“…We are each other's business; we are each other's magnitude and bond.”
These words by the poet Gwendolyn Brooks, the first African American to win the Pulitzer Prize, serve as the maxim for CARE: Community Alliance for Research and Engagement. For nearly 300 years, Yale and New Haven have co-existed and our futures, as University President Richard Levin observes, are “inextricably tied.” There have been many successful partnerships: active collaboration in economic development, cultural and scientific enterprise, education, and health. Yet, we can do better.
CARE: Community Alliance for Research and Engagement was established as an integral component of the Yale Center for Clinical Investigation (YCCI). A goal of YCCI is to bring research from “bench to bedside”. The Alliance takes that one step further – ushering research from “bedside to community.” CARE seeks to enhance the health of the citizens of New Haven by fostering rigorous, community-based research and by converting scientific breakthroughs into practical benefits. The New Haven and Yale communities are collaborating in bold and innovative ways to improve the health of our city.
New Haven is at an elevated risk for many negative health outcomes compared to Connecticut and the United States, including low birth weight, high infant mortality, childhood obesity, elevated lead levels, asthma hospitalizations, teen pregnancy, and disability status. High rates of poverty and unemployment contribute to these risks and disproportionately affect racial and ethnic populations: 28% of African- Americans and 35% of Latinos in New Haven live in poverty, as do 40% of African American and Latino children under five. In addition, research shows that the urban environment has bearing on New Haven’s rates for chronic diseases such as heart disease and cancer. These disparities keep our children from starting life with a strong foundation for health. High rates of obesity among New Haven’s children (50% greater than across Connecticut and the U.S.) put them at an elevated risk for heart disease, cancer, and diabetes. Other challenges such as public safety, pollution, and unemployment further exacerbate these health issues. To prevent these diseases, we must explore the various factors that influence people’s health over the course of their lifetimes.
The data presented here are from randomized household surveys conducted in six low-resource neighborhoods in New Haven in 2009 (Number=1205 adults). Rates of chronic disease were indeed higher than national averages. In addition:
- 1 in 5 experience limited or uncertain availability of food, skipped meals because no food or money for food in past 30 days
- 1 in 4 have high stress/depression, related to health
- 1 in 3 smoke cigarettes daily, 2x national average
- 2 in 3 feel unsafe in neighborhood, barrier to activity
CARE is an alliance of leaders from New Haven organizations and Yale University. In May 2007, more than 70 representatives from business, government, health care providers, community-based organizations, as well as Yale faculty, staff, and administrators came together for a consensus conference and made a public commitment to work collaboratively to improve New Haven’s health through research and engagement.
Since then, CARE has completed its preliminary research phase, surveying 2400 adults and children from six high-risk neighborhoods and 12 schools to assess the health and health attitudes. Researchers also mapped health assets in these neighborhoods—including types of food stores and restaurants, access to healthy and unhealthy foods (e.g. fruits and vegetable, fast food, liquor, etc), as well as proximity to parks, recreational activities, community gardens, and health facilities. From these data, CARE has created a structural foundation for developing intervention programs and policy initiatives tailored to the needs of the city’s neighborhoods.
We are moving from evidence to action! Interventions are now underway in neighborhoods, schools, and in City Hall. These evidence-based programs that work include, but are not limited to, a healthy corner store initiative, church/scripture-based lifestyle intervention for African American women, school policies as well as integrating health into district-wide reform efforts.
What We Hope to Achieve
The CARE mission aims to improve the health of New Haven residents through vision, leadership, community engagement, collaborative community-based research, dissemination of findings and development of intervention models.
- Research: Community Interventions for Health, CARE’s cornerstone research project, is a global collaborative of the Oxford Health Alliance that addresses chronic disease risk factors – unhealthy diet, physical inactivity and tobacco use – through health promotion, policy and structural initiatives. New Haven is the first US City to join this global effort.
- Dissemination/Communication: Disseminate relevant findings and intervention models through electronic and print media as well as through community events. Encourage and train Yale investigators to share relevant research results with the community.
- Training: Create better access to research-based professional development for public health professionals and health care providers, while developing new models for community and university partners to engage in community-based research.
- Collaboration: Strengthen collaboration on the foundation of existing community-university partnerships including the New Haven Public Schools, City of New Haven, and private organizations; integrate, coordinate, and leverage existing resources/programs.
- Advocacy: Advocate for health/institutional policy changes based on research findings (e.g., structural interventions such as smoking bans, school health policies).
Partnership for Change
The Yale Schools of Public Health, Medicine, and Nursing are committed to improving health through research, clinical care, and education. We work with faculty and students from Yale College as well as with Yale’s Graduate and Professional schools. Yale University as a whole is committed to contributing to a strong New Haven, and we recognize that a strong New Haven is a healthy New Haven. Financial support for CARE is critical if we are to implement and sustain this vision for a strong and healthy New Haven. This support will help us to:
- Fund research pilot projects or full-scale studies
- Develop, publish, and distribute= health-relevant materials
- Provide student internships and scholarships
- Implement community engagement events that draw explicit links between art, science, and community health