community … that has an absolute effect on their physical wellbeing.” ― OLDER ADULT SERVICE PROVIDER, QUEENS

of our neighbors.

In 2014, the Academy’s Center for Evaluation and Applied Research reached out to thousands of them from

on the issues that repeatedly show up in research as linked to poor health— limited services for older adults, poor nutrition, little or no opportunity for physical activity, discrimination in health care (especially for transgender residents), and mental health challenges.

The series includes these reports: • The City Voices Overview:

“ I have been in line for three hours before. Three, four hours in the cold in line for the pantry to open so I can be one of the first in line. I try not to be there past ten, because if you are, that line will go all the way around the corner, two lights down sometimes.”

New Yorkers on Health • Transgender: Speaking Out for Better Health • Mental Health: Context Matters

block. There’s a Bojangles on every block. So, this is what we have on every block. Look in a one mile radius and this is 90 percent of what we have in our neighborhood.”

low-income communities in Queens, Manhattan, Brooklyn and the Bronx

“ A liquor store on every block.

People don’t look at that.

There’s a fast food store on every

― FOCUS GROUP PARTICIPANT

― FOCUS GROUP PARTICIPANT, BRONX

“ People in the Bronx suffer from trauma just because of the areas that we live in. You walk down a block on a Saturday afternoon and nothing’s going on until you turn a corner and get shot.” ― FOCUS GROUP PARTICIPANT, BRONX

• Physical Activity: New Yorkers on the Move • Immigrant Communities: Bridging Cultures for Better Health • Aging: Health Challenges and the Role of Social Connections • Food and Nutrition: Hard Truths

44

About Eating Healthy

“ Oftentimes they would forego getting any care,

getting screenings, or even if they were deathly ill, they will totally wait until the end. And even with people who had insurance, because they were afraid of the cost of care.” ― ASIAN COMMUNITY HEALTH ADVOCATE

P.S. 282 Elementary School student garden, Park Slope, Brooklyn

The decision to share information like this, and the other

Borough President Gale Brewer, Community Voices Heard,

numerous insights from New Yorkers in the City Voices

Community Board 11 and the plan’s Steering Committee—

series, was an easy one, Weiss says. “We wanted to make

and led eight community visioning sessions with hundreds

sure that all this was heard and to make the information

of residents to get feedback on how the plan might affect

more broadly available to everybody in New York City so

them.

that it could be used in developing policy and programs,” Weiss says. “It’s rare to have so many organizations come together like this.”

While community members mentioned concerns such as food access, parks and pools, these were not their top worry, says the Academy’s Director of Prevention and

When New York City unveiled its plans to dramatically

Community Development, Kimberly Libman, PhD, MPH.

alter the East Harlem neighborhood via rezoning

“Their top concern was almost always housing affordability

and development, it was immediately clear that the

and displacement,” Libman says. With good reason.

proposed changes could have big impacts on the health of neighborhood residents. East Harlem, the Academy’s home, is the twelfth-poorest NYC neighborhood, and is home to some of the highest density of public housing,

East Harlem has lost more than 1,800 units of affordable housing since 2011 and is estimated to lose 6,800 units more over the next decade.

poorly-maintained housing, and a disproportionate

East Harlem residents wanted to have their voices heard throughout the neighborhood plan process.

In response, in 2016, the Academy completed the city’s second-ever health impact assessment to outline the potential implications of the plan’s zoning and

To help make this happen, the Academy worked with

affordable housing recommendations and

its partners in the neighborhood plan process—New

offer recommendations on how to reduce the

York City Council Speaker Melissa Mark-Viverito,

impact on East Harlem residents.

45

number of older people living in poverty.

“ The Health in Action Summit allowed regular people to feel like they were part of the process.” ― NILSA ORAMA Community Visioning Workshop, photo from the East Harlem Neighborhood Plan

Among these: improve the indoor environmental conditions of existing housing, particularly in older buildings and public housing; mitigate dust exposure during construction; help small businesses provide affordable health care for their employees; and reduce housing violations.

Words Into Action Like the public deliberations used in Brooklyn to discuss mental health, the Academy again partnered with the New York City DOHMH, NYC Health Center for Health Equity, Mount Sinai Hospital, the New York State Health Foundation and the Fund for Public Health, but this time the focus was supporting promising community work in East Harlem.

Working with residents, the group reviewed applications from 20 organizations. Nine were chosen to receive $25,000 grants at the 2016 Health in Action summit held at El Museo del Barrio. Recipients included East Harlem Council for Human Services, Inc., for East Harlem – Up, Out & Healthy; Harvest Home Farmer’s Market, Inc., for Healthy Seniors NYC; and Sisterhood Mobilized for AIDS HIV Research and Treatment project.

For many East Harlem panelists, the opportunity was their first community engagement, says Cinthia De La Rosa, project coordinator of the East Harlem Neighborhood Action Center.

46

Not so for panelist Nilsa Orama, 55, an East Harlem native and member of Manhattan’s Community Board 11, who has worked for 18 years with non-profits in her own

neighborhood. “I think it’s more important to be proactive than reactive: Change happens … if you’re not involved, you’ll only be reacting, and by that time it’s too late,” she says.

The Academy’s Health in Action Summit allowed “regular people to feel like they were part of the process,” Orama says. “I thought that was really important because you want buy-in from the community for any project to be impactful. If you don’t have buy-in then the results are always going to appear skewed.”

De La Rosa says that too often regular people are excluded from the grant-making process. “Having those voices represented throughout the process is really key to understanding if we’re doing things the right way,” she says.

The public deliberations were a hit in Brooklyn, too, where the Academy and DOHMH are planning a Spanish language session in the summer of 2017.

“There was tremendous gain from the deliberative panels because we were able to keep the voices of the community at the center, and we had neighborhood context,” says Easterling. “Residents were so happy—we received so much feedback afterwards asking when they could do this again, how they can help, and what other initiatives they can get involved in.”

Brie Zeltner is a health care reporter for the Cleveland Plain Dealer and the 2015 winner of the Academy’s Urban Health Journalism Prize.

East Harlem: Making a Difference at Home

The Academy took its place on the corner of

To ensure that the changing neighborhood

The Community Alliance is only one aspect

East 103rd Street and 5th Avenue in 1927,

would offer economic opportunity and

of the Academy’s work in the neighborhood.

when East Harlem was already a diverse,

affordable housing to newcomers as well as

As a member of the East Harlem Healthy

bustling community. As the years passed,

longtime residents, the Academy became one

Neighborhood Initiative, the Academy

and Italian Harlem became Spanish Harlem in

of a group of local organizations determined

works with the NYC Center for Health Equity

the 1940s, then grew to become El Barrio—a

to promote the health and wellbeing of

and Mount Sinai Hospital to increase the

sweep of city blocks stretching from 96th

community members.

availability of healthy foods, improve the built

Street to the 140s, the Academy remained a

“About eight years ago, there was a group

environment, boost economic opportunities

of non-profits that worked together here

and connect residents with programs that

That began to change in the 1990s when the

sometimes, but it was not a formalized effort,”

support health-enhancing lifestyles.

Academy’s researchers established an office of

says David Nocenti, executive director of Union

Urban Epidemiologic Studies in the community

Settlement, the third largest employer in East

As a member of the East Harlem Neighborhood

and, along with other health institutions,

Harlem.

began tracking urban health issues. The

Nocenti decided that bringing the group

conducted, in 2016, the first “East Harlem

together regularly to share ideas, concerns

Neighborhood Plan Health Impact Assessment

and resources would increase their ability to

(HIA): Connecting Housing Affordability

address the community’s needs. “At the first

and Health”—the first HIA ever conducted

Academy’s partnership—Community-Based Participatory Research—was cutting-edge at the time and focused on HIV/AIDS, substance use and asthma.

Plan Steering Committee, leading the subcommittee on health and aging, the Academy

meeting, we had 10 people. At the second,

for the community. The HIA informs policy

The organization took on the full roll of

there were 20. It just grew after that,” he says.

makers about how redevelopment may affect

community advocate in 2009, when we

That organization became the East Harlem

residents.

became partners, through our School Health

Community Alliance—as a member, the

Program, in the Strategic Alliance for Health,

Academy leads the effort to help neighborhood

While the Academy brings resources to the

a Centers for Disease Control and Prevention-

businesses expand their markets. “I want to

funded project created to make sustainable

say kudos to Jo Ivey Boufford. Not everybody

improvements in policies that might affect

stepped up, but she did. When I got here,

children’s health. The initiative concentrated

people did not see the Academy as involved in

on nutrition, physical education and wellness

the community, but she’s been a great leader,

in East Harlem schools. The first age-friendly

a great partner.”

neighborhood was also in East Harlem.

community and works to raise its voice, community members also give to the Academy by sharing their stories and ideas. “The community partnership has made us more effective as we advance urban health in the state, nationally and internationally,” says Academy President Jo Ivey Boufford, MD.

47

good, but somewhat quiet neighbor.

1. Joseph Fins, MD, leading medical ethicist and Academy Fellow Ambassador, speaks to new Fellows.

2. Francine Cournos, MD, 30-year Fellow speaking at the Annual Meeting.

ON THE FRONTLINES FOR HEALTH

as an advocate for patients who cannot speak for themselves, as he passionately and convincingly argues that better treatment for people with traumatic brain injury is a civil rights issue, and engages in other tough health issues.

“One of the things that attracted

KIRI OLIVER

me to the Ambassador program in

T

2016 was that it was full circle for my “The Academy has really

discuss common concerns and pursue

been a touchpoint for

common interests in a way that was

me for almost 25 years,

nurturing to all of us.”

almost the entirety of my career in medicine,” says

Joseph Fins, MD, a leading medical ethicist and Academy Fellow since his days as a young resident.

began in 1990 when his mentor, Jeremiah Barondess, MD, became the Academy’s president. Barondess encouraged the young resident to

Early Champions of Urban Health As a Fellow, Fins is a proud member of the Academy’s oldest tradition. The first Fellows founded the Academy in 1846 as a place for physicians to come together and enrich their

Now the director of Medical Ethics

give one of his first public talks—

at New York-Presbyterian Weill

and publish in the organization’s

Cornell Medical Center and Chief

journal. As he became an expert in

Now a group of more than 2,000,

of the Division of Medical Ethics at

his field, Fins would join then Senior

the Fellows not only work on

Weill Cornell Medical College, and

Vice President, Alan Fleischman, in

critical issues within their various

an internationally known advocate

developing an education project for

sections, they expand the Academy’s

for patients with severe brain injury,

young Fellows on medical education.

key intramural research, policy

Fins credits the Academy, and the relationships he formed there, as key to the development of his career.

48

Fins’ relationship with the Academy

career,” says Fins.

In 2016, Fins also became a public face of the program as one of 12 Fellow Ambassadors. Accomplished leaders

“The Academy is an indispensable

in their respective fields, Fellow

institution in the city,” Fins says. “I’ve

Ambassadors act as spokespersons

really always liked that it serves as the

for the Academy.

Switzerland of New York medicine—a

Through op-eds and

place for people in different health

media commentaries,

care systems to come together and to

he advances his role

contributions to public health.

and program work. “I see it as a partnership with the Fellows and the various sections and the people they bring in, the speakers and others,” says George Thibault, MD, chairman of the Academy’s Board of Trustees.

The Fellows have grown from a small group of pioneering physicians to a vibrant, diverse community.

FIVE FOUNDING FELLOWS

Alexander Stevens, MD

Isaac Wood, MD

John Stearns, MD

John W. Francis, MD

Valentine Mott, MD

“The Academy has really been a touchpoint for me for almost 25 years, almost the entirety of my career in medicine.”

-JOSEPH FINS, MD

1.

2.

Rewarding Excellence As an extension of the Fellows program, the Academy administers more than $400,000 in endowed research awards, grants, fellowships and lectures each year. Among them: The Ferdinand C. Valentine Fellowship Award

The Edward N. Gibbs Memorial Award and

for Research in Urology

Lecture in Nephrology, in partnership with the

Cardiovascular Diseases

New York Society of Nephrology The Thomas W. Salmon Award and Lecture in Psychiatry

49

The Glorney-Raisbeck Fellowship Award in

Today, the group has grown from

Healthy Aging: A New Interdisciplinary Approach

fourteen pioneering physicians to

One of the most important areas of the

community activities, public advocacy,

a vibrant, diverse community of

Academy’s work is improving health and

leadership development, education, research,

individuals, elected by their peers,

wellbeing for the more than 1 million New

and policy. The section will also work in

York City residents, or 12 percent of the total

partnership with Academy staff on its Age-

population that are age 65 or older—a number

friendly NYC initiative.

projected to increase by 40 percent over the

More than 60 Fellows from across disciplines

from across the professions affecting health. Working collaboratively across disciplines and specialties,

next 25 years (projected from a 2010 baseline).

signed a petition to establish the Section—

in a tradition of honor and service,

In support of that work, a new Fellows

something Boufford says “never would have

the Fellows are organized into 20

section—the interdisciplinary Section on

happened 10 years ago.” The interest is a

diverse sections and interdisciplinary

Healthy Aging—was established in 2017.

testament to the paradigm shift the Academy

The goal is to bring a broad range of experts

and Age-friendly NYC have facilitated in

together to identify opportunities to make

positioning aging as a cross-sectoral urban

it easier for older adults to have healthy

health issue.

workgroups that address clinical and population health issues facing individuals and communities in New

lives in New York City. The group will target

York City and cities around the world.

“The first 150 years of the Academy’s successes in urban health were the successes of the Fellows,” says Academy President Jo Ivey Boufford, MD. Their accomplishments included the establishment of the city’s first sanitation department and board of health—a system later replicated

organization’s Fellowship also opened

Fellows and the Academy and created

for the first time to non-physicians.

a centralized source of support for the

New professionals who were admitted

Fellows and their work—the Office of

at that time included nurses and

Trustee and Fellowship Affairs. The

social workers.

office’s staff supports the Fellows’

“Interdisciplinary—that’s the

across the country.

condition of the world we’re working

Working together in committees

of the population is the aggregate

and sections representing different specialties, they advocated for public health issues and organized frequent lectures and continuing education events for the medical community, exploring issues such as maternal mortality. Under Barondess’ leadership from 1990-2006, the

in,” says Barondess. “The health health of the individuals in it. We’ve learned in recent decades that social determinants are incredibly important in how healthy people are. Public

a range of clinical specialties, but also nursing and oral health as well as health care delivery, the history of medicine and public health, and a working group in primary care and population health.

“There’s no other organization in the

clinical community.”

city where the health professions come together across institutional

“The first 150 years of the Academy’s successes in urban health were the

focus as an urban

successes of the Fellows.”

with units devoted to epidemiological studies and urban bioethics, among others. During this time, the

boundaries to learn, network and be agents for change together,” says Boufford. “We wanted the Fellows to be reengaged as a meaningful force because these are our roots, and the

― JO IVEY BOUFFORD

health policy, urban

50

working groups, including not only

health was at a distance from the

Academy refined its health organization

increasingly diverse sections and

unique character of the organization.”

With increased staff support from

When Boufford became president of

the Academy, the Fellows renewed

the Academy in 2007, she sought to

and increased their engagement

enhance the connection between the

in discipline-specific activities,

interdisciplinary collaborations,

Health Foundation and NYU Langone

and work with Academy staff and

Medical Center’s Department of

programs. The section on pediatrics,

Population Health.

for example, was bolstered by staff support in securing a grant for influential research on child health.

Fellows acted as expert advisors on the Academy’s HIV/AIDS research.

The Section on Health Care Delivery, staffed by the Academy’s policy unit, continues to host several, wellattended events each year, including the annual Albany Update on New York State health care reform. Most recently, the Academy established

At the fourth annual summit in December 2016, nearly 400 federal, state and local leaders in health care and public policy, community leaders, researchers and others packed the Academy’s Hosack Hall to talk about advancing population health, addressing disparities and facing the uncertainty surrounding the new administration’s plans to repeal the Affordable Care Act. Jeremiah Barondess, MD

a new section on healthy aging, in partnership with its Age-friendly NYC

Every year at the annual meeting, new Fellows are inducted and there is an Anniversary Discourse and Awards. It dates back to a tradition begun by the Academy’s founders in 1847 of inviting a major figure, often in medicine or government, to address the group.

Each year, the Academy honors some of the world’s top leaders in biomedical science, clinical practice, health policy, and public health, as well as Fellows celebrating 30 years of affiliation with the organization.

The Fellows office, sections and workgroups host more than 40 events each year, including lectures, panels, symposia and authors’ nights featuring Fellows’ publications. One of the most popular events is the Population Health Summit, organized by the Fellows’ work group on Primary Care and Population Health in partnership with the New York State

Pioneering Fellows Albert Anderson, MD Expert on rehabilitation of the disabled and founding director of the rehabilitation medicine department at Harlem Hospital Center

Ruth Watson Lubic, EdD, RN Midwife, MacArthur Fellow Herbert Pardes, MD Executive Vice Chairman of New York–Presbyterian Hospital

Robert N. Butler, MD Leading expert in aging and gerontology and Pulitzer Prize-winning author, who was the first director of the National Institute on Aging

Stephen Smith, MD Founder of the American Public Health Association

Duncan Clark, MD, PhD Public health expert and preventive medicine specialist, and former Academy president

Elizabeth Swain Former CEO of the Community Health Care Association of New York State (CHCANYS) and leader in community healthcare advocacy

John W. V. Cordice, Jr., MD Eminent surgeon on the team that saved Dr. Martin Luther King, Jr.’s life at Harlem Hospital in 1958

Today’s Leaders

Rose Dobrof, DSW Pioneer in the field of gerontological social work and nationally recognized expert in aging

Claire Fagin, RN, PhD Prominent nurse considered the founder of family-centered care, and the first woman to serve as president of an Ivy League university

Alfred M. Freedman, MD Past American Psychological Association president responsible for removing homosexuality from the DSM in 1973

Catherine Alicia Georges, RN President, AARP Board of Directors Chair, Department of Nursing Lehman College

Phyllis Harrison-Ross, MD Pioneering African-American pediatrician, psychiatrist and mental health administrator

David Hamburg, MD President Emeritus, the Carnegie Corporation

Abraham Jacobi, MD Founder of the medical specialty of pediatrics

Ruth Westheimer, EdD Internationally known sex therapist, media personality and author

51

initiative.

Members of the next generation of health professionals also find many opportunities at the Academy to

“Nurses must be full partners with doctors and other health professionals.”

conduct and present research, seek the guidance of mentors and find new ways to solve today’s health

networking to the effect that it landed

practice for vulnerable, underserved

problems. Students and residents

me here in the health department in

communities across the city.

are invited to join at the student

this dream job,” says Hewitt Chiu, a

and associate member levels, and

2015 Mahoney Fellow.

many sections hold annual student or residents’ nights. In addition, four of the Academy’s research grant and fellowship programs are for students, including the Margaret E. Mahoney Fellowship Program in Health Policy. Mahoney Fellows are medical, dental, public health, public policy, and graduate nursing students who complete summer research projects on aspects of health care delivery transformation for vulnerable populations or early childhood health and development.

Chiu is referring to the night he sat on a Fellows’ panel with Academy Executive Vice President Anthony Shih, MD, MPH, who said something that stuck with him. He told Chiu that every single job he’d had was through networking. Chiu took the advice to heart and consulted him for career advice. That led to a position at the NYC Department of Health and Mental Hygiene where he now leads the Mental Health Service Corps, the largest program under the mayor’s

“There’s a huge base of different health professionals at the Academy, and it’s uniquely positioned at the center of urban health here in NYC,” Chiu says. “There are so many different ways to get involved: attend events, apply for a fellowship, network, seek out advice. I really don’t think I would be where I am today without that kind of access.”

Kiri Oliver is a communications manager at The New York Academy of Medicine.

Thrive NYC initiative. In this role, Chiu

“I knew the importance of networking,

manages the integration of behavioral

but I never experienced the power of

health services into primary care

Nurses: Critical Partners in Improving Health Ensuring that the Academy is truly a home

research and rehabilitation (co-presented with

for all health professionals, the Fellows’

the Section on Ophthalmology). The sections

section on nursing was established in 2015 by

panels include an analysis of progress—at

leaders in the field of nursing. “Nurses must

five years—of the groundbreaking National

be full partners with doctors and other health

Academy of Medicine (formerly IOM) report,

professionals in redesigning health care in the

the “Future of Nursing: Leading Change,

United States,” says Donna Nickitas, PhD, RN,

Advancing Health.”

52

NEA-BC, CNE, FAAN, vice chair of the Section on Nursing. With the support of organizations

“This organization is really the only one in the

“As we look at the areas of the mission—

that include the Jonas Center for Nursing

New York metropolitan area that provides

disease prevention, health promotion, the

and Veterans Healthcare, the section events

true interdisciplinary, inter-professional

elimination of health disparities, and healthy

cover a range of topics—technology in the

opportunities for dialogue and action related

aging—these are nursing’s interests and

classroom, end-of-life care, the importance

to urban health,” says Section Chair Connie

values. We think that we’ll bring a particular

of nurses in leadership roles in health and

Vance, EdD, RN, FAAN, professor of nursing at

perspective and energy to these goals of the

medicine, and updates in ophthalmology care,

The College of New Rochelle School of Nursing.

Academy.”

1.

3.

2.

1. The Ferdinand C. Valentine Award and Lecture in Urology 2. Dr. Boufford speaking at the 2016 Anniversary Discourse & Awards 3. Fellow Ambassadors class of 2016-2017 group photo 4. Dr. George Thibault presenting new member Gloria Otoo, RNC-OB, C-EFM, MS, PhD(c), Member, Clinical Adjunct Faculty, Molloy College, with a certificate at the Annual Meeting induction ceremony.

53

4.

54

Drs. Barry and Bobbi Coller Rare Book Reading Room, The New York Academy of Medicine

improve the health of pregnant, parturient and postpartum women.

LOOKING BACK TO SHAPE THE FUTURE

And while the story, to be sure, is an example of Boufford’s determination to resolve tough public health issues, it is also a story of how she has integrated the Library with the two other pillars of the Academy.

To change the way physicians took care of mothers-to-be, she drew on the Library’s vast historical collection of books and reports to inform the Academy’s Fellows and

RANDI EPSTEIN, MD, MPH

Institute of Urban Health, as well as other stakeholders, about the need In the spring of 2008,

The assumption was that medical

to develop new policies on maternal

Academy President Jo Ivey

care since then had at least partially

health and other contemporary health

Boufford, MD, was preparing

solved the problem. But the facts got

problems.

her opening remarks for an

in the way of her triumphant story.

event in the Academy’s library. The

Boufford’s research found that in

upcoming evening commemorated

2008, New York ranked among the

the 75th anniversary of a pivotal

worst states in maternal mortality.

maternal mortality report.

It is just one of the ways the Library has been transformed over the last ten years, from an esteemed 20th century medical repository to a

As a pediatrician who had practiced

unique and active interdisciplinary

Her plan: to retrieve a copy of the 1933

for 15 years, the health of newborns

intellectual hub for 21st century

manuscript housed in the Library’s

and their mothers was integral

scholars, attracting physicians,

Drs. Barry and Bobbi Coller Rare Book

to Boufford’s medical training.

Reading Room—and contrast it with

As clinician and policy maker, the

the gynecologic advances today. Or as

contemporary data shocked her all

Boufford says, to “start by saying how

the more. “There we were, [number]

far things have come.”

46 out of 50,” she says. That is, New

The original study— “Maternal Mortality in New York City: A Study of Puerperal Deaths 1930-1932, by the New York Academy of Medicine’s Public Health Relations”—was a

York ranked nearly rock bottom, with only four states scoring worse. The mortality data comparing AfricanAmerican and white women was 7 to 1 in the city; 3 to 1 in the state.

landmark exploration revealing a

Instead of a celebration of medical

dismal and embarrassing state of

advances, her talk transformed into

affairs. Back then, upwards of 60

a call for action, one that would lead

women died for every 10,000 births,

to further meetings and encourage

researchers found.

policy changes on a state level to

Anatomical Manikin, 1700s, from the Academy’s Jerome Webster collection

55

I

the researchers in the organization’s

FESTIVALS & SERIES

2014 2013

Festival of Medical History and the Arts

Art, Anatomy & the Body: Vesalius 500 Performing Medicine Chef Jacques Pépin, Eating Through Time Festival

historians, and students not only

Hospitals then were hospitals—not

from New York but from across the

medical centers. That is, they did not

Garbage & The City: Two Centuries of Dirt,

country—and indeed overseas as well.

have their own libraries. Indeed, the

Debris and Disposal

“The big shift for us was to have the Library share the collections with the public rather than protect them from

Eating Through Time: Food, Health & History

tradition of going to the Academy for current and historical articles and books continued throughout the 20th century. Many physicians credit the

original mission of the Library—as

Library’s collections, both current

a go-to place—was fading in part

Or as Arlene Shaner, the Historical

and historical, for providing crucial

because medical centers had their

Collections Reference Librarian put

materials for their own publications.

own collections, but also because

it, Boufford “has presided over a

But more than that, the librarians

researchers could access articles

complete restructuring of the Library,

there have also served as a trove of

online. It was time to reconsider the

with an emphasis that falls squarely

information, a human card catalogue,

Library’s aims. The result was creating

on the historical collection [rather

directing researchers to much needed

the Library’s Center for the History

than modern texts]. That’s not the

and little-known sources.

of Medicine and Public Health and

the public,” says Boufford.

library we had when she arrived.”

A Rare NYC Resource The Library was established in 1847.

It quickly became the only place for local physicians to read medical journals, to retrieve news and to explore the legacy of their fields.

56

2015

“Our library was the medical library where everyone came to study as well as do their research in the 20s and 30s and 40s,” says Boufford, “but as health centers developed their own libraries, this part of its role gradually became less relevant.”

By 2008, she realized that the

bringing in Lisa O’Sullivan, PhD, in 2012, to expand programming and highlight the historical collections. A former senior curator of Medicine at the Science Museum, London, where she curated the Wellcome Collection, O’Sullivan brought an extensive knowledge of historic medical collections.

2016

2016

Fast, Cool & Convenient: Meeting New Yorker’s High Demands

2017

Changemakers: Activism and Advocacy for Health

Where Will the Next Pandemic Come From?

Legacies of War: Medical Innovations & Impacts

O’Sullivan expanded the Library’s

judge and NYC restaurateur Tom

current health and policy issues.

public image by building relationships

Colicchio. The topic was a natural

Boufford’s vision is to ensure that the

in the scholarly, professional, and local

choice for the Library—home to a

Library modernize and continue to be

communities and initiating public

collection of 10,000 culinary books

a valuable resource for the city.

programming that included evening

dating back to the 9th century

events with noted authors as well as

Apicius, the oldest surviving cookbook

day-long programs highlighting the

in the west. Another event was the

gems of the collection.

Vesalius 500 celebration, exploring

where people can, whatever their background, explore questions about health, both individually and in a broader context,” says O’Sullivan.

“We want to think about our public programs more broadly by exploring

the long history of art and anatomical investigation through the work of the father of modern anatomy. It

The Academy Library’s collection is unique in the world and includes:

NEARLY

550,000

delved into contemporary aesthetics and representations of the body and their implications for people with disabilities.

VOLUMES ABOUT

32,000

the political and social components of

The public programs reflect the

medical and health issues.”

diversity of collections from key

formative texts from the Renaissance

MORE THAN

Nearly a thousand people packed the Academy to hear legendary author and speaker Oliver Sacks, MD. In 2015, a one-day festival exploring food history and food systems lured culinary historians and famed French chef Jacques Pépin and Top Chef

to New York-centric stories, on occasion in collaboration with the

RARE BOOKS

450,000

Academy’s next door neighbor, the

PAMPHLETS

Museum of the City of New York.

APPROXIMATELY

Among the goals is to link important historical and cultural questions to

2,000

LINEAR FEET OF ARCHIVES

AND MANUSCRIPTS

57

“What we are trying to be is a space

By the Numbers

Oliver Sacks (2nd from left), book signing at the Academy

Digitizing History

The Gladys Brooks Book and Paper Conservation Laboratory

maintain their original look and feel.

decade ago, Boufford called together

Digitization and projects like the

directors of hospitals, physicians,

To capture the next wave of innovation and preserve key parts of the collection for generations to come, the Library has launched a project to digitize the collection.

Biography of a Book (supported by

advocacy groups and policy makers to

the National Endowment for the

draft proposals that are improving the

Humanities) will allow ever wider

health of women today. “As a non-

audiences to explore and share the

profit,” she added, “our only skin in

Library’s treasures.

the game was to work systematically

It also means providing Internet

These initiatives provide a rare sense

access to some of the unique and significant materials so they are accessible to global audiences, exploring ways to make the material available to scholars and to the public

of authenticity about the books and will also allow the collection to continue to serve as an agent of change.

That was certainly the case when

The Academy’s book conservation

Boufford presented her maternal

laboratory repairs collection materials

mortality talk using old and new

not just to continue to make them

material from the Library. Since that

available to the public but also to

commemorative presentation nearly a

58

Who knew? In partnership with the Museum of the City of New York, the Academy launched a three-part series in the summer of 2015 entitled Garbage & the City: Two Centuries of Dirt, Debris and Disposal that was attended by over 600 New Yorkers.

Learning about the untamed Manhattan of the 19th century, the pork and milk industries, and a web of corrupt politicians was just the beginning of the program’s foray into the refuse and ultimately the health of the city over time.

change,” she added. Using technology to extend the Library’s reach greatly contributes to the Academy’s role as a key player in the future of urban health.

who have different research needs.

New Yorkers Love Garbage

with key stake holders to implement

Randi Epstein, MD, MPH, is a professor and writer whose work has appeared in the New York Times, Washington Post, the Guardian and other publications.

The series was just one of several programmatic series offerings initiated in 2013 by Vice President and Library Director Lisa O’Sullivan, PhD. The introduction of event series and festivals has drawn thousands of culturally inquisitive New Yorkers past the Academy doors and built a loyal following of programming supporters.

Showcasing the significant holdings of the Library, the series and festivals offer a unique insight into the connection of the history of medicine and health to the cultural mores of yesterday and today.

1.

2.

3.

4.

“Our Library was the medical library where everyone came to do their research in the 20s and 30s and 40s.”

-JO IVEY BOUFFORD, MD 59

1. Lower jaw of a denture made for George Washington by Dr.John Greenwood in 1789.

Gift of Mary and Eliza Greenwood, 1937.

2. Apicius. [De re culinaria, Libri I-IX]. Manuscript penned at the monastery in Fulda, Germany, in 830.

3. Detail from the title page of Andreas Vesalius. De humani corporis fabrica libri septum. Basilea: [Ex officina J. Oporini, 1543].

4. Shibata, Koichi. Geburtshülfliche Taschen-Phantome, 2nd ed. Munchen: J.F. Lehmann, 1892.

5. Penicillium Notatum from the Original Culture presented to Ruth Draper by Sir Alexander Fleming in 1936 and given by her to the Academy in memory of her father, Dr. William Henry Draper.

5.

Cookery books, like the 9th century

PRESERVING HERITAGE AND HISTORY

manuscript of Apicius, De re culinaria (sometimes also called De re coquinaria), widely referred to as the oldest surviving cookbook in the west or our 1596 copy of Bartolomeo Scappi’s Opere, with the first printed illustration of a fork and its many other images of kitchen tools and cooks at work, connect us to the long history of thinking about the foods

ARLENE SHANER

we eat, how we prepare them and how they connect to our ideas about health.

Some books in the collection have

Almost everyone who walks into

the extraordinary items the librarians

the Drs. Barry and Bobbi Coller Rare

pull from the shelves to share.

Book Reading Room comments on the beauty of the space. From the embossed plaster medallions in the ceiling to the specially designed chandeliers decorated with early printers’ devices to the elaborately carved moldings to the locked grills that protect the 16th and 17th century rare books housed behind them, the room looks just the way many people imagine a room that houses a rare book collection should look.

Those who wish to discover the early

features that make them truly unique, even if copies exist in other libraries. An early owner of our copy of Guillaume Rondelet’s 16th century

history of medicine may begin with the collection of anatomical atlases, such as Andreas

“Our 1596 copy of Bartolomeo

Vesalius’ De humani corporis

Scappi’s Opere connects us

fabrica (On the structure

to the long history of thinking

of the human body) from

about the foods we eat, how

1543 or the 18th century editions of Bernhard Siegfried

we prepare them and how they

Albinus’ tables of the bones

connect to our ideas about

and muscles, or even our

health.”

recently acquired Bodyscope

The true excitement of the room—

from 1948, with its wheels

refurbished and named for the Drs.

that rotate to show various organs

Coller with a generous gift from the

and systems. Each volume helps

Samuel J. and Ethel LeFrak Charitable

us understand the choices made,

Trust and Foundation, Inc.—though,

over centuries of medical discovery,

comes from having the opportunity

about how to best illustrate the body

to explore some of its treasures.

and explain its functions. These

Visitors, who may be students,

books also illuminate the many

filmmakers, researchers, physicians or

collaborations between physicians

the general public, often crowd around

and artists that make them so

the tables to take advantage of the

engaging to look at.

60

opportunity to see, up close, some of Scappi, Bartolomeo. Opere. Venice: V. Pelagalo, 1596.

Guests at the Academy Fellows’ Section on Ophthalmology’s History Night discover the treasures of the Drs. Barry and Bobbi Coller Rare Book Reading Room, with the help of Arlene Shaner, Historical Collections Librarian, 2016.

Friends of the Rare Book Room

book on marine fish pasted in his own

The history of health and medicine in

hand-colored drawing of a whale that

New York can also be explored through

washed up on the beach at Ancona,

the Library’s collections. A visitor

Italy, in 1585, noting on the drawing

might begin by poring over physicians’

Established in 1945 by a dedicated

how many teeth he could count in

notes from the cholera epidemic

group of Academy Fellows, the Friends

the whale’s jaw as well as how long it

that swept through the city in 1854.

was. Underneath the gilded edges of

Every page personalizes the impact of

an 1805 medical dissertation about

that epidemic, offering us glimpses

In 1947, the first three volumes were

arthritis by John Booth is a double

of individuals who succumbed to or

bought and presented to the Library.

fore-edge painting, with portraits

survived the disease. The 1865 report

In the ensuing 70+ years, that small initial

of William Harvey, John Hunter and

of the Council of Hygiene and Public

group of Friends has grown considerably

Edward Jenner. This short book, in a

Health of the Citizens’ Association, the

as has the breadth and depth of their

collector’s binding, reveals its secrets

document that finally helped get the

interests and contributions to the Library.

only to those who know that they

legislation to establish the Metropolitan

need to fan the edges of the text block

Board of Health passed, articulates how

to view the hidden faces.

many of the health issues city residents

and protect the Academy’s collections.

faced were preventable even then, and

The Friends are also avid supporters of

living conditions. A day spent in the Drs. Barry and Bobbi Coller Rare Book Reading Room is a chance to delve into a cache of riches that reveal, in many ways, how our past informs and shapes the present,

contributions for rare book acquisitions.

Although the majority of the Friends are now from the general public, they are just as dedicated in their support to preserve

the Library’s public programs in medicine, history and the humanities.

This unique community of curiousminded New Yorkers also enjoys private behind-the-scene tours, events, and receptions with leading historians, authors, and collectors. Whether

while lighting the way to a healthier

attending an Academy lecture, touring

future for all New Yorkers.

Ellis Island or the Morgan, visiting the

Arlene Shaner, MA, MLS, is the Historical Book with fore-edge painting from the Academy Library. De arthritide. – Edinburgh: Excudebat J. Ballantyne, 1805. Author, John Booth. Painting depicts John Hunter at the top and Edward Jenner at the bottom.

to collect member dues and external

Collections Librarian at the Academy.

home of a private collector, or researching in the Academy’s own Drs. Barry and Bobbi Coller Rare Book Reading Room, the Friends are a dedicated group that is ensuring the history of medicine is preserved for generations to come.

61

could be ameliorated by improving basic

of the Rare Book Room was established

LEADERSHIP LESSONS FOR 2017 AND BEYOND

The Academy was founded by physicians who decided to take a leadership role, beyond their clinical practices, to change conditions in society that prevented people from living their healthiest lives.

Encouraging such leadership in research, education and policy and supporting the leadership development of young professionals has been and continues to be an important commitment of the Academy. Visionary individuals, foundations and businesses have supported Academy programs in leadership development and other clinical specialty areas. Their support of community medicine and public health and of health policy has made a difference in the careers of those who participate. Participants’ work, in turn, improves health in the communities they serve.

Q.

The role the Academy has played in the past, and is well positioned to play in the future, can be a model for building the leadership capacity the nation needs to address the new

A.

62

and public health.

Yes, each year, nearly a half million dollars is invested in fellowships and awards to support the work of the next generation of leaders in many health professions as well as to recognize the

and coming challenges in the ever changing world of clinical medicine

The Academy invests in young scholars who are researchers and future practitioners through grants and fellowships. Why is this such an important part of the Academy’s work and what are your hopes for those supported through the years?

accomplishments of distinguished experts whose work has set the

standard for future leaders.

“…we hope that future leaders will make addressing existing health disparities a priority in clinical care and in the communities in which their patients live.” ― JO IVEY BOUFFORD

Boufford discusses newly-launched Age-friendly NYC at New York’s City Hall.

philanthropy. Supported by gifts from the Robert Wood Giving students and young professionals the opportunity

Johnson Foundation (RWJF), the Commonwealth Fund,

to pursue a research interest, to work with students from

the Carnegie Corporation and the Tides Foundation, this

other health professions on a community project, or to

program supports applied research projects for up to 10

explore the world of policy and how their work might have

students a year with the goal of preparing them to present

implications for broader societal change is very exciting.

their work to other professionals and link their research to

Leadership development should ideally be a fundamental

policy change.

that they can be more effective in any kind of professional setting and work easily with others inside and outside their organizational homes to tackle challenges to health.

In programs like this, the Academy offers specific leadership training that includes communication skills, conflict management, policy analysis and advocacy, as well as visits with key health policy leaders in the city and

On a global stage, I also work with the InterAcademy

nationally. These special sessions are offered in addition

Partnership, the network of the world’s medical and

to work on their applied research project with a senior

science academies, to create and sustain the Young

mentor.

Physicians Leadership Program (YPL). Each year, an average of 20 young physicians under 40 are chosen from a global pool for their leadership in their area of medicine and contributions to the health of society. There are now more than 120 alumni from more than 40 countries from all regions of the world who are making a difference for health in their countries.

Q. A.

What types of skills do the Academy-funded fellowship experiences include?

A great example of the training we offer is a program we conduct for medical, dental, nursing, MPA and MPH students—the Mahoney Fellowship Program. It was established to

honor Margaret Mahoney, a long-time leader in health

The Academy also continues to support the career development of its alumni by promoting peer learning and support among the group. We know that many of these fellowships can be life-changing experiences because we hear about their importance from those who stay connected to the Academy throughout their careers.

Q.

Throughout your career, you have made it a priority to share your knowledge to guide the next generation of health leaders. What are some of the important trends that they need to be prepared to address in the future?

A.

A big change for all students is the imperative of interdisciplinary collaboration. This is not limited to collaboration among other health 63

part of the training of all young health professionals, so

Jo Ivey Boufford,MD, announces “Age-friendly NYC Enhancing Our City’s Livability for Older New Yorkers” report and the program’s 59 initiatives to make the city age-friendly, 2009.

professionals to deliver clinical care, but now includes collaboration with individuals from disciplines like urban planning, transportation, education, housing, economic development and environment.

the next generation of health professionals.

Finally, we hope that future health leaders will make addressing existing health disparities a priority in clinical care and in the communities in which their patients live.

We learned this firsthand, during our decade as the

This means joining with others to act outside the walls of

National Program office for the RWJF Health & Society

the hospital or clinic. Giving students these experiences

Scholars program—an interdisciplinary collaboration

and the leadership skills to be effective early in their

with six major United States universities, created to train

training makes it much more likely that they can make the

leaders whose research would ask new questions and

difference they want to make in the communities they may

uncover new solutions for improving population health and

eventually serve.

addressing health disparities. Alumni of the program are now in leadership positions in academia, state and federal agencies that influence health policy, and in independent think tanks and non-profit organizations working to apply evidence from their research into policy and practice.

The ability to communicate across disciplines and collaborate for evidence-based health action is even more of a priority as the evidence becomes clearer that

64

health care, while important, contributes a relatively small

Q.

How is the education system for health professionals changing to address these trends and prepare young physicians, nurses, social workers and others?

A.

Many academic health centers are trying to support interdisciplinary team training, but it still proves challenging, especially in the clinical

amount to maintaining an individual’s health and wellbeing

setting. The experiences offered by the Academy can

and preventing premature mortality. This broader

provide opportunities for future professionals in different

definition of health determinants, beyond medical care, is

disciplines in an environment that supports exploration,

a new idea for many and must be seen as fundamental by

debate and collaboration.

A gathering of health care leaders at the Academy.

The kinds of opportunities we can offer to promote

its winners are highly distinctive, from community activists

leadership skills in the next generation will be important

to distinguished clinical leaders. In their own way, they

until they are features of most health professions’

epitomize the importance of working across institutional

curricula, and an explicit part of preparing young scholars

and disciplinary boundaries and the critical importance

who will advance our understanding of the evidence base

of being partners with the patients, populations and

for action on the broader determinants of health. A career

communities we seek to serve and support. For me, one of

as an interdisciplinary scholar advancing this new model

the best examples of this approach has been our work on

requires leadership skills and the willingness to challenge

Age-friendly New York City, which starts with the voices

the traditional incentives of universities.

of older people telling us what makes it harder or easier to live actively and give back to their community. Because

This year, you are being recognized by the Academy with the Urban Health Champion Award for your many years of accomplishment in leading change for health in cities in New York City and around the globe. Prior winners of this award include Valentín Fuster, MD, director of Mount Sinai Heart; previous Academy President, Jeremiah Barondess, MD; Marcel Van Ooyen, president and CEO of GrowNYC; and Earvin “Magic” Johnson, HIV/ AIDS activist and philanthropist, an illustrious group.

What does the award mean to you and what would you say to the urban health champions of tomorrow?

of the unique history of the Academy, we have been able

A.

its pioneering work to improve urban health, and I know it

I am honored to be recognized in such illustrious and diverse company. This award and

to work to translate these messages from the community into evidence-based interventions that city policy makers and political leaders can implement to address older adults’ concerns at the individual and community level, in a sustainable manner. The same model—linking communities to policy makers—has also been at the core of the Academy’s leadership of the New York State Prevention Agenda, a blueprint for making New York the healthiest state.

It has been a joy to lead the Academy in this past decade of will continue to play a critical leadership role in the future.

65

Q.

As New York continues to be one of the world’s most dynamic and vibrant cities, the Academy will remain a leader and innovator in the advancement of urban health.

In every endeavor, we will stay true to our core values. We are determined to remove the barriers that prevent every individual from living their healthiest life.

Our work is grounded in our readiness to take on new challenges, as they arise, and continue to play this important role for years to come.

Please join us in this quest to ensure the health and well-being of those in cities worldwide.

66

NYAM.org/support

The Academy in the City was produced by the Academy’s Marketing and Communications department.

We would like to acknowledge the talent and contributions of the many staff members who have made this possible including our editor Sheree Crute and designer Jill Vance as well as thank our fellow colleagues for their support including Anne Garner, Lindsay Goldman, Kerry Griffin, Kim Libman, Tina Mukherjee, Robin Naughton, Kiri Oliver, Lisa O’Sullivan, Jose Pagan, Arlene Shaner, and Linda Weiss.

We also extend thanks to our authors for their dedication to helping us tell the Academy’s story, and to Dr. Jo Ivey Boufford and Dr. Anthony Shih for their leadership.

5

– Gina Ravosa, director

OUR MISSION The New York Academy of Medicine advances solutions that promote the health and well-being of people in cities worldwide.

Cover photo and New York City street photography by Neil Gavin. Š 2017 The New York Academy of Medicine. All rights reserved.